Does my nephew have some mental disability?

My nephew is two years old. Most of the time he seems like he’s lost in his own world and doesn’t respond to stimuli very well.

For example, a new person might enter the room and start talking to him. Most of the times he won’t even turn his head and simply keep doing whatever he was doing. Some time later he might start paying attention to the new person.

Or for example somebody turns on the TV. Despite the loud noise, he won’t react immediately or at all.

I 've pointed this out to my parents and other people but they all say this is typical behavior for a boy his age. From my limited experience with other babies I’d say this is not typical behavior.

Am I overreacting or there might be some underlying problem with my nephew?

EDIT: I should add that other than that he does everything a 2 year old does.

I wonder if he has a hearing problem. That’s something you could kind of informally test.
.Is he in any day care?

I thought of hearing problems too, but I might be standing right in front of him, waving some toy and he will ignore me.

No, he’s not in daycare, my sister (his mother) is a SAHM and takes care of him.

How does he interact when he does? Does he smile, make eye contact, give hugs, cuddle, answer questions, etc? Does he talk at all? Can he follow simple commands like, “bring me the ball, please!”? Does he play with a variety of toys in a variety of ways? I assume, since you said he’s otherwise normal for his age, the answer to all these is yes. If not, then he needs to be screened for autism or a developmental disorder.

Mostly, I wonder about hearing loss, and urge you to urge them to have him formally tested. For reasons we don’t really understand, kids are stunningly compensatory, and many deaf 2 year olds will “startle” or otherwise act like they’re hearing during informal tests.

He should have received a ABR (auditory brainstem response) hearing test before he left the hospital for this very reason - it catches far more hearing deficits than dropping your keys, clapping your hands or talking to him from behind. So if he was born in a hospital, then chances are very good that, at birth, he could hear. Most states (44 for sure, I’m not sure about the last 6) have made this a mandatory universal screening for all newborns. If he wasn’t born in a hospital, his pediatrician should have it done in the first month of life.

But of course, the results of 2 years ago won’t tell you if he can hear today. Some viral illnesses (usually accompanied by a high fever) can cause hearing loss in infants and small children.

ETA: Of course, it’s possible that he might just have very good focus and not be easily distracted. This can be a boon in some ways (focusing on schoolwork) and a pain in others (crossing the street.) It would be pretty unusual at 2, but not impossible.

It could conceivably be an autism spectrum disorder, and it would be well worth getting this checked out, as the sooner it is diagnosed the more can be done to help him - and if he tests out OK, no harm is done.

It can be very difficult to bring issues like this up with proud/anxious parents, though. In my family, for about a year everyone in my extended family except his parents was convinced that my toddler nephew was autistic, but nobody dared say anything about it to his parents.

Eventually they did catch on, and got him diagnosed, and (since they have money) they were able to get him some excellent treatment. He still has some issues, and is sort of strange, but in most respects he is very high functioning. Nevertheless, he would probably be in even better shape now if he had not lost that year.

Symptoms sound similar to my nephew at that age. Lack of attention, seldom talking. Eventually, a hearing test showed about 15% hearing in one ear, and even less in the other. Treatment with drain tubes in his ears, and other procedures took care of that completely. Within a few months, he was talking fluently (and continuously – he’s hardly ever stopped since).

Get his hearing tested!

We had a thread on a similar issue a few months ago. Some very good advice in there, in particular I’d like to highlight trupa’s quick checklist in post 28

Thank you for the replies. My nephew has all those symptoms from the checklist. I’ll try to convince their parents for a hearing test at the very least.

The indications were there since he was 1 yo but everyone is in denial. I’m afraid I will have a very hard time to convince them to do the tests.

Thank you for the support and I will keep you posted

This question is probably better discussed in IMHO, so let’s move it there.

samclem Moderator, General Questioins.

There may be a problem but maybe there’s not.

When my oldest niece was about that age, my SIL was worried sick that she might have a hearing problem.

My brother decided to try a very scientific hearing test on her. From behind her he whispered “Hey Melissa – ice cream!”

Her hearing is just fine.

Offer to babysit for them some afternoon, then take him for a hearing test yourself. You will probably have to pay for it yourself, rather than insurance, but hearing tests aren’t very expensive.

I wouldn’t do that without the parents’ consent. It’s very rude at best

So what? That is rude, but what those parents are doing is neglecting the child, and failing to provide appropriate medical care. Nearly child abuse.

I’d willingly be rude to the parents if it means my nephew got the medical examination he needs.

If you’re afraid to do this yourself, you can always make an anonymous call to the local child protection agency, and tell them this child is being denied necessary medical treatment. They will check it out, and they don’t mind being ‘rude’ to neglectful parents.

No, I think that if the OP is going to call in the local child protection agency, he should have the stones to tell the parents up front that he’s the one that has involved this agency in their and their child’s life, because his opinion is that their child needs a medical test that they don’t think is necessary. Child protection agencies are famous for having lots of common sense and never removing children from their families for spurious reasons such as, say, accidentally giving their kid a “Mike’s Hard Lemonade” at a baseball game because Dad thought it was regular lemonade.

I do agree that the kid needs a hearing test, and support the OP’s trying to convince the parents to take him for one. Calling in CPS for this is a completely insane overreaction, though.

An autism evaluation would be appropriate at this point as well. I would be interested to know how this kid does when he’s around other kids in his age group. I might ask his parents how he does in playground situations, etc. My oldest has Asperger’s, and one of the first red flags for us was his total, utter, complete disinterest in what other kids were doing. This can be normal at age 2, as kids that age are more interested in “parallel play” (i.e. playing alongside other kids but not really “with” them) but in his case it continued well into toddlerhood, and he’s still sort of that way as a third-grader.

Anyway. When you’re making your case to the parents, I’d point out that a test will only show them what is already there (or not there) – and early intervention, with either hearing difficulties or autism spectrum, can make a huge difference in a child’s life.

Dog80, what exactly is the parents’ objection to at least having the child’s hearing tested? Religious? Financial? Would Rather Not Know? Embarrassed? Fearful?

You might just print out those indicators/questions in the earlier post (or find a similar list from the Mayo Clinic or some highly credible source) and leave them on the kitchen counter with a neutral sort of note, e.g., “Take a look at these.”

If you get too insistent, it could just make them dig in their heels and then the issue of “saving face” (alas) gets piled on top of everything else.

Dog80, how often do you see your nephew and how much do you interact with him when you do? As a childless person who only occasionally sees many small nieces and nephews and cousins, it seems to me like a lot of small children are completely unwilling to interact with people who don’t have an established pattern of being familiar and “fun”. In fact, most of these kids won’t appear to pay attention when I speak to them, won’t reply when I ask them a question, and won’t follow directions given by anyone but their parents. I put it down to being shy and having the social empathy of, well, a two-year-old.

Kindergarten is the magic gateway that turns small children into human beings, it seems.

Yesterday I talked to my parents (the child’s grandparents) about the issue and yes, they admitted that there’s something strange with his behavior. They also told me that he had his hearing tested very recently and it was fine.

I tried to bring up the issue to his mother (my sister) several times in the past, asking something along the lines “Why is he ignoring me” and the answer was “he’s tired”, or “he’s too young”.

I’ve decided that I need to speak upfront to her about the issue but not in a confronting manner.

“Hey sis, if I thought there was something you needed to know and I didn’t tell you, I’d be a crap sister wouldn’t I?”

The hardest part of recognizing that something ‘may be’ wrong is 1) it isn’t your child and 2) parents have to come to terms with it and see it for themselves in a whole new light ( usually by a doctor or several complete strangers commenting on it.)

It is very frustrating.

I have a neighbor who’s youngest whom I’ve suspected is very high functioning Aspie or something else that I cannot pinpoint. (He doesn’t seem to have the obsession over collections that aspies are prone too.) I’ve known him since he was an infant and he is now 10.5, but he is very senstive and prone to crying ( Mom coddles him because of this and it makes everything worse.) He rocks when he sits and he has no friends at school. He is not coordinated at all and one day will probably be about 6’5". He has such a football player build and runs like every arm and leg is controlled by some puppeteer.

None of the neighborhood kids like him, despite the fact he is a sweet kid who is good in school and has a good sense of humor. And to quote one of the other kids " He smells like fish sticks." Which pretty much sums this kid up all the time. He is mostly internal and recently had an ulcer. The parents think that that is normal for a 10 year old. I’ve tried since he was two to get them to say something to doctor’s or go to a Shrink with him now for a proper eval, but they won’t listen. This will only manifest itself as puberty hits. If any of the kids on our little street hang themselves during their teen years, it will be this one for sure and only the parents will be shocked by it.