Expert: James Michael Roan - 1/3/2006

Question
Hi James,

I really appreciate your response, but I have another follow-up question.  My son avoids eye contact at times that I do not think he is overstimulated.  For example, if I pick him up from the crib and he faces me, he looks away.  He does this when I carry him or feed him.  If I am in his line of vision, he has some eye contact when I feed him.  I do not notice anything else more interesting like a light or window that could catch his interest.  I find that I have better eye contact with friends' infants.  It worries me because I thought he was supposed to attach to me as his mother.  He does look at me at other times, but it seems to be on his terms.  He does smile in response to a smile and smiles spontaneously.  Is this normal?  He has his four-month appointment in the middle of January so I'll also ask his pediatrician too.

I have been playing peekaboo with him.  He does respond sometimes with a smile and laugh.  He has not reached up to be picked up.  

In all other ways, he seems to be developing normally.  Thanks for your response.

Regards,
Mary

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Followup To
Question -
My 14 week old son exhibits a few behaviors that worry me.  His eye contact has improved recently.  Before, he would not look at people and preferred to look out the window or at lights.  Now he will avoid eye contact when he is overstimulated.  Sometimes he responds to people like me or my husband with a smile.  Other times he does not.  Does it depend if he is in the active alert or calm alert stage?  Two weeks ago I went into his room in the middle of the night.  He was fully awake and rolling his head side to side and against one side of the crib bumper. He does not move other parts of his body. Now I notice that he does this sometimes in his bouncy seat.  He is extremely active and advanced in his motor skills.  I also would like to tell you that he has very demanding personality.  It has improved now that he is 3 month's old, but it is still there.  He responds very well to swaddling, shushing and rocking.  

He smiles, coos and moves his body a lot these days.  He seems to be more interactive, but I do worry that he is autistic because he avoids eye contact sometimes and rolls his head.
Answer -
Hi Mary;

Your son is a little young to diagnose, and I do not diagnose over the internet. I have not heard anything that alarms me. Your son may have sensory issues that are typical of a child his age. Does he reach to be picked up yet? Do you tickle him and play peek-a-boo? Peek-a-boo is a VERY important mother-son interactive game. It stimulates social development.

Kind regards,
James

Answer
Hi Mary;

I still don't think you have much to worry about at this stage. Please keep in mind the huge variability among infants and toddlers. Some individuals are simply more social than others. Forensic studies of children who are autistic are based on the memory of the parents and videotapes of birthday parties, etc. There isn't much information below the age of 9 months that has been published.

It is important when interacting with your baby to exaggerate facial expression and vocal intonation. Attachment theory (Bolby) frequently gets confused with "bonding." Attachment in infancy occurs between the child and with whomever consistently, immediately responds to the emotional and physical needs of the child. The child learns they can "predict" that those who they attach to will follow through in meeting their needs in a predictable and reliable fashion. It is the beginning of their social development. Tickling works well to develop social cognition and communication such as in: "Mommy is going to get you,!" followed by exaggerated facial expression and vocal intonation, and tickles. These activities stimulate and devlop cognitive processes, social thinking, and teaches the infant that tone of voice and facial expression contain important communicative information.  

I hope this helps a little.

Kind Regards,
James