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Topic: Autism

Expert: Michelle Fattig
Date: 1/16/2008
Subject: 10 month old signs of autism

Question
Michelle,
My son just turned 10 months and it seems like he selectively responds to his
name. Most of the time he will turn and look if you say it, but when he is
engrossed in something else, like crawling over to a toy, he ignores me. He
also ignores me if he is focused on playing with a toy. He does notice when
people come and go though, and always responds and comes over when I or
anyone else enters the room.

When he is playing with his toys, I can sit on the floor with him but it feels
like I am watching him play, not participating. He doesn't give things to me or
show me things very often. He likes to have me in the room, but otherwise
doesn't play with me or imitate. Also, when anyone holds him, he almost
never will look that person in the eye, but looks around to objects around the
person. He makes good eye contact and smiles alot, as long as you are not
the one holding him.

He doesnt' seem to recognize anything by name yet even though we have
said hundreds of times "truck, light, balloon, drink, etc." It's like he doesn't
focus on me long enough to understand when I say "where is the... or can you
show me the..." His only repetitive motion is hitting his palm against surfaces,
but usually he does this when he wants something, like food or a toy off the
coffee table. I am so worried. Does this sound like autism to you?

Cindy

Answer
This is an excerpt from a good article involving autism in young children, and the difficulty in diagnosing:

Autism is difficult to diagnose in very young children because several of the disorder?s main symptoms?such as the child?s relationship with peers?involve behaviors that don?t fully develop in children until later in childhood, says Fred Volkmar, MD, of the Yale Child Study Center.

According to the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV), the essential features of autistic disorder include trouble interacting with others and a tendency to have narrowly focused and odd interests, as with the boy who was fascinated by watches to the exclusion of anything else. Most researchers admit that these traits are the hallmarks of autism, but they also say that they don?t help much when trying to diagnose autism in children younger than age 2 or 3.

Diagnosis of autism is also difficult because the best early indicators involve the absence of consistent social and communication behaviors rather than the presence of an abnormality. 'There could be lots of reasons you?re not seeing a behavior,' says autism researcher Wendy Stone, PhD, of Vanderbilt University School of Medicine. 'You could not be seeing it because it?s not developing, or it could be that the child is not showing it to you at that time.' (Azar, 2008) article found at:
http://www.apa.org/monitor/nov98/autism.html

The best thing to do if you are worried about autism, is contact your local school system for a comprehensive multidisciplinary evaluation and mention your concerns specifically.

In the diagnostic manual used to classify disabilities, the DSM-IV (American Psychiatric Association, 1994), “autistic disorder” is listed as a category under the heading of “Pervasive Developmental Disorders.” A diagnosis of autistic disorder is made when an individual displays 6 or more of 12 symptoms listed across three major areas: social interaction, communication, and behavior. When children display similar behaviors but do not meet the criteria for autistic disorder, they may receive a diagnosis of Pervasive Developmental Disorder-NOS (PDD not otherwise specified).

Problems in social relatedness and communication.
(Difficulty in mixing with other children; prefers to be alone; aloof manner; difficulty in expressing needs; uses gestures or pointing instead of words ).

Abnormal responses to one or a
combination of senses; such as sight, hearing, touch, balance, smell, taste, reaction to pain.

Sustained odd play.
Uneven gross/ fine motor skills.
Not responsive to verbal cues
acts as deaf.
Little or no eye contact.
Insistence on sameness; resist changes in routine.
Noticeable physical over activity or extreme under activity.
Tantrums; displays extreme distress for no apparent reason.

Speech and language absence or delays. Inappropriate laughing and giggling. Echolalia (repeating words or phrases in place of normal language).
Abnormal ways of relating to people, objects and events. (Inappropriate attachment to objects; don't seek cuddling )
Spins objects.

An aspect of language that tends to be disturbed in autistic people has to do with knowing how to use language appropriately and in context. That includes knowing how to hold a conversation, thinking about what the other person in a conversation understands and believes, and tuning in to the meta - linguistic signals of the other person, such as facial expression, tone of voice and body language. It is important to remember that communication is as much nonverbal as it is verbal, and autistic people have great difficulty understanding nonverbal language. (Autism Symptoms Checklist found at: http://www.autism-pdd.net/checklist.html#checklist

I hope this is helpful. Let me know if you have any more questions.

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