Expert: James Michael Roan - 1/16/2008

Question
QUESTION: My son just turned 10 months and I feel like he is not quite "normal" even
though he is my first child so I don't know exactly what to expect. When I
hold him in my arms and walk around the house, he rarely will look me in the
eye. If he is in my lap, it is even less frequent that he looks me in the eye. He
will look at anything else if I am holding him. However, if he is playing and I
enter the room he does look up and look me in the eye. As long as I am at
least a few feet from him, he seems able to look me in the eye.

He also seems to respond to his name most of the time, although I'm not
sure if it's his name he's turning towards or just the sound of someone trying
to get his attention. He can't walk yet, so his favorite things to do are crawl to
play with the laces on my sneaker or the doorstop. Even though we read
books to him, he often just throws the books around if he has them alone.
I've seen him try to push around a toy truck, but that's about it as far as
playing with toys correctly goes...

When he's angry or tired he will scratch his head. He also stares at details,
such as the raised pattern on his highchair table, but only for a few moments.
He does not spin or line up things. He does not point and does not wave (he
did wave for about 2 days, then stopped). He does not seem to recognize
objects by name yet and calls most everything "mama"... I have a hard time
figuring out what he wants, except when he is tired which I know by him
nuzzling his head in my lap...What do I do?



ANSWER: Hi Cindy;

We know little about signs of autism at this age, although he shows a few. Look at the red flags we do know about and get back to me as to how his behavior lines up against them.

6-12 Month Markers:

·   Infrequent eye contact
·   Failure to orient to name
·   Does not smile in response to smiles from others
·   Social and emotional passivity
·   Fixation on objects


Kind regards,
James

---------- FOLLOW-UP ----------

QUESTION: He looks at me frequently, but as I said before, only when he is more than about three feet away. He especially likes to look back at me when he knows he is about to possibly do something/go somewhere he is not supposed to. Sometimes, though, if I have something in my hand, it seems he looks at me quickly and spends more time looking at that.

He responds to his name some of the time. Most often he doesn't when he is engrossed in something else, like playing with a sneaker or eating.

I'd say he does respond to smiles from others. Many say that he is a very "happy baby" due to the smiles.

What is passivity? He is not an "easy" baby to say the least. He does yell when he wants something and he laughs and smiles. One concern though is he does not point. For instance, he was just in his walker, saw a toy on the ground he wanted, but instead of pointing or looking at us to get it, he started to cry and scratch his head/ear until we took him out of the walker. He was then easily distracted with something else.

I don't think he gets fixated, his issue is more jumping from one thing to the next. It seems he has about a 10 second attention span. Any more questions?

Thanks



ANSWER: Hi Cindy;

I'm a little, mind you...a little, concerned about not responding to his name. I would like clarification regarding social smiles. When he wants something from someone, does he smile as part of his repertoire of behavior to get it versus smiling because he is happy? Pointing just starts developing between 9 to 12 months so don't worry about that yet. Unfortunately, it is hard for me to gauge the quantity and quality of his eye contact without observing him. I am, however, somewhat reassured by your observation that he: "especially likes to look back at me when he knows he is about to possibly do something/go somewhere he is not supposed to." That tells me that he is developing social thinking skills, which are usually absent in children on the autism spectrum.

Regards,
James

---------- FOLLOW-UP ----------

QUESTION: I feel like Joshua always gets what he wants exactly when he wants it, so there is almost never a time that he is smiling in order to get something. Get what? If he wants his bottle and sees it, he screams and puts out his hands. If he wants to be picked up he looks demanding and puts up his hands. Most things he wants he just gets for himself.

I am concerned that he does not imitate the typical things like bye-bye, "so big" or anything really. You can wave at him and he just stares and smiles, you can read a book, he will flip a few pages and then throw it. I see some babies at 10 months can point or at least look in the direction of objects when named. I feel like I can't get Joshua to focus on what I'm saying long enough for him to understand "where is the truck" or "where is daddy" or "where's the balloon"...As far as body parts, he doesn't pay much attention when I show him where his nose, feet, ears,etc. are. I feel like he should recognize more things by their name. Also, "no" to him is something funny. He purposely does things that I say "no" to and laughs. I don't know what's going on.

Answer
Hi Cindy;

His social development sounds delayed. It sounds like he does have some degree of attention deficit. He certainly should be much more tuned into you. If you live in the U.S.,I recommend that you contact the special education department in the school district in which you live and make a referral to their Early Intervention program's team and make sure they do a full evaluation as soon as possible. To be safe and thorough say you have concerns for his social, cognitive, and communication development and that you suspect an autism spectrum disorder.

Kind regards,
James