Expert: James Michael Roan - 11/8/2008

Question
QUESTION: My Question is regarding my 12 month old daughter Sydney. Between 4-6 months she had seizure like activity on 15 separate occasions lasting 10 seconds or so each episode. She had MRI's and EEG's the neurologists said that the Left side of her brain is "A little slow" but just to watch her. She doesn't say any words and i know it's still early. At 10 1/2 months she started babbling mama, baba, and papa. She has stopped and now just says yaya. She points to things she wants and says ahhh or ohhh. She also yells AHHHH ALOT. All of her gross motor and fine motor skills are on task or advanced. She is walking and almost running. She likes to feed us her food and smiles when she does. laughs frequently, especially when other people are laughing, but strangers who come up to her, cannot make her smile. She wants to be held when she first wakes up and when she is tired, but other than that she would much rather run around and explore and wiggles away if we try to hold her most of the time. She does give hugs, she waves bye bye and hi and seems very happy for the most part.
There are some things that concern me though, other than the language. She falls and bangs into things frequently and most of the time, she fails to even notice she has hit something and some of her hits seem pretty hard. But she will cry if she falls really hard, pinches something, or steps on really hot ground.
She started this upper torso twisting thing to music... always with a big smile, always when the music is playing and we think she is dancing. But now she will twist for a few seconds here and there throughout the day with no music and no smile, like she is just moving, it only last for maybe 4 or 5 seconds. She also has developed this weird habit of putting her hands behind her head and holding her head tight. Almost like a person would hold their hands if they were doing a sit up. She doesn't seem bothered by it, but she will do 4 or 5 in a row a few seconds apart and kind of be staring off. the pediatrician says don't worry about it. If i pick her up she stops and doesn't restart.She is usually tired at the time, not exhausted, not everyday either, some weeks it is everyday, then she doesn't do it for a week.

I am concerned about the possibility of her being autistic. We are working with a developmental therapist through regional center for the language delay, the therapist who initially evaluated her said they can early screen for autism at 10 months and she showed no signs, she was social engaging etc. But she was delayed 5 months in expressive language. The therapist we have now says there is not screen for autism, she can't even pre-screen for it, and we will have to see how Sydney does and just try and put it to the back of our minds. I feel like i got hope and then got it taken away. It has been a rough year with this little girl and we are just very worried.

My questions is given the above info, should i be concerned that my daughter might be showing signs of autism with the twisting and head holding thing.

Your opinion would be greatly appreciated!

Thank you so much!

Amanda K

ANSWER: Hi Amanda;

Nothing you have described sounds like autism. At this age the only reliable behaviors that may predict autism later are these:

1. Failing to respond or orient to name being called.

2. Looking askew or sideways at objects and/or hands.

Other behaviors along with these are discussed in length in this article: http://blog.newsweek.com/blogs/labnotes/archive/2008/11/06/harbingers-of-autism.

The two language centers are on the left side of the brain.

The hands behind the head may be petite mal seizures. I am not a physician or neurologist, however you may want to bring these to their attention.

If you are still worried, I have a free developmental screener I can send you (email me at: roanpsych@gmail.com). Also, if you live in the U.S., you can refer your daughter to your school district's Early Intervention program through the special education/services department. They will test her, and if she qualifies, will provide early intervention services at no cost to you.

Kind regards,
James

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

QUESTION: Thank you so much for your response! She is in the Regional Center program which is the early intervention program. I will follow up with the pediatrician about the possibility of petite mal seizures.

In reference to the looking at things askew. She does do this. Not consistently though. She has always done it. I can rememeber playing with a long ribbon and she was laughing when it flew in the air. But she wasn't looking at it. She was looking straight ahead and the ribbon made a sound and she would laugh when she heard it. When I play peekaboo with her and i am at her side she usually looks straight ahead and laughs and giggles. Toys and stuff she looks at head on and she does make frequent eye contact. But she certainly does look straight ahead at some things that amuse her when they are to the side and she knows they are there. There is usually an anticipitory look on her face and a smile. She also will fail to look up sometimes when we call her. she responds probably 60 - 70% of the time. I just figured she is busy and ignoring us. does that fall with in the normal range?

Again thank you so much for you help!

Amanda K

Answer
Hi Amanda;

This all sounds pretty good and o.k. The looking askew thing becomes pretty obvious. It can be flicking of the fingers near the side of the eyes, obsession with strings and dangley objects, walking alongside vertical railings looking at them from the side of the eyes while the head is pointed forward. Her looking at you 70 percent of the time is normal. I think her speech delays are related to the mildly delayed development of her left brain and/or her history of seizures. She doesn't at this point sound autistic in any way.

Stay in contact if she develops any worrisome behaviors.

Kind regards,
James