Expert: James Michael Roan - 9/29/2008

Question
Hi,
Thanks so much for taking the time to read my question. I have an extremely active son who will be 11 months old in two days. I was a little concerned about him a few months back because he was babbling and then stopped for a while. In the past two months he has started babbling again and has about three or four discernible consonant sounds. The things that have me a little concerned now are that he hand flaps quite often, which I understand may or may not be anything to worry about. But that coupled with the fact that he infrequently responds to his name is concerning me. When he plays he moves from toy to toy very quickly and gets completely engrossed in whatever the toy of the moment is. I can say his name twenty times from a few feet away and he won't look at me. In fact he rarely reacts to his name when called. He will look at you if he is restrained and facing a blank wall, but on most other occasions just seems too busy to bother with you. He can play with a ball with his brother and laughs a lot in response to things his brother does. He does not look at me when I try to play with him though. He is usually too fixated on what he wants to do. He is rather destructive and will often shake and throw the toys about and then move on to something else. He does seem to play correctly with toy cars and trucks, perhaps from watching his two year old brother.

When pushed in his stroller he sometimes seems engaged in what is going on around him and sometimes seems spaced out.

Other than that he crawls and cruises and is into everything. He makes good eye contact when he is focused on you. I consider him to be something of a mama's boy as he adamantly prefers me over anyone else and often crawls up to me so that I will hold him. We have recently moved to a new apartment in a new city, and since then he has definitely become more whiny and less calm. He still doesn't sleep through the night, waking every few hours to breastfeed. Up until last month I considered him an extremely smiley baby, but recently have noticed that he doesn't always smile back now when people smile and talk to him. Sometimes he just stares back. Seeing that behavior at a party this past weekend actually struck me as a little odd (and no, he wasn't tired, but possibly overwhelmed by the noise, though he showed no visible signs of distress) and is the reason I finally resolved to write this email to you.

In your opinion does any of this sound like I should be concerned?

Thanks,
Jennifer

Answer
Hi Jennifer;

The only researched based marker at this age is "failure to orient to name being called." I have provided other red flags below associated with autism. I have heard enough to recommend you have him assessed. That does NOT mean I think he has autism, I don't have enough information. If you live in the U.S., your school district is responsible through their Early Intervention program for assessment and services if he is found to be eligible. Call your school district's special education director for how to go about making a referral. It's free. The intervention services they provide for communication and social delays will benefit him whether or not he is on the autism spectrum. You can place him on a waiting list for Children's Hospital or an autism team at a local university. They are usually 6-9 months out and you can always cancel. He's very young, and no one may feel capable of diagnosing him at this age. If he is on the spectrum, it sounds like it would have to be on the high functioning end. Please keep in mind, I have no opinion at this stage whether he is or is not on the spectrum. He shows some mildly worrisome concerns. It is better to rule out an autism spectrum disorder than to take a "wait and see" approach thus missing out on valuable early intervention if it were found out later that he did, in fact, have autism.

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

By 12 Months:

•   Poor or no eye contact
•   Failure to orient to name
•   Poor imitation
•   No babbling by 12 months
•   No gesturing by 12 months


Kind regards,
James