Expert: James Michael Roan - 1/27/2009

Question
Hi!  I am concerned about some behaviors in my 12 month old son, and it is all that I can think about.  Do you think that these are early signs of autism?  

Concerns:
- When I pick him up from daycare, he crawls over to greet me, but he does not smile and seem like he is happy to see me.  But he does smile and laugh a lot when we are playing.
- Eye contact is not great when I’m holding him.  It is good when we are on the floor playing or when we’re not up close.
- Only points about 50% of time and reaches the rest.  It seems like he mostly points with his right hand and reaches with his left.  I’m not sure if that is more of a physical issue.  He did learn to use the pincer grasp with his right first and then the left about a month later.
- No words, but babbles.  Will say mama to me and when upset but also says it to other things too.
- Not cuddly but likes for you to pick him up and hold him and will give kisses when requested
- Likes balloons and things that hang, which I noticed that you often ask about.  However, he isn’t obsessed with them.  If he sees one when he comes into a room, he wants to go over and see it.  He will play with it for about a minute and then he’s off to something new.
- He recently became afraid of the vacuum cleaner and seems startled when the front door opens.  The vacuum does not seem to be an oversensitivity to sound because he is okay with it if you are holding him and he is far away from the vacuum.  It appears to be more of a fear, but I don’t know if this is related to ASD or not.  As for the front door opening, he will sometimes crawl as fast as he can away from the noise (or towards me if I’m on the floor with him) and then turn around to see what it is.
- I have read that rapid head growth can be a sign of ASD.  He was born with a smaller than average head size (~15%) and is now in the 65%.  His weight and height have also followed a similar pattern but not quite as extreme.

On the other hand, there are several positive behaviors.
- Responds to name 85-90% of time
- Will bring me things to show me
- Will give me objects
- Sometimes tries to feed me
- Will feed his stuffed animals if I ask him
- If I point to something, he will follow it and look at the object
- When requesting items, he will point/reach and make a noise and then look up at me and then back to the object
- Will make noises back and forth with me as if we are having a conversation
- Claps and waves bye-bye
- Often looks at me when he is playing to see if I am watching him
- Imitates actions
- Sometimes tries to imitate sounds
- Understands and follows simple commands
- Understands no
- Will point to objects in a book when named
- Likes peek-a-boo and likes to be chased, will initiate it sometimes

Sorry this is so long, but I wanted to give you all of the information that I could think of.  I brought up my concerns at his 12 month check up, and the doctor was not worried.  What is your opinion?  Should I continue to keep an eye on him or schedule an appointment with Early Intervention?

Thanks,
CJ

Answer
Hi CJ;

I'm not worried about autism a bit. I have included some red flags for autism up to two years of age. Post it on the fridge and keep an eye on him to be on the safe side.

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

By 16 Months:

•   No single words by 16 months
•   No pointing to objects or events of interest in an effort to share

By 24 Months:

•   No spontaneous two-word phrases
•   Loss of any language or social skills at any age







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Bio

James Roan is a certified school psychologist who has been consulting in the areas of autism, Asperger’s Syndrome, and learning difficulties in the United States and in Ireland for over ten years (http://www.jamesroan.com). James earned his M.Ed. in School Psychology and M. Ed. in Adult Education and receives ongoing post graduate training in autism at the University of Washington’s Autism Center. James Roan has traveled to Galway, Limerick, Mayo, Clare, Dublin, Cork, Waterford, Kerry, and other cities and counties across Ireland assessing children and adults, and consulting with solicitors (lawyers) in defense of children with disabilities. James Roan was the consulting psychologist responsible for many of the autism and AD/HD screening tools and other content for Access Special Needs.Com. James Roan consulted with the graduate department of the Waterford Institute of Technology in Waterford Ireland in the development of their graduate program for the certification of private autism tutors. James has conducted formal assessments of students in the Autism Unit in the Claddagh National School in County Galway Ireland.