Expert: James Michael Roan - 11/10/2009

Question
Thank you for taking the time to read and answer my questions. I have a 6 month old baby boy that I am concerned is showing signs of autism. I know it may still be a bit early to tell at this age, but I have an autistic cousin and I know how important early intervention is. Basically my main concern is that he is still not answering/responding when I call him. Maybe 10% - 20% of the time he will look at me if I call him and that's after repeatedly calling out to him. Sometimes he just doesn't aknowledge me and seems like he doesn't hear me or is just ignoring me. But when I do get his attention he is very interactive - all smiles, gets excited and does the baby dance (moving arms up and down and kicking legs). Also, I'm not sure how long a child his age should be keeping eye contact but he can only hold eye contact for maybe a couple minutes at a time and then he looks away. I really don't feel like he is avoiding eye contact (except when he's eating and holding his bottle, in which case he turns his head everytime I try to make him look at me), but just distracted. He'll have great eye contact, will turn away to look at something else (could be an object or another person in the room) and then come back to me. He also is not babbling a lot. He's much of a screamer - seems to scream when he gets excited, is frustrated, wants to get picked up, pretty much whenever he wants to express himself he screams. He does make the "mmmmmm" "hah" and some vowel sounds (ahh, ehhh). I also just noticed him rotating his feet today while sitting in his high chair (granted he was really pushing hard for a bowel movement since he's been constipated, so I'm not sure if this has anything to do with as this is the first time I've ever seen him do it). He's also doing this thing where he curls his lips over his gums and moves his mouth up and down (as if saying mama) but no sound coming out (is this the start of him actually saying the word or is this something I need to watch?). He's starting to show some stranger and separation anxiety, which I think are good signs.



The other thing that has me concerned though is this study I found. Here is the link http://www.pnas.org/content/95/23/13982.full It basically theorizes that autism can be detected early by looking at the baby's movements (lying down, rolling over, sitting, etc.). I wanted to know if you know of this study and if you think it has any validity. I ask because my baby doesn't seem to roll over the way they say a typical child does and he's definitely fallen over from a sitting position without sticking an arm out to try and prevent himself from getting hurt, which they say is typical of autistic kids. Granted he did this at 4months old and has pretty much been able to sit on his own since then. I check to see if he favors one side over the other, as the study also says that autistic kids tend to be asymterical in their movements, but I have not noticed that.



Can you let me know if there is anything I should be worried about? Do I need to be watching him very closely over the next couple months or do these seem like normal baby behaviors?  

Answer
Hi Mary;

Please understand that I do not, at any time, attempt to diagnose or rule out a diagnosis or condition over the Internet.

I haven't heard anything that worries me. He is social, interacts well, and has good eye contact for his age. Over the next ten months you will want to look for emerging signs of sharing, showing you things, and nonverbal gesturing. Work with establishing joint attention with him by reading books to him and encouraging his interaction.

If you are still worried, you can refer him to your school district's special education department for an assessment and possible placement in their Birth-to-Two Early Intervention program. The assessment and services, if he is found eligible for them, are at school district expense.

I have read that piece of research. The authors warn that by themselves body movements are not yet a standalone diagnostic tool and that their hope is for body movements to add value to early diagnostic assessments.

Kind regards,
James

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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, 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 assessment professional 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.