Expert: Jene Aviram - 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,

When someone you are close to is affected by autism, it is natural to be afraid that your own child might also have autism.

While there are no guarantees in life, it sounds to me like you are a loving mom, who ADORES her baby and is terrified of him being on the autism spectrum.  And you can be rest assured that almost everyone would feel exactly like you do.  But let me set your mind at ease.  Your baby sounds like he is developing just perfectly.  Everyone you've said is typical of a 6 month old baby.  

Professionals only become concerned about children not putting their hand out to stop a fall when they are between 12 and 18 months.  Eye contact is very intermittent at this age because babies are still developing their vision.  I would NOT be concerned with the study you read.  While I can't vouch for the validity of it, I do know on a practical level that there are many children with and without autism that don't fit the movement patterns in a certain way.  The bottom line is that it still is not possible to diagnose a child with autism until they are about 18 months old.  A movement scale alone is simply not a reliable test.  With regards to rotating his feet, that is absolutely fine.  Just think about it.  Your baby is seeing the world for the very first time.  He's getting to know his body and his environment.  As his vision and growth develops, he pays attention to more things.  Things you and I don't even notice anymore.  It must be fascinating!

I know it's hard to do (practically impossible) but try to forget about autism.  Your baby is doing just fine and as the months go by I think you'll wonder why you were ever worried at all.

I hope this has been of some help.

Jene Aviram
http://www.nlconcepts.com