Expert: Paul Johnson - 12/31/2009

Question
My friend's baby is seven months old and does not smile when smiled at. I have never seen a photo with the child smiling. although I did see one with a sneer. She has sent me pics during the fall, Thanksgiving, and Christmas of this child. The mother says the child doesn't like people, and recently had a screaming fit when she was taken to a basketball game and said Chloe doesn't like loud noises. They had to leave the ballgame. My friend says they mainly keep her at home, as they don't want to expose her to sickness (swine flu). The baby's behavior just seems odd to me. I know right after the child was born the mother had some kidney problems and swelling while still in the hospital, but everything cleared up okay after that. I don't know if this could be related or not. I do know all of the other babies I have been around smile by around three or four months of age. This is my friend's first child (it took years for her to get pregnant) and I think she thinks the baby's behavior is because they have kept her so secluded.  Do you think this is early signs of autism? I am afraid to suggest anything is wrong, just because she is so protective. But I know early intervention in autism is very important!

Answer
Hey Donna,

Thank you for your sensitive and important question.

This is one of most difficult questions I receive. You are correct early detection is crucial. However 7 months is difficult because all of the criteria one could use at this early stage of development is unrealiable. The behaviors you speak of have multiple meanings. Yes one can begin to deduct the possibility of Autism from them but it can also mean so many things.

The most sensible way you can be a support to your friend is to inform your self of the specific characteristics an Autistic infant might display. There are many excellent websites availiable like OASIS. Carefully follow the development of the child according to the early Autistic symptoms like a delay in speech development.This will give you more specific information for a diagnosis.

At about 13-15 months there should be a pattern emerging that might be more telling of the child's neurological condition. Plot the chlid's development with the Autism criteria and if it continues to look like Autism, then broach the subject with your friend. At that point, (should it emerge), tell her that the child appears to have a Pervasive Developmental Disorder or issue.
PDD used to be the name for Autism and as such is easier for her to digest. Tell her the child does not appear to developing is a typical way. Give the mother plenty of support and then suggest having a quality pediatrician neurologist examine the baby; One who is versed in Autism.
At point the child would still be in very early stages of the disorder and will be quite amenable to intervetions. The baaby's age is still hopeful for treament; under a year and a half. Seven months will be too early to yield a reliable diagnosis.

Note: I have a bias that Autism is notsomething by which we suffer from. As such I choose the description of nottypical or differently abled to disabled. All of us on the Autism Spectrum of Disorders have gifts to offer as we are, some are more able to function in society than others as such intervention is important for us to share our significance.

I would like to ask you to please update me on the situation when this time frame has come.