Expert: Valerie Herskowitz - 3/30/2009

Question
Dear Ms. Herskowitz,

I am writing to you because I am concerned about some possible signs of Autism in my 9.5 month old boy. I am a first time mother who had my baby at 39 yo.  He was delivered at 37 weeks due to me developing cholesystitis.  At 2 weeks old, he began crying inconsolably 24 hours a day with small 30min - 2 hour naps scattered between.  This crying went on for about 4 months.  They diagnosed him with reflux at about 1 month and he was put on medication but he still cried most of the time and was an extremely gassy baby.  He began to smile at about 2.5 months and rolled from front to back at 4 months and back to front at 7-8 months.  I did not do a lot of tummy time since he hated it.  Things have calmed down now that he is older but he is still an extremely fussy baby.  He has difficulties sitting and playing by himself.  He is extremely oral and puts everything in his mouth almost to the extreme.  He is and has always been extremely sensitive to sound.  About one month ago he was diagnosed with Sensory Processing Disorder.  My current concerns are the following:  he only likes to be held facing outward, does not like to cuddle, reaches for me but when I pick him up he immediately pushes off me, he is not yet crawling but when standing stands and walks while holding his hands on his toes or the sides of his feet or heels, kicks his legs extremely hard when excited to the point where you would think it hurt, on his back or upset, moves his arms and wrists in circular motions when upset or excited, inspects his hands while moving his wrist and fingers in circular motions (mostly left), babbles only slightly and mostly high pitched, responds to his name about 50% of the time, his eye contact now is pretty good but during his first few months actually would avoid it. His tracking is pretty good.  He is not yet pointing but he does always seem to look for me or my husband.  He has only slight stranger fear where he doesn't necessarily cry but inspects and looks at them cautiously.

He is currently in therapy for SPD x2 per week with an OT and PT.  But I was wondering if you see any signs that he would be developing Autism or if my concerns are just freaky baby behaviors.  I would really appreciate your input because I am worried sick.  Please let me know if you need any further information.

Sincerely,
Laura

Answer
I think that at the age your son is at, you should be focusing on what he needs rather than a diagnosis. I have seen children that exhibit the issues your son has go on and be diagnosed with autism later on. However, I have also seen children improve to the point where they are not diagnosed with autism, but may still exhibit some residual issues, and then I also see children who recover completely. So don't worry so much about whether he has autism. Focus on what you can do for him.Early intervention is so important.

Please add in Speech Therapy with your son if it is available to you. Since he is not pointing, he is delayed in his communication development. By the time a child is his age, we expect him to be in the 2nd stage of Language development where he is able to use some means of communicating his intentions. I don't see that in him yet. He seems to be stuck at stage 1. Your therapist needs to work on developing cause and effect skills for him right now. Very important.

He seems to have pretty involved SPD, so make sure your OT gives you daily exercises to do at home with him.

Keep in touch

Valerie Herskowitz, MA CCC-SLP
valerieherskowitz.com