Expert: Valerie Herskowitz - 7/12/2009

Question
QUESTION: My concern is about my 2 1/2 month old son.  He rarely makes eye contact.  I have noticed that he will look at me every now and then if I am about 18 or so inches away, but its very brief and doesn't happen often.  Any closer, he won't look at me.  When I sit him in front of me on my lap, he looks to the side.  I can get him to smile and laugh very easily by putting a burp cloth over his eyes, pulling it down and saying peek a boo, but still looks to the side when I do it.  I can also get him to smile and laugh by kissing his feet, tickling him, rubbing his head, etc, but still he looks to the side.  He coos all the time, kicks his legs when he gets excited and does seem responsive to my voice.  He can visually track large, colorful objects if he's in the right mood.  Otherwise, he doesn't seem too interested in toys and won't really fixate on them.  He doesn't cry often (only when hungry or wet), but when he does, as soon as I pick him up, he calms down quickly.  When on his belly, he holds his head and shoulders off the ground very well by straightening his arms.  He also has complete head control.  He does suffer from bad reflux, but with the help of medicine is doing much better.  We don't give him a pacifier too often, but when we do, he often has trouble keeping it in his mouth and drops it a lot if he's awake. If he's sleepy, he can get a really good suck going and fall asleep without dropping it.  I am anxious to hear your thoughts on my son's development and whether or not the eye contact issue is a big enough concern to get him into an Early Intervention program for autism?

ANSWER: Hi Ashley

I can tell you that your son has autism from just the information you supplied. Could you elaborate a little more on his other skills such as taking?

thanks

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QUESTION: Oh gosh, so you definitely think he does have autism?  Is it the eye contact that makes you so sure?  Should I get him into early intervention now?  I wasn't sure if they would take a 2 1/2 month old.  In terms of more info, he coos all the time, makes other noises such as oooh and ahhh and sometimes does little squeals, which I believe is normal for a 2 1/2 month old baby.  As I mentioned, he will look at me from his change table and even follow me a bit with his eyes from there, but anything close up, he wont look at me except for a brief second, then he immediately turns his head.  I took him to a pediatric optometrist, but his eyes are fine.  He was born full term at 39 weeks via c- section because he was breech.  I had very mild hypothyroid during my pregnancy which my doctor chose not to treat until I was 26 weeks pregnant, so that concerns me a bit too.  He is a very happy baby and shows his excitement to my husband and I, but just wont quite connect with the eye contact.  If you are certain he has autism, any info on how I should proceed would be greatly appreciated.  I am so devastated over this, but want to do everything I can for him.

ANSWER: Hi Ashley

I am so sorry-I thought he was 2 1/2 years not months. My bad. I am more concerned about the reflux than anything else right now as well as the low tone in the mouth. Tell me more about that. And I am so sorry-I miss read. Don't worry too much. Doesn't sound like a big issue right now. I feel really bad for worrying you. And another mistake I made: I meant to say that I couldn't tell you that your son had autism from the info you gave me. I feel so bad that I really botched up my answer. I know I must have upset you a great deal. I feel terrible.

---------- FOLLOW-UP ----------

QUESTION: Thank you so much for clarifying, I was so worried about him.  I know there could still be a future issue, but I am at least glad it's not prevalent now at such a young age.  I appreciate your quick response to clarify.  As for the reflux, he took to breastfeeding very well and didn't have any issues until about 3 or 4 weeks of age.  Then he started spitting up a ton and it was obvious that he was in pain.  He would moan, arch his back and pull his legs into his chest.  I could hear his belly rumbling like crazy.  He would start to eat, then would have to pull off the breast in pain.  We tried a few medicines that didn't help much, but he's now on Prevacid and is doing much better.  I also eliminated dairy from my diet just in case that was the culprit.  He does well with both the breast and bottle with minimal pain and problems now.  As for the problems with the pacifier, he seems to have trouble keeping it in his mouth if he is awake and active like like kicking his legs a lot or moving his arms around.  I constantly have to pick it up and put it back in his mouth.  He does better with some brands than others.  If he's sleepy, he can get a really good suck going and hold it in his mouth for a long time, then fall asleep no problem.  A few other things that may or may not interest you are that when he wakes up in the morning, he arches his back to stretch, but then easily relaxes and is happy to be picked up.  He definitely likes being held and touched.  When he gets fussy, he rubs his face a lot, which I find a little odd, but am hoping it's just a little quirk.  I think my biggest concern is the minimal eye contact in conjunction with a few of these other things such as the reflux and possible low tone in the mouth.  I appreciate you taking the time to answer some of my concerns.  Thank you!

Answer
Hi Ashley

I know that you mentioned that your son has complete head control, but I am wondering if that is 100% true as he does seem to have some low tone issues in his mouth.  I am concerned about here about the tone issues with the reflux and food sensitivity issues, and of course the eye contact and lack of interest in toys.

Is he cooing a bit? (making happy noises like o-o-o of ah-ah-ah?)
Does he turn his head toward some sounds?

Write me back and answer the two questions above before I make my suggestions to you.