Expert: Jene Aviram - 4/15/2010

Question
hi, and thanks in advance for an answer. my son is just 7 months old and i've always had some concerns about him (i am an overly anxious person by nature). here they are:
--he does not make eye contact while nursing, although otherwise his eye contact is GREAT. he looks at everyone and has always been EXTREMELY smiley.
--he has never once imitated anything--no facial expressions, gestures or sounds.
--he does some odd hand movements up near his face--these seem to be happening less, but i still catch them on occasion.
--he does not engage in "conversations" with me, though he babbles often.
--he sometimes gags at certain solid foods (we started at 6.5 months so haven't been at it very long)
--i'm pretty sure he doesn't yet know his name (he responds about half the time, but i feel like it's more just a response to the noise, as opposed to his name)
--no separation or stranger anxiety

in terms of the positive--he smiled socially at a very young age, and has always been great with smiling and is often described as "very engaging"...his eye contact is excellent except when nursing. he loves to laugh, though he only does it in response to silly things i do or faces i make. he wouldn't laugh if he were alone.
he's physically advanced--crawled at 6.5 months and is already pulling to a stand. held his head up from day 1. he also cooed early and started babbling mama at about 4.5 months--though i'm quite certain there is no meaning behind the sound. he now has about 4 consonant sounds, with more being added every week. my dad swore he was imitating his head shaking (they did it back and forth for a minute), but that only happened once so i'm not counting it. same with lip smacking, which he did with me one day and then never again. i think it's a coincidence. he LOVES faces. the other day he was grinning at my book, and i realized it's because there was a smiling baby on the front of it. he's definitely not what i would imagine an autistic baby to be like (in other words, it's not like he's off in his own little world lining up toys--he definitely prefers to be around other people). however, because i'm anxious by nature and have done so much research, i'm really worried by the lack of imitation. every book makes it sound like this starts right at birth--you stick out your tongue and your baby will do it back. so why isn't he doing it yet? i feel like if that kicked in i would relax, or if i felt he understood his name or any other word.
thanks again...would love some guidance. my husband thinks i'm nuts.

Answer
Hi Mele,

I can truly understand how nervous you are about your baby.  But I really don't think you need to be.  He sounds like he is doing just fine.  Let me tell you why....

Your baby is way too young to detect autism.  And while many look back and reflect on characteristics their babies with autism had as infants, the characteristics you mention do not tie in with these.
Your baby is often described as "very engaging."  This description would be highly unlikely for a child with autism.  And your baby LOVES faces.  This is one of the characteristics that is typically not present in children on the spectrum who usually prefer objects over studying people's faces.

I know you have some concerns so lets address some of those.  Your baby studying his hands - all babies do this.  They are fascinated by their hands and most of their body parts.  As they mature the fascination becomes less and then fades.  I think you are seeing this in your child now.

Stranger anxiety - while some babies have a lot of stranger anxiety others show little to none.  I wouldn't be concerned at all.

Gagging on solid foods - totally normal as he learns how to eat.  

Not responding to name - 7 month old babies are not expected to respond to their name all the time.  They are still developing and are easily distracted.  Just because he doesn't always respond doesn't mean he doesn't know his name.  Why don't you play some peek-a-boo games from across the room or coming out from behind a sofa.  Call his name first and see if he turns to look for you.  My guess is he knows his name.  He's just not going to respond every time at this point.

Not making eye contact while feeding -  There is a lot of confusion about eye contact.  If you and I are having a conversation you look at my eyes to see how I'm responding.  Am I bored?  Interested?  Amused?  You look at me for information.  Children with autism don't see that information so they figure what's the point of them looking in your eyes?  Your baby is not expected to look at your eyes every minute.  But if you suddenly whoop with joy or exclaim something or shout "No" if he is doing something dangerous, he should stop and look at you for more information.  Do you see what I mean.  The point of looking at people is to get social cues and information.  As your baby develops this is what you should look for. Don't get stuck on just "staring" into people's eyes.

Lack of imitation of facial gestures - I absolutely would not be concerned at this point.  While many babies do imitate facial expressions as an infant some do not.  I have also found that girls are far more likely to do this than boys.  Between 6 to 7 months this skill often becomes a bit more developed.  But babies develop at different rates and one skill alone is not enough to worry especially at this point.  I would be far more interested to know if your baby likes interactive games such as pat-a-cake.  Holding up his hands to play and being a willing participant in social games is a good hallmark of typical development.  Your baby is doing so many things right on track.  I think this skill is probably on the way.

All in all you described a picture of healthy development.  I know it's impossible not to worry but I think that all will be just fine.  So try to relax and enjoy every minute with your baby.

I hope this has been of some help.

Jene Aviram
http://www.nlconcepts.com