Expert: Dr. Sharon A. Mitchell - 6/21/2011

Question
QUESTION: I just happened to have come across something about my son that made me nervous about autism. He LOVES to spin everything! He does it so often that I was curious to see if anyone else's child likes so also and typed it in a search engine. All of a sudden to my surprise nothing but articles on Autism pulled up and I started reading more signs of it. He doesn't respond to his name still, is VERY hyper, and sometimes you would swear he is deaf but I know he isn't because he will respond to certain sounds. He also, when excited, will flap his arms up and down and roll his feet around. Recently I have noticed some odd behaviors like he loves textured things and instead of feeling them with his hands like my friends little girl does, he will open his mouth and try to feel it with his mouth. I'm not sure if that correlates to autism, however, I find it an odd behavior. He loves watching TV and has since he was 2 months old, even though we try to limit his time on the television. I have asked the Pediatrician about these findings but he said that it is too early to diagnose autism and to just enjoy him. I'm just concerned. Everything I read on the internet says the earlier they can recieve interventions the better for the child. Any help would be appreciated.

ANSWER: Hello Jessica,

This is a difficult question to answer without knowing your son.

It's a matter of degree. Many little ones his age seem hyper. Many little ones will become so engrossed in the TV that they do not respond to their name. A spinning top will enthrall many babies and toddlers. There are children who flap their arms who do NOT have autism; there are kids with autism who do not flap.

Mouthing objects is a stage babies go through before they move on to using their hands to explore things rather than their mouths. Some older babies mouth objects to sooth their gums during teething.

If you take a look at this website link, you'll see what is considered typical development month by month for babies between seven and twelve months of age. (http://www.babycentre.co.uk/baby/development/milestones7to12months/). It states that most ten month olds can:

• Wave goodbye
• Pick things up with pincer grasp (thumb and finger)
• Crawl well

About half of ten month olds can:

• Say "dada" and "mama" to the right parent (is specific)
• Respond to name and understands "no"
• Indicate wants with gestures

Here is another list of milestones to watch for in your child's first year of life: http://www.marchofdimes.com/baby/growing_indepth.html. Keep in mind that each child is an individual, no two children develop exactly in the same lock-step fashion and these lists are just guidelines.

While you mention the spinning, flapping and fixation with objects that are commonly seen in autism spectrum disorders, autism is also a disorder of communication and socialization. In fact, these latter two aspects may be the most important.

Is your little guy social? Does he like physical contact with you? Does he enjoy being comforted? Does he smile, make eye contact, mimic your facial expressions (for example, if you smile, will he smile back? If you stick out your tongue, will he try to copy?). Will he follow where your finger points? Does he like to play peek-a-boo?

At this next link you'll find common speech/language skills that most babies acquire before their first birthday, divided into age ranges. (http://www.asha.org/public/speech/development/01.htm. At the bottom on the page are suggested things you can do with your child to encourage his development.

From your reading on autism, you have come to the right conclusion that early intervention is helpful. But whether or not your child has any kind of diagnosis, there are lots of things you can do at home, even just in the way you play with your child. Have you heard of Floortime? It's a way of playing with your child to help his development and a technique that can benefit any child. Here are a couple links with some brief information: http://www.mindspring.com/~dgn/playther.htm and http://stanleygreenspan.com/. I like strategies that can be incorporated into a family's day to day life, such as this.

First Signs (http://www.firstsigns.org/asd_video_glossary/asdvg_about.htm) has an excellent video glossary that shows a typical developing child alongside a child of the same age who has autism. To watch these videos you must first register on the site, but there is no cost and no one will be contacting you or pestering you. You might find the videos reassuring, that your son seems to be developing typically. Or, if you see him in the videos of the children with autism, then you have more information to take to your physician.

If you're a person who enjoys reading, here are a couple books you might like:

- Early Intervention Games: Fun, Joyful Ways to Develop Social and Motor Skills http://www.amazon.com/Early-Intervention-Games-Processing-Disorders/dp/047039126

- Using the Floortime Approach http://www.amazon.com/Engaging-Autism-Floortime-Approach-Communicate/dp/07382109

Your son is still quite young and I agree with your physician; autism is often not easy to detect or diagnose in one so young. I would suggest that you monitor closely your child's development through guidelines such as the links provided above. If you continue to have concerns, talk to the doctor again or the public health nurse. In your state, early intervention is handled by the Department of Health's Early Steps (https://www.laeikids.com/). By calling Early Steps you may get more specific guidance for your city if you are still worried about your son's development.

I wish you and your son all the best,

Dr. Sharon A. Mitchell
www.autismsite.ca

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

QUESTION: Thank you so much for all the information! I did forget one of the things he did which was he wouldn't look at us. You try and get his attention and he wouldn't look at you but for a second if you make a weird noise to get his attention. Also when our friends little girl of the same age would come over he would cry if she would get near him. I definitely understand why my physician is waiting now because it is individual I just wanted to make sure because he seems to blow off a lot of other things that we become concerned over (with his actual health). My son had a rough start with being in the NICU for a month when he was born and then on oxygen at home for four months so its just scary to think something else he may have to face. I appreciate your prompt response and can't thank you enough for all the information you gave me!

Answer
Often babies who were in NICU are then followed by the neonatal specialists. Is that the case with your son? If so, these would be good people to get in touch with about your concerns.

The Floortime information I gave you is a good method to follow if you are trying to encourage eye contact. You also might want to check out the techniques pioneered by speech pathologist David Loyst - Reference and Regulate at http://www.randrforautism.com/.

You have not mentioned if your child is vocal. Does he mimic sounds you make? Can you engage him in a back and forth game of sounds? You might want to seek out the advice of a speech therapist. You can find one near you by going to: http://www.asha.org/proserv/. Some health insurers will pay for these services. You could also contact your local school division to ask them how you find services in your city.

Best wishes,

Sharon