Expert: James Michael Roan - 9/23/2005

Question
------------------------Based on that study do think my son may be autistic? At this point, my biggest concern is that he arches when he rolls. I think I will contact birth to three have him assessed and take it from there. Thanks for all your help.-
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He has been with the sitter since about the time he should have been born, so he was basically a newborn when he started with her. He is there from 7:00 to around 4:00 M-F. So during the day, she is his primary caregiver. My mom lives out of town, she sees him maybe once a month. At home, I primarilly feed him, bathe him, dress him, put him to bed, but when he is fussy, my husband plays with him and talks to him. So I do most of the care, but he does more playing and interacting. My mom and sitter have different personalities than I do, they are more animated. So maybe it is more of an attachment issue. Have you ever heard of a study done by Tomelian (not spelled correctly). I know he was on Good Morning America. He watched and analysised videos of infants that eventually autistic. He found that they had different movement patterns-like when they were learning to roll etc.... I was just wondering if you thought it had any reliability. Oh, and last night he was very interactive. Smiled when we played peek-a-boo and laughed when he was tickled. The night before he was totally different. He is teething and has a cold, so I am sure that factors in.
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We play peek-a-boo and sometimes he smiles and reacts and sometimes he doesn't. I think it depends on how tired he is. It also seems to take a lot to get him to laugh, but he will. I think what bothers me the most is that he doesn't always get excited when he sees me. He reacts much more to my husband. Also, in the middle of the night when he wakes up crying, he doesn't calm down when he sees me or I pick him up. Even after rocking he doesn't calm down. Usually I have to give him a bottle and then he will. In the morning when he wakes up, he will smile at times when he sees me, but not consistently. I guess that is the hard part. Sometimes he does something that concerns me and then the next time he may not react the same way. He was really colically for the first few months and he was in the NICU for 2 weeks and I think I was some what intimmadated by him. I am not sure if we bonded all that well. He has been a difficult baby. We end up holding him a lot. He isn't the type of baby you can put down for a little while and he is happy. He loves his execersaurce and will play in there for 30-45 minutes but after that he whines. In all honesty, he seems more ADD to me. He is consistently looking at things, and manipulating things. If he is playing, he doesn't always respond to his name. He doesn't like to stay in one place for very long and even as a baby he was consistently moving his arms and legs. He has bonded well with his sitter and my mother. The sitter says him and another baby babble back and forth with one another. I have seen him smile when other children at the sitter come near him. You know, I know if he is autistic there really isn't anything I could do about it. An occupational therapist that I work with gave me the same advise you did, play with him, love him, enjoy him, and just let him develop at his own pace. Sorry this is so long. Thanks for "listening"

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--Hi,I reviewed the list at the website you suggested. It is for older children and I was just wondering if it is possible to tell at 5 months adjusted whether or not a baby may be autistic? Are premature babies more likely to be autistic than full-term babies? From the information I gave you, do you think I am being overly concerned?-----------------------
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-Thanks for all the information. He does not arch when placed against a vertical surface or immediately when put on the floor. He basically only does it when he is trying to roll or move, reach for something, or is mad.

You said that you did not suspect that he is autistic. Can you tell at this young of an age if a child would be? He really seems to need/seek out visual stimulation and he isn't the cuddlest kid in the world, but he does smile when he sees my husband and I.

Do you have any suggestions to help him to roll, or is it something he will figure out on his own?

Thanks again------------------------
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The problem is, I am not sure if what I am seeing is actually something to be concerned about or I am just over-reacting. I am a teacher in the birth to three program and I am finding it is difficult to be objectional about him. Anyway, I was just wondering about him not rolling. He continues to want to arch his back. He really hasn't been placed on his tummy or his back a lot because of reflux. He actually used to arch during feedings and sometimes after and every once in a while he still does after feedings. He also slept in his car seat for about 2-3 months and he sleeps in a swing when at the sitters. I am just wondering if I should be concerned about his muscle tone since he is arching his back when he tries to roll or does he just need more tummy time. He actually does a good job of sitting and will bring his arm's down for balance if he starts to fall. I did mention this to his doctor and he wasn't concerned. I have talked to occupational and physical therapist and have gotten different answers but they seem to think his neck extensor muscles are stronger than his tummy muscles, but would this be true if he sits so well. Sorry about the long inquiry.-------------------------
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My son is 6 months old but was born 7 weeks early. He is not rolling and when he tries to roll, he does so by arching his back. He also moves around when in his crib by arching his back-on his back. Is arching a sign of autism? Also he loves to stare at Diet Pepsi bottles and blowing leaves outside our window. He will typically reach for logos on T-shirts instead of looking at me. He seems to really like the color red. He inconsistently turns when we call his name. He is babbling and playing appropriately with toys. Should I be concerned about any of the above mentioned behaviors?
Answer -
Hi Amie;

This is a critical time for initiating his social development. Interact as much as you can with him. Tickle him and play peek-a-boo using exaggerated tone of voice and facial expression. He may have sensory delays and should reviewed by a child study team at your school district if you live in the United States. I did not hear anything in your email that alarmed me. Stay in touch for two reasons:

1. He is very young for a psychologist or pediatrician to assess with any accuracy, and
2. I take a mother's concern VERY seriously and you are seeing "something" and it has caught your attention. I think we/you should watch his development very closely.

Engage him in physical and stimulating interactive play and keep notes on his behavior. Keep me informed.

You can take your data to your pediatrician when you are ready.

Kind Regards,
James
Answer -
Hi Amie;

I'm certainly not concerned about autism and I had to call a colleague of mine who is an OT with "loads" of experience. She confirmed my thesis that your son is most likely in the midst of developing the skills to roll over. This conincides with his lack of experience with developing this skill due to reflux preventing him from being on his back for very long.

Here is what to look for: If he arches his back when placed against a vertical surface in a sitting position or initially upon being placed on the floor, he could have hypertonia. This could cause him problems with his development and you should get your pediatrician's attention with this. If, on the other hand, he only arches after a while of being on the floor it is most likely his attempt to roll over. Let me know what he does after several trials.

Kind Rehards,
James
Answer -
Hi Amie;

Children's personalities are present from the beginning. Some are more sociable than others. If you are still concerned I highly recommend that you download the Checklist for Autism in Toddlers at:
http://depts.washington.edu/dataproj/chat_pv.html

This just a screener intended to predict the probability of autism in children 18 months and older and will help you to look for signs now and in the next few months. If it looks like there may be a risk, have your physician refer him for a specialized evaluation at a local children's hospital or university in your area. Meanwhile have as much fun as possible with your new little guy!

Kind Regards,
James
Answer -
Hi Amie;

I do not think you are overly concerned. Something about your baby's behavior is alerting you. I suspect that it is the social interaction between child and mother that might be low. Can you describe what happens when you try to play peek-a-boo type games? Can you experiment with the social interactions and give me more information please?

Kind Regards,
James
Answer -
Hi Amie;

How much time has your sitter, mother, and husband spent meeting your son's physical/emotional needs compared to you up until now? This is not a critical remark, it has to do with attachment (bonding).

Kind regards,
James
Answer -
Hi Amie;

As a follow-up to your query about Dr.Teitelbaum's work I found some contact info. I suggest you email him directly about your concerns, and of course, I'll be here also.

Professor Teitelbaum is pioneering a more extensive study into early diagnosis and needs additional early home videos of children (0-18 months) later diagnosed with autism. For more information, please call (352) 392-0615, e-mail Jennifer Nye nye@psych.ufl.edu or write Dr. Teitelbaum at Campus Box 112250, UF, Gainesville, FL 32611.


Kind regards,
James

Answer
Hi Amie;
I don't think you have anything to worry about, but that's what good mothers do: worry! I am sure the arching is part of his attempt to roll over. Remember, you stated that his opportunities for this exercise has been stilted due to reflux. At nine monthe write me back because there are several levels of social development he should have reached by then. You should follow-up with a birth to three rerral. Take care.

Regards,
James