Written by Tara Carnegie
According to the Center for Disease Control and Prevention (the CDC), in 37 boys in the United States will be diagnosed with Autism, with boys being about 4.5 times more likely than girls to develop the disorder.
That's scary stuff. And exactly because autism is a spectrum and varies dramatically in severity and symptoms, the fate of a child and adult on the autism spectrum is really hard to predict.
- Some end up being the "quirky" kid and adult, with eccentric style and highly specialized hobbies and interests, like comics, fantasy games, or video games. These kids are usually able to make it into college, find a small group of friends who are similarly quirky, and they can become highly functional members of society. This form of autism is more like what experts used to call Asperger's.
- Some others end up being genius savants with a lack of social skills but a highly specialized expertise in some complex domain, like computer programming, engineering, or mathematics. There is high respect for these individuals in academic and highly educated circles, and at the peak of achievement they might become college professors or even Nobel Prize winners. All of those smarts, of course, are usually at the expense of typical social skills.
- Still others have such strong symptoms that they end up not being fully functioning members of society, with attentional or behavioral symptoms that prevent them from succeeding their goals. This is the most challenging form of autism to deal with for parents, and is even more challenging for the child, adolescent, and eventually adult living with autism.
As a new parent of a 5-month old baby, I feared all of these forms of autism. It didn't matter to me which one it was, I didn't want my child to suffer any of the stigma and challenges (educational, social, behavioral) associated with autism.
And, to be honest, I didn't want to spend the rest of my life worrying about my child's day-to-day life and future. What were they doing, were people being nice to them, and were they receiving both the attention and opportunities they deserved? And my career. What about my career, my future? That sounds selfish but moms need to think about themselves in addition to their children.
My baby always seemed uncomfortable in his skin, and there wasn't much I could do to soothe him.
My baby boy was very colicky for the first 6-8 months of life. Cried for hours on end, didn't sleep well, and seemingly wanted to spend most of his time challenging me rather than cooperating. If I sat, he wanted to stand. When I wanted to nurse, he didn't want food. When it was time for a nap, he wanted to be awake. You get the picture.
And more concerning, I didn't experience much bonding with my little boy. I wanted desperately to experience what other moms were experiencing: the loving glances, the social smiles, and the staring into your eyes while nursing. All those little things that help develop the special bond between a mother and her baby.
So I started to think that maybe something was wrong. Maybe he had poor vision or hearing? Maybe he had a motor or attention problem that prevented him for orienting his eyes toward people? There were so many things running through my mind.
And my pediatrician wasn't very helpful. He constantly reassured me that my baby was fine. One day in the office he did a little test that he thought was somehow diagnostic: he pointed at the clock to see if that would make my boy look up at the clock.
You see, he followed my point to the clock, nothing to worry about!
Problem was, my little boy was already looking at the clock. Probably because it had a fascinating tick and rotating second hand. Just like he looked at ceiling fans and blinking lights.
My advice is to find yourself a specialist called a developmental pediatrian who will be much more knowledgeable about the signs of developmental disorders.
So I started to do some research of my own. Using my background in child development, I began by reading some of the most recent scientific articles on the topic.
Here are some of the early signs of autism that I came across:
1. Eye contact. This is huge, babies should spend a lot of their time looking up at mom while breastfeeding, watching mom for her facial expressions and reactions, and learning how to gather important social and communication information from mom's eyes. Some research suggests that babies who later develop autism will show less eye contact, especially as they move through months 2-6. That means in the first few months of life, eye contact does not appear to be deficient. But as the baby moves through months 2-6, it seems to become progressively worse (Jones & Klin, 2013). Some other research suggests that this decline can continue all the way through about month 12.
2. Social smiling. This is something called reciprocal social smiling. In other words, when you or another person smiles at your baby, does your baby smile back? If not, this is one behavior that predicts the future development of autism.
3. Motor planning, control, and typicality. Infants that end up developing autism tend to have some less than common motor movements as a baby (Provost et al., 2007). They might not reach across the midline, like using the right arm to reach and grab something on the left side of the body. They might not organize their behavior well, like moving their limbs suddenly or frantically, as if they don't have a good plan on what they should be doing. Finally, they might do things that your friends' babies don't do. For instance, they might not roll or crawl like other babies, they might only roll to one side, they might have repetitive behaviors, or their posture might look different from other babies who are the same age. If you notice any abnormal motor movements, this could be an early sign of autism.
4. Visual tracking and orienting. This involves the ability to track objects that are moving, like if you are moving a stuffed animal in front of your baby's face but they lose track of it as you move it. Or, they just don't care enough to watch because they can't stop focusing on something else that's of interest. They also might not be able to easily shift their attention from one thing to another, especially when that other thing involves something social (like someone calling their name, someone looking at them and smiling, or noticing or caring about a person entering the room).
5. Imitation. Babies also learn imitation around 7-8 months old. In addition to smiling when you smile, they might imitate certain noises or movements you do, or have fun moving a toy to copy what you're doing. In infants that might be at risk for autism, they tend to show delayed or non-existent imitation of their parents or others (see a study about this here). This might also include responding to different facial expressions in an appropriate way. If mom is scared or sad, baby should recognize that and stop smiling.
6. Delayed Babbling. Around 6-8 months, babies begin babbling. Below is one of the most adorable videos of babbling, in this case between two twin boys; if you're on a mobile device or otherwise don't see the video below, you can see it on YouTube here. While your baby may never babble anywhere near as much as these babies, this is the sort of social babbling that is expected of babies. Babies may do this with mom, dad, or other care-givers. Delayed or non-existent babbling can be one of the early signs of autism.
7. Sensory seeking or sensitivities. Infants that end up developing autism sometimes show atypical sensory behavior. They might seek out certain feelings, textures, tastes, or smells. And they might be completely revolted or upset about other sensory experiences. It's hard to predict what they will like or dislike, and they might be labeled as "picky" or "sensitive." I do realize that it sounds like the opposite to be saying that your baby might seek or avoid certain things, but that's simply how it tends to work. Your baby might be very drawn to certain things, and completely avoid other things. As they get older, this might turn into something resembling sensory processing disorders, where social behaviors are normal but they are very sensitive to certain sounds, smells, etc (like the vacuum, hand dryer, blow dryer, dog barking, etc).
8. Baby is hard to soothe. This is one of the reasons I ended up looking into early signs of autism in the first place, because my baby was just so difficult to soothe. While other moms could pick their babies up and quickly console them in their arms, my baby would simply keep crying or cry even louder when I cuddled them. Babies who end up developing autism tend to be harder to soothe than other babies.
9. Delayed language development. In children who develop autism, delayed babbling (I talk about that above) usually transitions into delayed language in general. This can be a receptive language delay, which means that your baby doesn't seem to understand the things you say like other babies of the same age. This can also be an expressive language delay, which means that your baby doesn't produce sounds and words, or string words together like other babies of the same age.
10. Detachment and more. A recent study suggested that there are tons of early signs of autism that parents recognize but are not used by clinicians. These include things like "my baby is in his own bubble," and detached from the play or interaction of other children, care-takers, and parents. Parents of children who end up being diagnosed with autism also report that their babies had difficulty regulating their emotions, crying a lot and having challenging tantrums that didn't end easily. They also reported that their baby had sleeping problems, such as not following a regular nap schedule, and having difficulty self-soothing to sleep during the day or night.
A common theme I noticed during my research is that my baby just wasn't like other babies. He was different in so many ways. On the one hand that's what made him unique and continues to make him unique. On the other hand, as a mother you want to make sure that you are providing your baby with everything he or she needs, whether that's therapy or early intervention, or just continued monitoring.
I learned a lot, and realized that I was able to diagnose my own son before any clinician. He's now 6 years old and I am happy to report that he is doing very well. Yes, he is on the autism spectrum, most like what Asperger's used to be. He likes cars, motorcycles, and trains. He learns quickly but has difficulty holding his attention on any topic, unless it's about cars, motorcycles, or trains!
He has a small group of friends who are just like him. And he's happy, and that's all I can really ask for as a mom.
Soon I will write more about my experience raising a child on the autism spectrum, so check back in the upcoming months!