Did you know that children with autism often begin showing signs within the first few months of life? Would you be able to identify these “red flags”?
Since my son’s eye contact was always pretty good and, up until just before his diagnosis, he always seemed to enjoy physical connection, I assumed autism wasn’t something I needed to consider.
I would later learn that my son had been showing subtle signs, pretty much since birth.
Here are eight autism symptoms we missed:
“911, what’s your emergency?” These are the words a parent never wants to hear. I finished nursing Jacob one night and laid him down in my bed when he appeared to be struggling to breathe. But he was only one month old, what could he possibly be choking on? He clearly could not breathe, his little face turning bright red, his lungs unable to draw in a breath. I started yelling for my husband, and he called for an ambulance.
I had taken an infant CPR class while pregnant and was scanning my brain to recall the steps when, out of nowhere, Jacob started wailing. But before relief even began to sink in, he was struggling for breath again. This went on for what felt like an eternity until the paramedics arrived. The episodes seemed to stop in the ambulance and Jacob finally fell asleep. I watched his chest rise and fall not taking my eyes off him, afraid that if I even blinked, he might stop breathing again. We finally arrived at the hospital and spoke with a doctor and he spelled out the four letters: GERD. Jacob had been choking on his own stomach acid.
We had no idea at the time, but GI disorders are much more prevalent in children on the spectrum. Of course, having reflux does not suggest that a baby has autism. But combined with other symptoms, this should have been a red flag.
Related: My Child on the Spectrum is 'Ausome'
2. Sensory challenges with food.
When the time came for Jacob to transition to baby food, he absolutely loved it! He did great with the first stage of finely puréed sweet potatoes, carrots and peas. But when it came time to upgrade to the heartier (and lumper) variations, that’s when the trouble started. If there was the tiniest lump or bump in his meal, Jacob would vomit so violently that he would turn purple. He was eventually diagnosed with a feeding disorder and began therapy. We were told his difficulty chewing and swallowing was due to his GERD. Jacob didn’t chew his first food (half of a Cheerio) until he was nearly 3 years old. It might not seem like much, but this half of an “O” was a huge breakthrough and boy did we throw a party!
However, it would still take years of therapy and hard work before the daily vomiting ceased and he was finally able to tolerate and enjoy a number of tastes and textures. It wasn’t until after his diagnosis that we learned how common it is for kids with ASD to have sensory challenges with food.
3. Absence of crawling.
Babies typically begin crawling between 7 and 10 months old. But Jacob never crawled. In fact, I often say he never crawled or walked, but went straight to running! We were told by doctors this wasn’t abnormal and that some babies just never crawl. We rationalized he was just so full of energy and ready to “go get up and go” that he skipped that step.
In the book “Does Your Baby Have Autism?: Detecting the Earliest Signs of Autism,” Philip Teitlebaum observed home videos of 18 children who were later diagnosed with ASD, along with 17 home videos of children who never received a diagnosis. He concluded that, “the absence of crawling, or persistent ‘army crawl’ is a common occurrence in infants who later receive an ASD (autism spectrum disorder) diagnosis.”
4. Delayed or not meeting milestones.
We used to think it was so cute when Jacob touched everything with his thumbs. He never pointed with his pointer finger and when I tried pointing something out to him, he would stare at my finger rather than follow through with his gaze to the item or object I was attempting to draw his attention to.
According to the Center for Disease Control (CDC), a child with autism might not point at objects to show interest by 14 months.
5. Regressive speech.
My son began those sweet little coo’s and boo’s right around 2 months old. By 6 months he was saying baba and dada. Then somewhere around 9 months he just stopped.
Whenever I asked the experts about this they would tell me, “he’s a boy, boys talk later” or “your a new mom, don’t be paranoid.”
By the time Jacob turned 18 months, I knew something wasn’t right. Other boys and girls his age were using three-word phrases, some even speaking in sentences. I pushed for a referral and Jacob finally began speech therapy by 22 months.
Looking back, I wish I hadn’t let anyone talk me into following the “wait and see” approach.
“Speech that begins, but does not progress is a worry. When language fades, it is never normal. Period.” — Dr. Brian Udell
6. Repetitive behaviors.
Oh for the love of fans! Jacob was never really one to play with toys, but he was always really into fans. He couldn’t sit through an episode of “Mickey Mouse Clubhouse,” but he seemed to be able to watch a fan spin for hours. When we went to visit a friend or family member, he would spend the entire time running from room to room to turn the ceiling fans on, and then off and on again. Jacob was also quite partial to windshield wipers and often insisted that all of our (outside) lights be on… during the day.
He had a strong desire to follow certain routines, especially at bedtime. For instance, we needed to toss the blue block into his crib first, followed by the red letter M, and last Dino (his stuffed purple dinosaur). He would refuse to go near his bed if we skipped a step or mixed up the pattern, but once the routine was met, Jacob became visibly more relaxed.
I remember wondering if a child so young could have traits of OCD. Then recalled learning in a child development class about the importance of schedules for small children and how children needed and often craved routines. This, combined with the doctors reassurance, got me off track.
7. Low muscle tone.
Jacob loved his exersaucer but he was always very wobbly. A few times he fell forward and banged his forehead. I assumed he was still too young to have developed the reflex to brace himself. When he began walking, he also seemed very clumsy. We figured this was because he had so much energy and always moving so quickly that it was more difficult for him to balance. When he fell, he never instinctively put out his hand to catch himself. This resulted in many bumps, bruises, a few chipped teeth and a heck of a workout for mommy!
One year after Jacob was diagnosed, new research emerged revealing a simple test for babies to help with early detection of autism. It’s called the, “head lag in a pull to sit task” and began at the Kennedy Krueger Institute in Baltimore. The scientists performed a task in which they pulled the babies, who were lying on their backs, by the arms up to a seated position. The infants were tested at 6, 14 and 24 months old. They found that 90 percent of babies who were diagnosed with ASD showed head lag as infants.
8. Extreme sensitivity to noise.
After Jacob’s 1st birthday, we began to notice he was becoming more sensitive to sound. He couldn’t stand the sound of toilets flushing or dogs barking, so we taught him to cover his ears with his hands. I was sensitive to loud noises as a child, so I empathized with him. The sensitivity began to increase as he got older; it got to a point where he would run out of the bathroom before the flush and dash inside when an airplane was flying overhead. One day he was at church and the fire alarm sounded. Jacob was visibly distraught and he froze, screaming with his hands jammed over his ears.
At this point, we decided it was time to get him evaluated by a Developmental Pediatrician. I have to be honest though, I still didn’t believe they would find any diagnosis. He was only 4 years old. Sure, he had some repetitive behaviors and hated loud noises, but he was also very smart. At 1 year old he could point out any of the 50 states on a map we named, along with the seven continents and nine planets (yes, Pluto was still included in our map back then!)
But he did receive a diagnosis. In December 2011, the doctor said Jacob had pervasive developmental disorder not otherwise specified (PDDNOS). She explained this was a form of autism, similar to Asperger’s syndrome, but with a speech delay.
So here’s the deal. I’m not claiming that if a child shows any one of these signs above it means they have autism. Autism is a spectrum disorder which means every child is different. Only a qualified practitioner is capable of evaluating and providing an accurate diagnosis. With that said, research shows that early intervention is key in helping a child on the spectrum and can make a huge difference in their overall quality of life.
If you have any concerns about your child’s milestones or are just unsure what exactly you should be looking for, talk to your pediatrician.
I may always have regrets about having missed these red flags that now seem so obvious, but I am grateful we acted quickly after the diagnosis.
The most important thing I’ve probably learned throughout this journey is that acting quickly, sooner than later, is probably the best decision a parent can make when it comes to developmental differences or delays. When a young child is struggling to meet milestones, we must speak up. Advocating on their behalf just might be their best hope for a fulfilled and independent future.