Source: Indys Child Parenting Magazine

Signs and Symptoms of Autism in Babies
Pediatricians tell you what to look for

by Carrie Bishop

September 01, 2011

Parents can expect a few things of kids with autism. One is they will present their own unique set of symptoms. The second is they will have social deficits. Knowing this, is it possible for doctors to predict which babies have autism? Sometimes. At a minimum, the medical community is learning more about early cues that indicate an infant may have an autism spectrum disorder.

To new parents this may come as good news. No more waiting until a child is 2 or 3 years, or later, to determine if he or she has autism. Was that a collective sigh of relief coming from nurseries across Indianapolis? Finally a checklist identifying which children are at greatest risk. Hallelujah!

Well, not quite so fast.

The Indiana Resource Center for Autism (IRCA) said that because autism presents itself differently in each child, some children will show symptoms of the disorder in infancy, but by no means do all children. Other children may not exhibit symptoms until they are 2 years or older when they stop reaching new milestones or lose skills they once had.

So while all children who ultimately are diagnosed with an autism spectrum disorder cannot be identified in the first year or so, some do exhibit symptoms that indicate they will likely fall on the spectrum.

Following are a few milestones pediatricians and other experts on childhood development say are ones to watch. Parents be aware: normal variance of reaching developmental stages is huge. Children develop at their own rate. While infants with autism may miss some of the below-noted milestones, so too do many typically developing children.

1 month. According to Dr. James Leland, a pediatrician on Indianapolis’ west side, infants as early as one month can be interested in facial expressions. Babies may respond, for instance, to a mother raising her eyebrows.

3 months. By 3 months, information published by the Centers for Disease Control said an infant should begin to develop a social smile, enjoy playing with other people, become more expressive and communicate more with his or her face and body, and should imitate some movements and facial expressions.

4 months. Dr. Mary McAteer, pediatrician with Meridian Pediatrics, said that by four months an infant should gaze with curiosity at strangers. It is a gaze different than the gaze they have toward their family. Yet she stresses that even an action like this is so individualized that it’s difficult for doctors to make a judgment on whether or not a child falls on the autism spectrum.

9 to 15 months. Leland noted that babies with autism are not big cuddlers. As such, parents may start to notice around 9 to 15 months the child finds little consolation with being rocked or held.

12 months. By one year the IRCA said babies should be able to respond to their name.

14 months. Children at this age, according to the IRCA, should be pointing at objects to show interest such as pointing at an airplane flying overhead.

18 months. The IRCA said by 18 months children should play pretend games, like pretending to feed a doll.

Parents concerned their child is not meeting milestones should speak with their pediatrician and request a full developmental assessment.

“The best way to determine whether or not your child has autism is to make sure he or she is meeting the appropriate developmental milestones,” said Dr. Luis Escobar, medical director of medical genetics at Peyton Manning Children’s Hospital at St.Vincent. He also stated that when a child appears to not be meeting age-appropriate milestones parents have to think in terms of developmental delay versus assuming the child has autism. First they need to determine if the child is truly not developing normally, then determine why. Are the symptoms adding up to autism or is there another underlying cause?

Like many others, he said doctors cannot make a firm diagnosis of autism before the age of 3 because in the very early years there is hope that the symptoms will improve. “By age 3, however, it may become clear that social interaction is not there,” Escobar said. He said people have tried to develop screening tests for autism, but there is no standardized test that can diagnose the developmental disorder with complete accuracy.

There are, however, tools that can offer a bit of guidance. For instance, the IRCA is making a screening tool called M-CHAT available for free as a downloadable app. M-CHAT helps identify which children under 30 months should receive a more thorough assessment for autism or other developmental delay. Again, not a foolproof method, but helpful. Now that it’s available as an app parents have easy access to the screening tool as well.

Parents who have concern that their child has autism should find a good psychologist or other autism expert to assess their child. Pediatricians will often have recommendations of psychologists who work well with children the age of their child and who also work well with the pediatrician. The IRCA also offers a list of people and organizations in the area who can assess children. Find it at

One last bit of advice. While keeping watch of the milestones, experts remind parents to also trust their gut.

“Moms really do have a gift, a kind of sixth sense about things. When they have a concern they need to make sure they act on it and bring it to their pediatrician’s attention and make sure we hear what they are trying to say,” said Leland.