Does Your Baby Show Symptoms of Autism?
New book claims disorder can be identified in infants
By Robyn A. Friedman
SouthFlorida.com
Linda Jackson, from Miami Beach, knew something was amiss with her baby. She started taking Kevin for evaluations when he was 15-months-old because of a speech delay, but doctor after doctor assured her that he was fine.
"We took him when he was 2, and they said he was not autistic. I took him when he was 3, and they also said not autistic. Then I took him again when he was almost 4," recalls Jackson.
The diagnosis: autism.
"People talk about the devastation when they get the diagnosis," Jackson said. "For me, it was like, 'duh' at that point."
Autism and its related disorders, such as Asperger's syndrome, are notoriously difficult to diagnose. According to The Center for Autism and Related Disorders, autism strikes as many as one in 150 children, many of whom display the following symptoms: problems with social interaction, impairment of communication skills and restricted or repetitive patterns of behavior, interests and activities.
But autism varies widely in its severity and symptoms. And it's particularly challenging to diagnose in young children or babies whose communication skills and social interaction are limited. Doctors often use a questionnaire or other screening tool to obtain information about a child's behavior and development. The questionnaire does not actually diagnose autism, but indicates the need for additional evaluation.
According to the National Institute of Mental Health, autism spectrum disorders can often be reliably diagnosed by age 3 -- and in some cases as early as 18 months.
"I use something called the Autism Diagnostic Observation Schedule, or ADOS, to diagnose autism," says Judith D. Aronson-Ramos, M.D., a developmental and behavioral pediatrician based in Boca Raton. "You can reliably use it for someone with a mental age of about 15 to 18 months."
Yet no one denies the advantages of even earlier diagnosis.
"There's pretty good research showing that early intervention works and is successful," Ramos says.
That's why a new book published by two University of Florida researchers is bound to excite parents. Osnat Teitelbaum, who teaches movement analysis in the Psychology Department, and Philip Teitelbaum, Ph.D., a graduate research professor, are the authors of Does Your Baby Have Autism? published in April. In this book, the authors claim to introduce "a breakthrough method" to reliably detect the signs of autism in babies as young as 3-months-old.
Because social interaction and communication skills cannot be gauged in a child so young, the Teitelbaums focus on movement as a way to spot the precursors of autism. The book discusses how to observe a baby without using specialized equipment to see if he or she displays any of the identifiable symptoms of autism.
"We looked at infants from the day they were born, so they have no social connections as yet," says Osnat Teitelbaum. "But they do speak to us in the most international language everyone speaks, and that's movement. Once you understand the movement language, you can see patterns. What differs in autistic-to-be babies is their motor development stages -- lying down, crawling and walking -- are different from typically developed babies."
The Teitelbaums say there are seven areas in which atypical brain development makes itself obvious in autistic babies: symmetry, reflexes, the ladder of motor development, righting, crawling, sitting and walking. They teach parents how to observe their children to spot the warning signs.
If parents do spot any, the authors suggest that they record their observations and talk to their doctor. The book also contains information on therapeutic approaches to treating autism.
But the book may be giving desperate parents false hope, say several experts.
"In the field of autism, the history is littered with really elaborate claims, so I urge parents to look at this somewhat scientifically and check the legitimacy of the claims," says Jack Scott, Ph.D., associate professor in the Department of Exceptional Student Education at Florida Atlantic University. "I would say that an awful lot of caution is called for here."
Others agree. "Many children with autism are diagnosed as toddlers or later, when in most instances we can reliably diagnose autism at 18 months," says Diane Adreon, associate director of the University of Miami/Nova Southeastern University Center for Autism and Related Disabilities. "To my knowledge, there is no reliable way to suspect or diagnose autism in the first year of life. If clinicians are suggesting that they can do this, one would have to ask who has replicated their research. We need to carefully examine their research and have it replicated independently by other researchers."
The Teitelbaums acknowledge the criticism of the medical community. "We wrote scientific papers that were published in scientific journals, and we know that nobody from the medical community picked up on this," says Osnat Teitelbaum. "That's why we decided to write this book -- directed to parents because we think that very little is being given to the parents in order to help them."
Ramos, the pediatrician, questions whether early diagnosis is even worth it. "What do you do with a 3-month-old potentially autistic baby?" she asks. "There aren't enough therapists. Is the state going to pay for therapy? Are insurance companies going to pay? These real world issues are the hard ones. You don't even have a lot of people trained in infant stimulation to work with 2- and 3-month-old babies."
Still, parents--many of whom have been searching for answers for years--remain hopeful that early diagnosis of autism is possible.
"If Kevin had gotten early intervention, a lot of things could have been corrected," says Jackson of her son. "When he was young, I ran around in circles trying to figure out the right kind of therapies for him and what to do. But it was very hard to figure out the right thing because he never had a diagnosis."
