A Parent's Instincts
It's a familiar story that parents of children with autism tell: They knew it all along. They knew it when their children were infants, when they were breastfeeding, almost at birth. There were thousands, perhaps millions, of anecdotes out there and all of them told the same story: The parents knew, and they knew early on.
When research finally caught up with these parents' intuitive understanding of their children, it prompted the American Academy of Pediatrics (AAP) to issue a recommendation for all children to be screened for autism twice by age 2. The two reports, which appeared in the November 2007 issue of the journal Pediatrics, include signs to watch for, such as babies who don't babble at 9 months and 1-year-olds who don't point to toys.
Many have hailed this move as a great leap forward because the sooner autism is diagnosed, the sooner therapy can start. However, it may be that the signs the AAP are asking parents to be aware of may tell only half the story. An intriguing new book by researchers Osnat Teitelbaum and Dr. Philip Teitelbaum, Does Your Baby Have Autism?, may offer clues that can lead to diagnosis even in early infancy.
The Science of Movement
What sets the Teitelbaum's work apart is that their criteria for detecting autism in infants are physiological and not social. "At present, the primary diagnostic criteria for autism is social interaction, so the reason that 2 years of age is the earliest that the medical community is willing to diagnose autism is because that's the age when most children get into a social setting," says Osnat Teitelbaum. "However, since autism is a neurological condition, analyzing movement enables us to diagnose autism much sooner."
The Teitelbaums' research spans decades of painstaking work evaluating videos of children diagnosed with autism and Asperger's syndrome using a system of analysis called Eshkol-Wachman Movement Notation (WSMN). This is a system of analyzing movement that allows for a standard interpretation of movement patterns.
What they found was that infants who were later diagnosed as autistic had predictably atypical movement patterns that appeared long before the language and socialization problems normally used to diagnose autism. "These things that we describe are not subtle; they are very obvious," says Dr. Philip Teitelbaum. "It's just a matter of knowing what to look for."
Developmental Progression Criteria
In their book, the Teitelbaums detail the developmental progression of an infant's first few months, with explanations of both normal and atypical development. The criteria include the following:
- Symmetry: Is the baby equally adept with movements on both sides?
- Reflexes: Are reflexes appearing and regressing on schedule?
- Ladder of Motor Development: Is motor development progressing appropriately from the head down?
- Righting: Does the baby's body rotate properly when righting?
- Crawling: Does the baby crawl symmetrically, on his knees, and with good balance?
- Sitting: Can the baby maintain the upright position and exhibit appropriate falling reflexes when tipping?
- Walking: Does the foot strike the ground appropriately and do the arms move in coordination?