| One of the most important clinical pearls I learned did | | | | autistic child had when she was an infant were not |
| not come from my professors at NYU medical school | | | | apparent in the second child. Sometimes the best |
| but instead came from my mother. I was the last of 5 | | | | learning comes from mothers and being a young |
| children born into my family with two of my brothers | | | | pediatrician at the time and a new mother I was not |
| (twins) severely mentally retarded. While I was doing | | | | going to miss out on this opportunity to learn something. |
| my pediatrics rotation at Bellevue hospital I became | | | | She than told me that her autistic child always seemed |
| very interested in pediatrics. I was seeing children with | | | | as if "she wasn't there" as an infant. She was also |
| very rare diseases and with various developmental | | | | much less verbal with minimal babbling and did not |
| delays. I remembered that my mother had told me that | | | | have reciprocal interactions of speech. These are |
| my brothers were not officially diagnosed as mentally | | | | some signs a parent might not be aware of unless |
| retarded until the age of 5 and now that I was in | | | | there have been prior infant rearing experiences. |
| medicine I realized that it took too long to make the | | | | I am going to talk about early signs of autism but I do |
| diagnosis. They should have been diagnosed at a | | | | not want parents to get into a panic if they feel one of |
| much younger age so they could have received | | | | these signs may exist in their baby. If there are ever |
| therapies at an earlier age. Of course my mother | | | | any concerns you must address them with your |
| knew there was something wrong with her boys. As a | | | | pediatrician. |
| matter of fact my mother told me she knew | | | | One of the earliest signs of socialization in a baby is |
| something was wrong very shortly after their birth. I | | | | the smile. This occurs at around the age of 2 months |
| remember her telling me this story many times while I | | | | in a full term baby. This is the time they also start to |
| was growing up but it became more meaningful when | | | | coo and respond to the outside world. If this milestone |
| I was studying child development in my pediatrics | | | | is significantly delayed, a red flag has been raised. At |
| rotation. I became curious as to how she knew | | | | this time babies will recognize a human face and start |
| something was wrong when the medical community | | | | to follow the face. They will also orient to sounds of |
| kept telling her that her severely retarded sons "would | | | | voices but they will not recognize or turn to their name |
| grow out of it" (you can't make this stuff up!) year | | | | at this time. This is a common concern raised by |
| after year. I asked her how she knew there was | | | | parents. Babies do not start to recognize their name |
| something wrong and her answer turned out to be | | | | until the end of the first year. |
| one of the most valuable pieces of information I have | | | | Not responding to their name at the appropriate age |
| used in my pediatric practice. She told me that by 3 | | | | can be a sign of autism. This usually occurs by the end |
| months of age they did not smile and react to her the | | | | of the first year but if it does not it can also mean your |
| way my older siblings did. This clued her into a problem | | | | child is not hearing well. Poor eye contact, preferring to |
| very early on in their life even though the medical | | | | play alone, lack of imaginative play, repeating words or |
| community (which I am now a part of) did not | | | | phrases without knowing the meaning, and repetitive or |
| acknowledge her concerns. | | | | ritualistic behaviors are all signs of autism in the second |
| This information was useful in two ways. First, she told | | | | year. Resistance to physical contact or not pointing as |
| me the most important developmental milestone to | | | | a means to communicate needs, are other signs of a |
| look for in a baby and secondly she taught me to | | | | problem. |
| always listen to what a mother is saying. | | | | There are also signs you can look for that can help put |
| Autism and mental retardation are not the same | | | | your mind at ease if you are concerned about autism. |
| diagnosis. There are some children who are autistic | | | | A smiling, responsive playful baby with good eye |
| that are also mentally retarded but there are many | | | | contact is a good sign. One of the earliest signs I look |
| autistic children who have normal IQ's. | | | | for to rule out the diagnosis of autism however is |
| There can be many signs of autism in a baby under 1 | | | | whether the baby is pointing to things. This is a sign |
| year of age. I have many families in my practice with | | | | that the baby wants to communicate with the world |
| autistic children and if you ask them they will tell you | | | | and is always a good sign even if other areas are |
| that the sibling with autism was very different as an | | | | delayed. The comprehension of language is also a |
| infant than the sibling not diagnosed with autism. | | | | very good sign and helpful when evaluating |
| Depending on the birth order a parent of a second | | | | development. If the toddler understands commands |
| baby may be cued into a problem early on like my | | | | and can follow the commands it makes any lack of |
| mother was. I can give you an example of the reverse | | | | expressive language much less worrisome. |
| of this scenario. Early on in my pediatric days I was | | | | The most important thing a parent needs to remember |
| giving a check up to an 8 month old child whose 3 | | | | is, if there are ever any concerns about your child's |
| year old sibling was diagnosed with autism. When I | | | | development you must communicate them to your |
| was asking the mother about the new baby's | | | | pediatrician. If for some reason you feel you are not |
| development she stated with confidence that the baby | | | | getting the right response it is important to get a |
| was "completely normal". I asked the mother how she | | | | second opinion with a child development specialist. |
| was so sure and she told me that all the signs that her | | | | |