Spotting Signs of Autism
Leslie A. Burby
I have worked with several different students with a wide range of learning disabilities, physical disabilities, and behavioral challenges. However, reality didn’t set in until I had my own child. Let’s face it, there is a huge difference between reading something in a book and living it.
My first child was a beautiful, healthy, bright eyed little girl. As an educator, I had such high hopes. I hung black and white pictures next to her changing table and read to her every day. Then one day, my experience in education told me something was wrong with my beautiful baby. Since her birth I struggled to get her to eat. Even drinking from a bottle was difficult. The formula would just run down the side of her face. She was very thin and the insurance company even sent someone to weigh her at home between doctor visits. All she did was sleep and then as she got older, it was impossible to get her to sleep.
Eventually, I learned that my daughter is autistic. To be more specific my oldest daughter, Mary, has Asperger’s syndrome and is mildly hypotonic. To me it seemed like a very long time to get her properly diagnosed and treated. It was quite the journey trying to get her help when I didn’t know what diagnosis she needed.
To me the early warning signs of autism were
- Doesn’t point to show things to others
- Can’t walk
- Doesn’t know what familiar things are for
- Doesn’t copy others
- Doesn’t gain new words
- Doesn’t have at least 6 words
- Doesn’t notice or mind when a caregiver leaves or returns
- Loses skills he once had
The CDC says – “If You’re Concerned – Act Early”
“The American Academy of Pediatrics recommends that children be screened for general development using standardized, validated tools at 9, 18, and 24 or 30 months and for autism at 18 and 24 months or whenever a parent or provider has a concern. Ask your child’s doctor about your child’s developmental milestones. The National Center on Birth Defects and Developmental Disabilities has recently launched a campaign to promote child development. For more information on child development, visit the Act Early website: http://www.cdc.gov/ncbddd/autism/actearly/.”
However, should you be concerned?
I remember people thinking that I was over-reacting. That nothing was wrong with my daughter. She was smart and beautiful, I was told.
My daughter’s first pediatrician told me, “To stop obsessing over milestones,” when I enquired about her not standing at 18 months. I changed pediatricians.
It wasn’t until my daughter’s first birthday that I realized her development was practically backwards. All her peers were running around or toddling around and using one or two word phrases. My daughter was speaking in full sentences but couldn’t crawl or stand (even when assisted.)
I went home and called the Birth to Three State program and set up a free developmental screening of my daughter.
It was the best thing that I ever did. Finally, I had other people that saw the delays that I saw. I wasn’t crazy. Something was off.
Today, when I tell people that I have a daughter on the autism spectrum they always ask 2 things:
1.“When did you know?” (Or what symptoms did you notice first?)
I always say, to be honest I knew almost immediately. I was sure by the time she was six months and had no doubt by the time she was one, that something was wrong. At first I thought she had S.P.D. (Sensory Processing Disorder). All autistics have sensory processing issues but NOT all people with sensory issues are autistic.
Even if you don’t suspect autism, there will be signs of other comorbid issues. Comorbidity means two or more coexisting medical conditions. Autism usually coexists with other medical conditions such as:
- Bipolar (or manic depression),
- Phobias, depression, and other psychopathological disorders
- Obsessive Compulsive Disorder,
- Bowel Disease (some sort of GI problem; commonly chronic constipation),
- Fragile X,
- Seizures/ Epilepsy,
- Motor Clumsiness (associated with sensory integrative dysfunction)
- Tourette Syndrome
- Tuberous Sclerosis
The other question that I often get is –
2. “How did you know?”
In my daughter’s situation, it was her sensory sensitivities that were very apparent from the beginning. Sensory sensitivity, sensory integrative dysfunction or sensory processing disorder (S.P.D.) is a neurological disorder involving the central nervous system that has trouble taking in, processing and responding to sensory information from not just the five senses (sight, smell, taste, touch, hearing) but with the proprioceptive and vestibular senses, too. I had never heard of the latter two so let me explain. Proprioceptive dysfunction is when your body doesn’t know where it is in space so your body has trouble positioning your limbs in relation to each other, which makes people with a dysfunctional proprioceptive sense appear clumsy. The vestibular sense is the sensation of body rotation, movement and gravitation that are controlled by the inner ear, which becomes apparent when you have a child that enjoys spinning for 20 minutes and can still walk a straight line.
I didn’t know what was wrong, but I knew that something was awry. So I started to make a list, which was very helpful to medical professionals. I recommend that everyone does the same with their child. I recommend viewing a checklist of SPD related symptoms at http://spdsupport.org/resources/symptoms.shtml
Below is the list of some of the sensory related symptoms that I noticed and when my daughter Mary reached milestones. Please note that having a few of these characteristics does NOT make a child autistic. Some of the characteristics listed below are related to her low muscle tone (not autism). Please seek a professional evaluation if you have concerns.
Hyposensitivity Vestibular Dysfunction
- · Craves fast, spinning, and/or intense movement experiences
- · Loves being tossed in the air
- · Could spin for hours and never appear to be dizzy
- · Always spinning in a swivel chair/getting upside down positions
- · Loves to swing as high as possible and for long periods of time
- · Is a “thrill-seeker”; dangerous at times
- · Rocks body, shakes leg/s, or head while sitting
- · Likes sudden or quick movements
- · Seeks out jumping, bumping, and crashing activities
- · Kicks his/her feet in chair while sitting at table
- · Sucks on fingers
- · Loved to be swaddled but is satisfied to just be covered when sleeping
- · Prefers clothes (and belts, hoods, shoelaces) to be tight
- · Loves/seeks out “squishing” activities
- · Enjoys bear hugs
- · Excessive banging on/with toys and objects
- · Loves “roughhousing” and tackling/wrestling games
- · Frequently falls on the floor intentionally
- · Loves pushing/pulling/dragging objects
Auditory Hyposensitivity –
- · Loves to make noise
- · Loves loud music
- · Needs directions repeated over and over
Hypersensitivity to Oral Input –
· Extremely picky eater
· Drinks must be a certain temp
· Extremely picky about cups and feel of nipples
As an infant Mary…
· Never mouthed objects even when teething
· Never put feet down to bounce on legs of a person; or in the “jolly jumper” or exersaucer
· Never put pressure on her legs
· Would raise legs into a seated position and hold them there when asked to stand up
· Showed poor motor skills – (most of these were met with the dedication and hard work of the PTs and OTs)
· rolled over (Nov. 10th 2007 – 4 months old),
· disliked being on belly as an infant,
· delayed in crawling (day before 1st bday),
· pull to stand (Oct 2008-15months old),
· cruising (Nov 2008-16 mo. old),
· stand up by herself in middle of floor (March 2009 – 20 months), take her first steps (mid January 2009 -18 months old),
· will take a few steps with assistance (Feb 2009)
· will toddle on own (April 2009 – 21 months)
· When she finally did roll over she wouldn’t roll back to her original position
· She doesn’t kick one leg at a time – instead she thrusts her legs from her hips bilaterally (stimming) Click here for a definition of stimming – http://en.wikipedia.org/wiki/Stimming
· Took a while to adjust to the feel of water, grass and sand (for months she had to be sponge bathed) (wouldn’t venture off outside blanket for fear of touching the grass) (took several days to acclimate her to the sand box)
As a toddler Mary…
· Was constantly seeking thrill
· Loved to rock
· Loved to be upside-down
· Loved to bounce
· Loved to spin
· Loved to climb
· Loved to swing as high and fast as possible
· Becomes distressed about having nails clipped or things in her hair
· Likes to wear hats/hoods
· Must have a hat/hood on to keep her hair from flapping against her head when jumping or swinging
· Hated the wind or anything that causes her hair to move
· Has frequent temper tantrums that can last 45 minutes
· Has many mood swings
· Becomes violent at times with herself (for no apparent reason will start hitting herself on the head or head-butting things)
· Needs to be wrestled down to have her diaper changed
· Likes to wear sunglasses
· Does not stay asleep – very easily awaken
· Is nearly impossible to get to sleep
· Loves hugs…although they usually have to be requested or initiated by her
· Likes to sit on different objects – will sit on books, boxes, cans, toys, etc.
· Sucks two fingers upside-down to soothe self
· Randomly throws herself onto the floor
· Is extremely difficult to feed (she is a very picky)
· In constant motion – when sitting or excited her legs and arms are constantly flailing
· Bangs or hits her head –not just when frustrated
· Purposefully sticks her fingers in the back of her throat to initiate her gag-reflex
· Seems very lazy –if anything is too heavy or too much work she gives up
If you are concerned please call or email Birth to Three http://www.birthtothree.org.
Birth to Three will evaluate your child in all areas of development.
Five main areas of development-
- Cognitive Development
This is the child’s ability to learn and solve problems. For example, this includes a two-month-old baby learning to explore the environment with hands or eyes or a five-year-old learning how to do simple math problems.
- Social and Emotional Development
This is the child’s ability to interact with others, including helping themselves and self-control. Examples of this type of development would include: a six-week-old baby smiling, a ten-month-old baby waving bye-bye, or a five-year-old boy knowing how to take turns in games at school.
- Speech and Language Development
This is the child’s ability to both understand and use language. For example, this includes a 12-month-old baby saying his first words, a two-year-old naming parts of her body, or a five-year-old learning to say “feet” instead of “foots”.
- Fine Motor Skill Development
This is the child’s ability to use small muscles, specifically their hands and fingers, to pick up small objects, hold a spoon, turn pages in a book, or use a crayon to draw.
- Gross Motor Skill Development
This is the child’s ability to use large muscles. For example, a six-month-old baby learns how to sit up with some support, a 12-month-old baby learns to pull up to a stand holding onto furniture, and a five-year-old learns to skip.
Now I know that autism is a very large spectrum of people and abilities. Children with severe autism are more likely to have speech then loose it where as children with high-functioning autism tend to have advanced speech but lack social communication skills.
To read more visit http://www.autismspeaks.org/what-autism/symptoms#physical.
Today, Mary is doing great. Most people don’t even realize that she has a behavioral disability. Some people are scared of “labeling” their child but it is the only way to provide your child the services they need NOW. If it wasn’t for the early intervention that I sought after, I wouldn’t be able to stand here today and tell this story. Don’t get me wrong, there are days or places that she still cannot tolerate. For instance, Stop & Shop has lighting that still sets her off into a meltdown. However, things have gotten a little easier and I am fortunate to have an autistic child with the ability of speech. After she is calm, we can sit down and try to figure out what set her off. She has learned many coping mechanisms to help her when she gets overloaded with sensory input. My husband and I have also learned to watch for cues that signal us that she has had too much and needs to be removed from an environment. This kind of learning, you can’t learn in a book. Some things, must be lived.
Leslie A. Burby is the mom of three young children (ages 2-6), an author, a public-speaker and the Editor of Autism Parenting Magazine. She worked for many years running a statewide tutoring company for children with learning disabilities and as a special education tutor before having her own children. Now Leslie Burby spends her days advocating for special education rights, and providing resources to parents to help their child/ren get the services that they need. In addition, she writes on autism related issues based on the belief that with knowledge comes understanding and with understanding comes acceptance. She hopes to spread knowledge and answers of autism in hopes to increase acceptance of all that it entails. To get one free copy of the magazine go to http://www.AutismParentingMagazine.com and enter your email. To buy her book Emotional Mastery for Adults with Aspergers visit http://www.amazon.com/Emotional-Mastery-Adults-With-Aspergers/dp/1481207350/ref=sr_1_2?ie=UTF8&qid=1372087404&sr=8-2&keywords=emotional+mastery+for+adults+with+aspergers
The first book of her children’s series is available! It is entitled Grace Figures Out School. Purchase it here!
To read more check out Books, Blogs, and Burby at http://leslieburby.blogspot.com/
For questions, book signings or speaking engagements email Leslie at Leslie.AutismParentingMagazine.com.
- 1. Milestones by age – provided by the CDC
- 2. Sensory Processing Help – http://spdsupport.org/resources/files/SPD-Parent-SHARE-International-Flyer.pdf
- 3. Comorbid conditions associated with Autism http://en.wikipedia.org/wiki/Conditions_comorbid_to_autism_spectrum_disorders