Now you are worried.
Your 7-month-old baby got excited and started jumping in your arms. Then she suddenly started flapping her little arms. It lasted nearly a minute, but it felt like an eternity for you.
Like most mothers do, you most likely have heard and read about autism.
There is even a chance that you know someone who has a child with autism.
So you kind-of-know what to look for.
But you are not certain.
Naturally, you worry.
Worry that any behavior, movement or lack of it can be a sign of autism or developmental delay.
Autism is a spectrum disorder.
On one end of the spectrum, there are children who behave almost like non-autistic children.
On the other end of the spectrum, some children are not able to learn even basic life skills.
And some can not control their behavior at all.
“Spectrum disorder” also means that not every child has the same symptoms/ signs/ delays/ challenges. Thus the diagnosis is given only to children who present with more than 1-2 signs.
So if your child is flapping their arms but has no other signs, he is most likely not autistic.
Of course, there is a chance that you are not able to identify the other signs. That is why to be certain educate yourself as much as possible and seek professional help.
Knowing and understanding what the signs of autism and developmental delay is crucial for every mom.
This knowledge will empower you to assess and teach your baby.
It will also assist you to seek medical intervention when necessary and help your baby as soon as possible.
It will help you clarify that not all “weird” movements your baby does are a sign of autism. Some are naturally occurring milestone. And some are signs of developmental delay.
It will guide you to understand the naturally occurring infant movements, behaviors, milestones.
As a guide let’s use the signs and delays of autism.
These are the signs that you should keep an eye on. If you notice any of them don’t wait, seek medical help because if they are not related to autism, they might be a sign of developmental delay or other medical issues.
The sooner your baby gets treatment, the better and faster her recovery will be.
But before you run to the medical community educate yourself.
Know your baby.
Know infant and child development.
Know the typical signs of autism and developmental delay.
This knowledge will help you understand your baby’s behavior.
It will also help you understand what and why your doctor or therapist recommends a particular approach.
Your knowledge will also assist you to ask constructive questions and make decisions more wisely.
The next segment below is a short explanation of the above list exploring the possible origins, causes and natural occurrences of these signs.
Smiling is a cognitive and behavior milestone.
The lack of smiling by the 4-6th month is a possible marker of the presence of autism.
However, lack of smiling could also be due to muscle weakness or high muscle tone (tightness) in certain parts of your baby’s body.
Low muscle tone could also affect her ability to hold her head well, roll or sit on time. Pediatric physical therapy can help your baby catch up with these delays.
So, in some cases, low muscle tone is the cause and diagnosis of lack of smiling, not autism
Unfortunately, some babies have low muscle tone and autism as well.
Seek medical help to rule out possible causes and get proper treatment if your baby is not smiling by the 5-6th month.
Momentary eye contact is present in newborns. Good eye contact can appear as early as 6 weeks and as late as 3 months.
The initial eye contacts are short and fleeting and don’t occur unless baby’s face is close to yours.
Eye contact is one of the most essential skills in imitation and social interaction.
Thus lack of eye contact is a common red flag for autism.
However, lack of eye contact could also be due to poor vision, weak or tight muscles in the eyes or the body.
I have worked with babies who had tight backs, and poor or no eye contact. When their tightness lessened, the eyes started to improve and eventually normalized.
Lack of eye contact by the 3-5th month could be a sign of autism or other medical issues.
Seek medical help to rule out possible causes if your baby has no eye contact by the 4-5th month.
Responding to sounds is the prerequisite of responding to name. Most babies in the US have a hearing test at birth which helps to rule out the majority of the hearing loss cases.
However, your baby could have difficulties hearing due to fluids in the ears, over sensitive hearing or other medical conditions.
Your baby should get startled by a loud unexpected noise from birth.
She should recognize your voice by the 2nd month and show noticeable signs of calming by the 3-4th months of age.
Your baby should respond to her name with a head turn and an eye contact around 9 months of age.
If your baby has physical challenges or pain her responding to your call will be different and could be delayed.
Look to see if your baby has challenges like weak or tight musculature, developmental delay, hearing issues and pain like teething, ear infections, colic ext.
Seek medical help if your baby is not responding to any sound by the 3rd month or if your baby is not calming down hearing your voice by the 4-5th month.
For your baby to make sounds, he needs to hear sounds. Your baby should start cooing around the 2-3rd month and babbling around the 5-6th month.
"Baby and mommy talk" is one of the favorite games of babies.
The first step is to rule out hearing issues.
If your baby is too quiet, it could be due to tightness or weakness in the mouth, neck, trunk, hips or the shoulders and arms.
Or your baby could be extra sensitive in or around his mouth or the ears.
Seek medical help if you notice any delays or challenges described with hearing or baby talk by the 4-5th month.
Imitation is also cognitive and social behavior skill.
The prerequisites of imitation are sensory processing like: proper hearing, good eyesight, good attention, good reaction and good body movements among others.
Imitation is one of our most important learning tools. There is even a saying in many languages around the world: “Monkey see monkey do.”
Imitation is the skill where your baby notices, assesses and recreates observed happenings - thus learns what she sees, hears, feels ext. and adjust her behavior accordingly.
Imitation is present even in newborns and is well developed by the 5th month.
When you smile at your baby, she smiles back.
If you make a pleasant sound, your baby tries to make a sound as well by the 2-4th month.
For example, lack of imitation could be due to poor hearing, poor eyesight, headaches, earaches, muscle weakness or tightness, delays in developmental skills and autism.
If your baby is not imitating by the 6-7th month seek medical help.
Looking into one direction or at one object for most of the time is a sign of some type of difficulty.
However, as you can see bellow, looking at a new object for 30+ seconds is one of the ways babies learn.
Staring at an object repeatedly for long periods of time could be due to poor vision, muscle weakness, muscle tightness like Torticollis or discomfort and autism.
It could also be that some of your baby’s reflexes are overpowering him.
Seek medical help if your 3-month old baby prefers to:
Not all rapid movements or repetitive behaviors are bad.
Remember, repetition, in other words, practice is the mother of perfection.
Imitation is a repetition of observed movement, sound, expression ext.
The problem occurs if your baby does not learn new movements.
Sometimes repetition occurs because your baby did not learn a new behavior yet and is practicing what she knows.
Or she has difficulty moving her body any other way due to muscle weakness or tightness.
Or she has a developmental delay, maybe autism.
If your baby is doing the same movements/ behaviors and does not learn new ones every 2-4 weeks seek medical help.
The ability to memorize and follow directions are significant milestones.
Look for these developmental skills to be well developed by the 18-24th month.
So why is it a possible sign of autism if your baby sings nursery rhymes?
Because repeating the songs over and over again could cause poor communication skills.
The main difference between being able to repeat nursery rhymes vs. single words is that words can be used for communication.
Not all “singing of nursery rhymes” are autistic behaviors.
A child could sing for joy or sing with you for fun. The “Happy Birthday” song is a favorite of 2-year-old's.
However, when your baby sings, she does not look into your eyes. Unless she sings with you or if she forgot a word and looks to you for help.
Thus singing is generally not used for communication.
When your baby is pointing, dragging you, speaking single words or 2-word phrases she is expressing her needs.
The good news is that singing nursery rhymes or baby songs are a sign of excellent memory skills.
But, if your baby sings 10 nursery rhymes, knows numbers, letters yet she does not communicate her need to you, she lacks a skill.
The skill of using her existing language to communicate with you.
Seek help if you have to guess what your 18+ months old baby wants.
Since communication is one of the other red flags of autism keep an eye on these skills from the first day you bring your baby home.
Some of your baby’s first communication skills are:
If pointing and babbling do not appear by the 10-11th month seek medical advice to determine the possible cause like: autism, apraxia, muscle issues and other medical conditions.
Babies and toddlers up to 3 years of age prefer to play in close proximity but alone. It is called parallel play.
Parallel play is a normal stage in your baby’s development. A more interactive play style should appear around the third year of age.
This does not mean that your baby won't interact with siblings, cousins, your pets or toddlers at the playground before she turns three.
It means that she generally won't play together with them for a prolonged period of time.
Babies prefer to play next to each other.
From time to time they glance at each other’s toys but continue to play solo.
If your 9 to 11-month old baby does not react to:
she could have difficulties with social interactions.
If your 12 to 15-month-old toddler does not go up to other toddlers to stare at them or take a toy away, it could show a lack of social interaction skills.
It is important to know that your baby’s personality traits and physical abilities could also affect her decision to play solo.
A weak child will choose to play alone and observe others from far to keep himself safe.
If you are worried about your baby’s social skills, seek medical advice latest by 15 months.
Playing is a combination of skills.
When a child plays, he uses a multitude of his skills and abilities.
His play skills are a representative of his understanding and utilization of his thinking, his physical abilities, his reactions and imitation skills among others.
Your best strategy to make sure your baby has age-appropriate play skills is to follow your baby’s overall development closely from birth.
Seek medical help if you notice that your baby has challenges with any skills mentioned in this post especially imitation, communication and eye contact.
This is a social interaction skill which is significantly affected by your baby’s surroundings and habits.
And it takes time to learn to be flexible.
Let's face it. Even adults like routines and schedules.
(More on that some other time…)
Routines offer predictability.
Thus babies thrive on schedules.
Keeping a routine with a newborn seems almost impossible. However, by the 6-8th week, you will notice that your baby is learning your family’s schedule.
HOW DOES YOUR BABY LEARN ROUTINES?
When your baby feels hunger pains, he cries to express his discomfort. Over time he learns that hunger, breast or bottle and the feeling of satiation are related.
In a few months time, he will also learn to wait and eventually ask for food.
The appearance of these skills is a good sign that your child will be able to adjust to changes later in life.
However, if you find yourself on your toes to avoid your 9-month-old baby crying uncontrollably because his feeding schedule is off you could have 2 issues going:
If your child is 7-9 months old and still cannot wait patiently for a bit late lunch your child could have difficulty with social interactions.
Don’t forget to rule out hearing loss and other possible medical issues.
Or you could be a micro manager, and it is actually you who is teaching your baby to become stressed if things don’t go as planned.
In this scenario, he might show difficulties with change when he starts school. When his environment is not controlled by only you anymore.
Even though schools try to keep strict schedules as well with so many kids in one place things can change fast.
And that could through your child off.
Other parenting styles could also affect your child’s reaction to change.
Most parents have difficulty hearing their baby cry. One of the strategies you might be using to calm your baby is distraction.
Distraction is very helpful to stop your baby from crying, but it is harmful in some other ways.
Let’s say your 18-month-old baby climbs onto the couch, falls off and hurts himself.
You quickly pick him up, asses his possible injuries and when you conclude that there are no major problems, you start to calm your baby.
If you calm him with a distraction, like:
“Look, a squirrel is climbing the tree!”-
- there is a much higher chance that he will forget what happened and why he hurt himself.
So naturally, when he climbs the cough again, he will not feel in danger what so ever.
But, if he is not distracted only comforted at the time of the fall he has to face his mistakes and challenges. This gives him the opportunity to learn easier and faster from his mistakes.
Distraction can be used in many situations and sometimes it is even useful.
However, if you notice that you are using the strategy of distraction several times a day, you are shielding your baby. Shielding is not teaching.
When your child goes to school, his shield (you) will be left home. Thus his dependence on you guarding him could pose difficulties with a change in his school routines.
Sensory difficulties are probably one of the hardest issues your baby could be dealing with.
Sensory experiences are present in anything your baby does and thus affect all areas of her development.
The origins of sensory issues can be hereditary, acquired, learned or both.
Some babies are born with very sensitive sensory organs – skin, ears, eyes, nose, mouth. Some babies are only sensitive in one organ, like their ears some in more or all.
For example, your baby could hear things louder than they are for you, feel the cold water to be icy, she could be blinded by a soft light source or taste the bitters in savory or sweet foods.
This extra sensitivity could be difficult or painful for your baby.
Naturally, your baby will cry if he is in discomfort or pain from a particular stimulus.
If something is repeatedly difficult or painful for her your baby will try to avoid it.
If you do not notice his extra sensitivity and do not adjust to it, he might turn into his own world to avoid “feeling” the stimulus from his surroundings.
For example, later in life, his strategy of avoiding “feelings” could cause your toddler not to respond when he is called.
And to make thing more difficult catering too much to his sensitivity could create a shelter environment. In this sheltered life, he will not have a chance to overcome his challenges gently and slowly.
In this scenario, his difficulties could appear when he gets out of your safety net.
Some children have difficulty processing sensory stimuli.
They enjoy and seek extremely strong sensory related activities.
The cravings for strong sensory stimuli arise from the desire to learn and understand “feelings”. Your baby could crave strong hugs, spicy food or super gentle ticklish strokes.
Look for signs of extra sensitivity in your baby from day one. Seek medical help if you notice any. Therapy is your best approach to teach your baby to overcome his sensitivity.
Unusual movements could have many causes.
It could be muscular weakness or tightness,
One of the most common and well known unusual movements and a possible sign of autism is hand flapping.
But it is also a naturally accruing stage in your baby’s development.
At the beginning of this post, I described a scenario where a 7-month-old baby was flapping her arms.
A young baby under 12 months of age could flap his arms because he is not able to differentiate his wrists from his arm yet.
So when he wants the toy in his hands to make noise, he has to move his whole arm to shake it.
Your baby could also flap her arms if she excited.
Exited to meet new people,
So at this stage in your baby’s development arm flapping is a natural way of expressing excitement, joy, his happiness... maybe even frustration.
Your baby doesn't have the emotional, the mental and/or the physical knowledge and capability to express himself and behave as we adults do.
Adults, despite the fact that they are very excited, are able to suppress their emotions.
Some of the adults can keep a “poker face” in even extreme emotional states.
Babies cannot do that.
Babies, when excited, are visibly happy. They might squeal, shake and flap both their arms and their legs to express their joy.
When a same age autistic child is excited or stressed he will tend to move his wrists or his forearm in a fast, swirly repetitive motion, not his whole arm.
That's why it's called a hand flap, not an arm flap.
This brings us to the end of the list.
And you are still reading!?!
Hashtag # I rock! - in the comments below to inspire others!
I congratulate and thank you for taking the time to learn about infant development.
If you made it this far in the post, you are a mom to be proud of!
You are the hope for your baby and the catalyst of our healthy next generation!
I thank you for that!
Now that you know and understand the signs of autism the natural next question is:
The best route is to seek medical help. As soon as possible.
Start therapy “yesterday” to help your child learn easier and faster.
You see the best teacher for your child, is you. The person she knows and trusts the most.
Taking your baby to therapy is a crucial initial step in her recovery.
The best approach, however, is to continually educate yourself in child development and the arts of therapy.
And to make thing even harder you need to learn to stay a mother and be a therapist at the same time.
It is a daunting task.
My attempt with this blog is to assist you along your journey.
It can overcome almost anything.
Use your child's diagnosis as a guiding list not a sentence of imprisonment.
And most importantly,
please, please, – p l e a s e -
permanently wipe out from your mind
the inadequate feeling of guilt.
As my dear friend said; the best advice she got when her son was diagnosed with autism is to focus on teaching her baby. Avoid worry and mulling over the hurdles ahead even though it is close to impossible.
At the time of the diagnosis, her child was non-verbal. Today he still has some challenges, but he is in college, works part-time and is searching for the love of his life.
If your child is diagnosed autistic or developmentally delayed I would like to suggest for you to become part of the pioneer movement:
The best approach to help your baby is to educate yourself about infant development and keep records about your baby's development.
With intention, a vision, a clear goal, patience, persistence, daily repletion, and a joyful firm belief in your baby, in yourself and the universe anything is possible!
As always, enjoy your baby and motherhood.
See your baby (babies) as a gift for you to love and cherish.
The information presented here cannot substitute medical evaluation, medical diagnosis or medical treatment. All and any content in this article, blog post and on this website: BabySmileStones.com, including any and all medical and physical therapy opinions and any other health-related information, is for informational purposes only and should not be considered to be a specific diagnosis or treatment plan for any individual situation. Use of this blog, site, and connected site: AgotaRakoczi.com and the information contained herein does not create a physical therapist-patient relationship. Always seek the direct advice of your own doctor and your baby’s pediatrician and physical therapist in connection with any questions or issues you may have regarding your baby’s health and development or the health and development of any other baby.
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