Autism in babies…

[PillowTrout]

My DC is diagnosed autistic and ADHD. Since then, I’ve become very interested in researching neurodiversity and have made friends with many parents of SEN children.

One thing I find interesting is symptoms in infancy. Most health professionals agree that you cannot reliably recognise or diagnose ASD or ADHD until around age 2. I have always maintained that I didn’t notice any symptoms until my DC started primary school, however, since talking to many parents I have found that most of our children exhibited one of the following extremes as babies:

• Extreme passivity as infants. Being too ‘good’. Happy to be left alone for long periods, not crying much, often sleeping through the night from an early age. Appearing very content, but with hindsight, a symptom of not being particularly bothered about interaction. Not particularly bothered about being left with new people, just generally appears very laid back.

OR

• Extremely unsettled as infants. Crying excessively, very clingy, not sleeping well or at all, sensory issues clear since birth. Often not feeding well. Just being generally very hard work. Often described as being very difficult to pacify.

I haven’t met many SEN parents that report average development or behaviours in infancy. It always seems to be extremes of behaviour, although at the time, it wouldn’t be recognised as too abnormal - just a particularly difficult or easy baby. It’s only with hindsight that these are noticed.

Another observation is milestones reached late, or too early. The too early group I find especially interesting as I feel this is under reported. Those in the early group put this down to their DC just being ahead, or strong, or intelligent. It’s certainly true for my DC - they were crawling by 5 months, walking by 11 months, and talking fluently by 18 months. I always assumed that because they didn’t meet milestones late, they were fine and couldn’t possibly be autistic… but this extreme of being so early on certain milestones I see in hindsight could also indicate ‘abnormal’ development.

Interested how many people identify with anything I have observed.

Same as @Spitalfieldrose! Both mine never slept, and when I say never, I mean 15 min cat naps only being held. Literally would not be put down. People didn't believe me. It was horrendous. We didn't sleep for about 3 years, they started doing longer stretches of 2/3 hours, thank god. We only had a second because we'd figured the second baby couldn't possibly be as bad a sleeper as the first...we were wrong - she was far, far worse. I was desperate for advice and then I discovered the term 'high needs baby' which did help slightly.

They were both delayed (but only slightly) in terms of major milestones. Biggest flag was my eldest refusing to feed himself til he was almost 2 and would not be toilet trained until 5-6. Both still not dry at night now and are always unsettled sleepers. I was always told y the HV and GP it must be something I was doing wrong

ASD runs in their dad's family so I did always have a feeling, but literally nobody would listen to me. Once they started school, they both behaved perfectly because rules/routines suited them, and academically they could scrape by, so nothing was ever flagged up.

They both now have a diagnosis of HFA and need referrals to SALT.

It is interesting.

I know a baby like this. 13 months. Doesn’t talk, at all. Doesn’t babble. No waving, no pointing, no clapping. No social smiles. If you say his name he does not turn around - yes he can hear fine as he turns round to the TV on his terms. Very interested in items that spin, zips, remote controls. Meets all physical milestones. Does this sound like ASD to anyone?

I suspect that I am autistic and am waiting for an assessment and so am quite alert to DD (18mo) milestones and behaviours and will seek out a diagnosis for her as soon as I notice anything in particular.
She was a very calm baby, only cried for specific things like food or if extremely tired, but I wouldn't say she was passive. She also didn't have a very irritating cry, it wasn't an unpleasant sound, and I have noise sensitivity.

She hit her milestones bang crawling at 7mo and walking at 13.
However she is a little slow with talking, she understands everything said to her but mostly communicates by pointing and gestures still. She also clearly has some sensory issues.

She was also very easygoing about nursery apparently she didn't cry at all there until about 3 months in when another child hit her. She recently stayed at my mother's for a few days whilst we were on holidays and she behaved like an angel there, slept better than at home.

It's still too early to tell anything. Some behaviours are normal for toddlers but resemble behaviors in autistic children.
But this thread is interesting.

@endlessperiods This is what I am talking about - it’s the extremeness as you describe here. I’d be interested in hearing more about the NT babies who have been described as ‘too good’ or ‘hard work’ by others on this thread.

Were they as extreme as described in @endlessperiods post? Or mine? A baby who I can only recall crying once and would literally be happy to spend their wake windows in a room or on a play mat alone for hours?

My eldest is awaiting assessment for autism and ADHD. She was an early talker, full sentences by 18 months and an incredible memory for facts and long words.

Yep, loads of signs were there - DC 1 autistic - totally passive, easiest baby ever. Wouldn't stand, walk or crawl. Learnt to count, read etc at a very early age.

DC2 - ADHD - total opposite, very demanding and very sociable. Constantly had to be held and engaged with people. Loved food, huge appetite but couldn't focus long enough to get enough into him, either milk or at the solids stage. Was nearly failure to thrive at the newborn stage because of this. Weeks of constant hunger screaming but bored after a few minutes - rinse and repeated all freaking day long!

So yes, signs were there from the beginning, even in the womb - first barely ever moved. Second had me in a lot of pain from constant kicking downwards!

Of course you can only see it retrospectively when all the dots join up.

Not quite the same thing in terms of extremes of milestones but I stumbled across this article a couple of weeks back about different patterns of movement in babies that went on to be diagnosed with autism. They compared videos of babies rolling, crawling, walking etc and noticed atypical patterns in autistic children. It was really interesting to note that there were physical signs there much, much earlier than the social signs.

It's now quite an old article and I would be interested to know if there was further research done to determine if it could be diagnosed earlier or if it was too small a study to warrant anuthing further but I found it quite interesting: https://www.pnas.org/doi/full/10.1073/pnas.95.23.13982#:~:text=Autistic%20Children%20May%20Show%20Deviations,forearms%20rather%20than%20his%20hands.

@Wrongsideofpennines I have seen this before, it is very interesting. It’s a shame it was such a small study and there doesn’t appear to have been any follow up. I can’t say I noticed anything strange about my DC’s movements, nor did anyone else ever comment on it, but then again I wasn’t looking for it. The earliness in achieving the motor milestones I do wonder about. My autistic and ADHD DC was crawling at 5 months. I have another DC, who is currently 6 months, and I take them to baby groups. The babies in their age group are getting steadier with sitting with support, being able to straighten arms during tummy time and rolling over. None are crawling, even the ones who are 6 months. So now, with hindsight and a second DC, I notice how unusual meeting that milestone at 5 months was.

DD1 screamed all night long from 12 hours old until 12 weeks old. She would only stop if she was continually slapped hard and rhythmically on the back.
When she was 4 months old, I used to sit her in a bouncy chair with toys over the top of it at 3 am.
She was late to meet milestones. No reaction to being left in a room.

This is really interesting. My son (now 14, ASD and ADHD) was such a delightful baby. Like yours, he slept and ate well, reached all milestones early. Was walking well by 11 months. Speaking in complex sentences by 18 months. We just assumed he was smart (and he is - diagnosed as gifted either a v high IQ). He wasn't diagnosed until 5 for ADHD and 7 for ASD. His social communication difficulties are a lot more apparent now at age 14. But I have a lot of friends with autistic children whose babies were really challenging - lots of allergies, colicky, unsettled babies or just didn't need to sleep. They tended to be diagnosed earlier than my son and now have more challenges with this autism (though this is totally anecdotal).

I don’t know - my second child was extremely extremely hard work. Almost impossible. Your second description. And she’s NT.

Babies can’t display many behaviours because of their limited body control. And lack of Language.

Thanks for that study, wrongsideofthepennines - it is interesting. My ASD son definitely did the unusual crawling method of one leg on one knee but kind of dragging his other leg. And now has the distinctive ASD walk / gait.

We were wondering when dd was 9 months. She was a demon baby. Wickedly smart, but barely slept and screamed if everything wasn’t perfect.

I can look back in retrospect and it’s so obvious all the things that were related to her autism.

I have two NT children - one was super easy/chilled and one was pretty hard work. And a ND child who was somewhere in the middle - generally jolly and a good sleeper but needed to be held and fed a lot.

I have an autistic son and an autistic daughter. Son screamed pretty constantly for the first three years. I raised concerns in his red book when her was six weeks old that something was wrong. He slept between two and four hours in 24. If he napped for ten minutes during the day you could guarantee he wouldn't sleep at all overnight. He was dx at 2 and a half and has never slept through the night and he's almost thirty.
Daughter was dx the week of her second birthday. She was nothing like ds, I told myself I wouldn't look for autism but I was worried at 4 months because she was too quiet and too solemn, very worried at 8 months as she made no efforts to get her needs met and knew she was autistic by her first birthday and she was referred to a paediatrician at 13 months and referred for a multi disciplinary assessment at seventeen months.

This is interesting to read. My 8yo DS had a slightly above threshold score on a screening questionnaire for autism recently and we've been advised to have further assessment.

He was walking completely confidently at 10 months old. Other milestones all a little ahead or on target. But he slept really badly for years, waking every one to two hours for years. He would also sometimes wake in the night but seem not really there and scream-cry for 2 or 3 hours, and the same waking from naps sometimes. I remember at 4 weeks old my mum, who is pretty reasonable, said "he's a very high needs baby" and I just thought she had forgotten the newborn stage.

He has always been really anxious and had awful separation anxiety, to the point that the reason for the screening was it was part of us working with a professional for help getting him into school. He has disliked being away from me his whole life, crying every morning for nursery for two years and then most mornings throughout infant school until year 4 really when he was given a special way to enter school that didn't involve the crowds in the cloakroom first thing.

He often uses almost extreme silliness to avoid demands, smiles and laughs when being told no or apologising....

But he can be quite empathic and tuned into people, he's sweet and funny and lovely and achieving fine at school. I can't decide whether to do the full assessment or not.

Yes, mine was ultra chilled out as a baby. I thought she was a good sleeper until I realised that although I'd put her into the cot asleep and then she'd wake up and lie there in total silence. No peekaboo, no social smiles, no apparent need for cuddles and didn't seem to like them, didn't ever meet my gaze when feeding and no response to name. It was a classic, lights on, nobody home.
Come 13 months and everything changed to the total opposite. No speech until 3.5, barely slept and generally caused hell. She developed obsessions, had the need to line things up and has absolutely no empathy.
I knew deep down that something was off with the eye contact and lying in the cot and it just became more and more obvious.
I would say, despite all these things, she is an absolute treasure and I'd not change anything. All children are different and its lovely to see my DDs character and personality emerge, even if it is a little strange at times.

DD doesn't have a diagnosis but is on the referral pathway on the recommendation of her childminder.

I suspected prior to the childminder suggesting it. It wasn't one stand out thing but lots of little differences from other babies and toddlers.

Very high needs. Like, oh my goodness we needed to anticipate her every little need before she even knew what it was.
Very unhappy and unsettled baby.
Has always struggled with routine changes.
Sensory defensiveness when we started weaning, struggled to eat a lot of foods.
Early talker, sentences at 18 months and lots of vocabulary. Heard a word once and remembered it. People commented on her speech a lot.
Never stops talking, it's like a compulsion.
Terrible sleep.

She's in reception now. Still struggles with sleep. Still very high needs. Most of her peers have caught up speech wise. It's becoming more obvious that she struggles socially.

It’s easy to say with hindsight but I knew there was something with my DD1 from very early on. Extremely noise sensitive from birth, poor sleeper, extremely unsettled. She got happier the more mobile and in control of her own environment she became. I ‘joked’ that she was hyperactive. Hit all milestones and no issues with communication but she was extremely wilful and wild. Diagnosed ASD with SPD at 8.

So was mine though, from 10 months. She just got up and walked one day. She's not autistic.

Just remembered, she didn't crawl and went straight to pulling up and cruising.

I read recently this can be due to ASD in some children and the inability to coordinate both sides of the body required to crawl?

Sorry if you’ve already answered but why did you think this out of interest, and if you do t mind sharing of course? I have a similar aged baby.

@Rectanglelights It’s so interesting, isn’t it? It’s really been since having another DC who is more typical and meeting other SEN parents that I have realised how unusual my neurodiverse child was in infancy.

My DC was very quiet too. They never cried when they woke up. Didn’t babble very much or make much noise, ditto the lying silent in the cot comment. Also, very happy to entertain themselves for long periods of time from too young really (1 year old). Though they were a smiley, happy baby who laughed a lot. But just far too independent and chilled out. Didn’t seem to rely on me or need me, if that makes sense? To be honest I was quite smug, I just thought I’d cracked parenting! People would often talk about how hard they found their babies or a certain stage, and that hard stage never came for me. Parenting was a breeze. However, it has got much more difficult as the social communication gap has widened as they approach secondary school age.

The links between prevalence of gut problems and ND may well explain why some babies are very unsettled from birth onwards. My daughter wasn’t diagnosed with adhd and sensory issues ‘til in her teens ,so very late ,we never had an inkling til then … but I had very unpleasant experiences of going to baby groups as she’d just scream continuously.

@KnickerlessParsons I think it’s the bigger picture being built with all the smaller pieces in combination.

The hitting milestones early, being so advanced with walking and talking so early, the extreme passivity and independence. Taken together, it all adds up to an unusual and atypical profile.