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.

Where's your control group to compare this and data?

I think this is just confirmation bias being fed by validation and belonging.

Your observations - whilst interesting - aren't reliable, valid, credible or generalisable.

It’s not that there are no symptoms before 2, it’s that totally NT children can display many of the same “symptoms” but will grow out of them, whereas with ND they usually become more obvious with time.

@freezefade I am not saying they are. There definitely needs to be more investigations done into whether autism / ADHD / neurodivergence can be identified in infancy, in order for children to access support earlier. My DC wasn’t diagnosed until 7, so missed a lot of this early intervention and support.

As a SEN parent, you become fanatical about researching and understanding your child. You also mix with a lot of parents of neurodiverse children. Far more than the general population. I found it an interesting pattern. Almost all parents I spoke to, without exception, had these ‘extreme’ babies. So I wondered if this trend continued with a wider net of people - hence the Mumsnet post.

there has been lots of research into early detection of autism - look up work from Klin - the title is 2 year olds but the study includes much younger kids
https://www.nature.com/articles/nature07868

and also the Basis Network
https://www.basisnetwork.org/index.html

My quick summary of the field (I do related research) is

• there is no reliable way to tell if a child has autism before age 2 and some say you can't really tell before age 5
• many kids who have autism also have other learning difficulties or developmental delays. those might be apparent at an earlier age, but the things you notice are not specific to autism
• all kids can and do learn and should be supported to learn. especially if there are signs of delay, then it should be possible to support kids & families regardless of diagnosis.

All exactly like my ds awaiting diagnosis

Ds was like your first description and dd like your second description.

I've spoken to lots of different parents who's children were one or the other descriptions you've written there too.

The research is wrong. Us parents know. I knew with ds when he was 1 that he was autistic. I remember googling signs of autism in a 4 month old. I've always known from when he was very young.

With dd I knew at 2 and she was diagnosed at 3.

Both my children hit their milestones. No early help whatsoever for ds even though I asked everyone to look into this. He was diagnosed at 8 after years of me pushing and arguing with everyone who wouldn't help us. We went private.

I have three children.

Dd1 was a "textbook Gina Ford" type baby - sleeping through the night from about six weeks, always content and didn't cry very much - so good in fact that my MIL used to say "You don't know you've got that baby do you?". She is Neurotypical.

Ds was not the greatest sleeper, but not awful either. He probably started sleeping through reliably at a year old. Didn't like being put down - preferred to be held. He is Autistic.

DD2 is the one who I have always said if she was born first, she would have been an only child! She screamed for hours on end at night and only took catnaps during the day. Constantly wanted to be held. Needed rocking, patting, shushing, white noise for hours on end sometimes for a whole 40 minutes of sleep...... She's just been diagnosed with ASD and ADHD at the age of 12

My dd was your first bullet point very laid back never cried (not even for a feed)slept from 6.30pm till morning I had to wake her for feeds could happily just leave her be and wouldn't hear a peep from her, starting walking at 11months.

Dc1 was mostly the former. Hardly ever cried but when he did get upset, he'd bang his head off the wall/furniture until you stopped him. Was speech delayed. Walked confidently by 13 months (capable of at least a mile). Never commando crawled. Normal crawled around 6/7 months. Has issues around food. Was late to toilet train, skipped the potty stage entirely and went straight to peeing standing up.

Dc2 was the latter. I couldn't put her down without her screaming at me. Took until she was 4 til she slept through the night. She was a confident walker by 12 months. Crawled by around 6 months. Was also late to toilet train (3) and then just switched with no accidents whatsoever.

Both had "obsessions" from an early age. Dc1 discovered (Admiral) Nelson at 3. I've spent more time on historic ships than I care to admit. Ancient Egypt, Titanic, Volcanoes, Rain Forests, Shipwrecks, Pirates, Kings & Queens, Drowned cities and European conflict from 1914 onwards are all things they've been focused on and they're currently 5 and 9.

Both are very rule focused with perfectionist tendencies.

According to the HV, GP and the school, neither are ND. Must admit there are distinct similarities between them and me/dh (lack of sleep, interests, food issues/pursuit of perfectionism).

DS1 was very chilled, would sleep anywhere and talked and walked at about 14 months. DS2 was a pain and cried a lot, walked at 9 months and is super bright. Both are NT

Well son was dx at two and a half and daughter dx at week of second birthday through multi disciplinary assessments. Their diagnoses were as right then as they are now. Both their assessments included six weeks attendance at the SEN nursery at CDC so that they could be assessed and observed by the assessment team. Ds was referred to paed at 17months and dd at 13 months so GP obviously noticed difficulties, Paed referred ds for assessment at 2 years old and dd at 17 months. He was confident after chromosome and metabolic disorderschecks came back clear that they would get autism diagnoses.

ADHD isn't diagnosed that early. It's usually around 6.

My adult son was diagnosed at 3. I remember him being a “difficult” newborn but by about 4 months he was the easiest child ever. If I sat him in front of the TV he’d stay there until i moved him. We barely knew we had him. He had very little interest in us or anything around him though . He was very early with physical milestones. When he started waking at around 11 months he just got up and walked. He never tripped or fell over. He’s mid 20’s now and i don’t think he’s ever fallen over. He’s severely autistic and non verbal but was very easy, no behaviours until he reached puberty when it all went to pot but that’s another story!

My son’s assessment was like that. He was referred at 18 months, we did various appointments with paediatricians, a salt etc . He had blood tests and a hearing test. Around 2 1/2 he attended an assessment centre every Thursday for 11 weeks then a multi disciplinary meeting with all HCP’s to confirm diagnosis.

DS1 was a happy baby. He always looked like he was studying things and absorbing what was around him. He woke frequently for feeds but was easy to settle with feeds. Bottle refuser, only had milk directly from source. (It turned out that he had CMPA and other allergies and intolerances) Would only go to sleep in the pram/ car/ crashing out.

His mood changed at 10m. Partly learning that "no" meant that he wasn't having his own way, and would respond by looking at you, howling and smashing his head on the floor. The first time he pulled up to standing, he realised that he was stuck then howled. He was a proficient crawler and despite at 12m being able to cruise, he did not walk unaided until 16m, then just walked across the room. He was also very impressive at reverse crawling.

At 18m I took him to the pet shop on a grotty day to look at the animals, and he stared at the ceiling fans. Loved watching the washer. At 5 we ended up in a silly stand off of him choosing to sit in the utility room for 2 hours rather than tidy for 5 minutes. The only easy thing about him being 2 was watching Thomas/ Fireman Sam DVDs on loop for hours (I was having a tough pregnancy/ recovery). It took a couple of years to really suss out his clothing preferences and reach a happy state of picking our battles.

He had a speech delay by 2. Did lots of pointing and grunting, then rolled his eyes at me when I got it wrong. Had SALT intervention from 3. Played side by side until 6. Would do his own thing at parties. Was generally liked at primary school though.

The "terrible twos" went from 10m until 5. 6 was nice... then SATs and the 3-4 hour meltdowns at 7. That's when I went to the GP and he was diagnosed at 9.
There were quite a lot of early traits but not glaring klaxxons. It took time to really build up the evidence.

TBH, I'm not 💯 that DS2 is NT. There's quirks that he's had since being a baby, and he's so much like me... which doesn't convince me either! I don't feel that the evidence is strong enough to get through the gatekeeping for assessment, but that doesn't mean that he isn't.

All of mine were walking by 10 months and they all have adhd (2 diagnosed, 1 on the pathway) early talkers too. As was I and I am also diagnosed adhd.

ASD dsc also walked and talked early, but their "symptoms" for want of a better turn of phrase were completely different apart from those 2 factors.

In my experience most people describe their baby as 'good' or 'difficult'. I don't know of anybody who says oh yes my baby is average. So many generalisations and people with good or difficult babies who turn out to be NT and the opposite. I was apparently a very good, passive baby. Didn't walk until 18 months. As far as I am aware I am NT.

I have an autistic cousin who was diagnosed at the age of 3. I suspected it from when he was 12 months - one of the things that alerted me was sensory seeking and sensitivities that he was displaying.

Interesting, I hadn’t realised that early milestones were also an indicator, I thought it was only delays. My DC was a very challenging baby, really didn't sleep much and screamed a lot. They crawled at 5 months and got up and ran at 9 months! Way before my other DC’s. There were very physical, had no fear of anything, trying to climb out of windows etc. They also talked early and put sentences together. I thought that I had a very bright child until they started school and from then on I was told that they were behind. They weren’t diagnosed with ASD until teens, after being assessed a few times, and being misdiagnosed.
However, my first DC was incredibly well behaved. They slept incredibly well and, even as a baby, I could go anywhere with them and they wouldn’t be screaming or fussing. They are NT so I am not sure about this theory.

My DC who has an autism diagnosis fits with the extremely passive as an infant description; this DC never cried or fussed, even when hungry!

You'd guess roughly when they wanted to eat, and they'd slug down all the milk on one go, but never cried for it, or got cranky without food. Same with dirty nappies, although to be fair they are still the same, but in a specialist primary school for DC with autism and is mostly non-verbal.

Hmm, my two neurotypical kids meet your criteria above though too??

I think you could apply those to most babies

@JPGR @Tooyoungto @coxesorangepippin

It’s the extremes of those descriptions that I am referring to. Lots of parents would describe their baby as ‘good’ or ‘hard work’, but were they as extreme as the descriptions provided here?

One poster describes her child not sleeping for more than 15 minutes and needing to be held constantly. My DC was so ‘good’ that they cried only once as a baby and was happy to spend hours on a play mat or in a room alone from being a very young baby (this behaviour never changed, they are now 9 and still spend most of their time alone pursuing their own interests).

So they may use the descriptors in my OP, but it’s about how these behaviours or traits are displayed in excess.

DSibs and I had 4 DC between us within a short space of time. The DC with autism was noticeably different from the word go, and extremely passive.

After birth he showed little interest in feeding, which had no physiological cause. He never engaged with faces, or went through the stage were they track their hands. At 3 months we were all saying there was something significantly different about him.

He was later hitting all of his milestones, but also because he was so passive he was happiest just lying down in his crib. In that context the late milestones, isn’t a surprise. You can’t learn what you don’t practice.

He was very later to talk. But could say and every street name within a certain radium from his house.

He only received his diagnosis in Yr1 when he was moved to a school with a specialist unit. He is doing really well there.

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. This was my eldest to a T. Her brothers fit neither category as babies. DS had trouble feeding and sleeping, but he wasn't a patch on DD. His behaviour went off the rails at 20 months, really felt out of nowhere. Youngest didnt really see anything till he was 3, and then only because by that stage his older brother had been diagnosed and I could see the similarities. All 3 are Autistic and all very different people, with very different behaviour as babies and little kids.