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.

I am autistic and the main symptom my family report is that I never smiled as a baby. There may have been others but they are too fixated on that one to tell me what they are.

The more I read about autism the more convinced I am that it's a handy label slapped on SO many different experiences. The young people in the Chris Packham documentary were all so very different that there must be a huge variety of conditions in play.

Yeah. That might be why it's called a spectrum.

@PillowTrout Think there are issues with the blanket term ‘autism’ as it’s an ever broadening spectrum these days and therefore any behaviour in hindsight might be interpreted as an early sign of an individual child’s autism. I’d like to see them break down ‘ASD’ again into specific categories again - my eldest DD was diagnosed with the now rejected aspergers label plus ADHD and is typical of this category within the spectrum; youngest DS has autism with a high anxiety index rather than ADHD (but as a tech nerd, I suspect the borderline QB score means he might still be ADHD). I think DS is more Aspie, but it had been removed by the time he was diagnosed. They are incredibly different in their issues and presentation, but there will be a sex/gender aspect to this imho.

However, baby experiences were near identical. Both were in the second camp of behaviours you mention - couldn’t latch/breast feed - DS because he was couldn’t get enough milk/quickly enough, the other just couldn’t; colicky (my youngest cried from 12noon to nearly midnight, non stop); both lactose intolerant and still as teens prone to gastric disturbances; crawled by 4m, walked by 8m (apparently this means they may have missed a cognitive window that longer crawling periods create); both late talkers - a few words at 14-18m; speech therapy by 2.5yrs because couldn’t pronounce all the sounds properly and were still reluctant talkers (not the case now, as we get veritable TEDTalks when they get started on pet topics, vocab beyond their years [eg 15 level by 10yr] ); DD was a problem sleeper (still is) and cry down method was traumatic for all of us, DS would sleep all day if allowed - still would at nearly 16) neither really engaged in small world play or role play preferring independent play and were happy puttering about on their own; we were asked to leave ‘music with mummy’ as DD wanted to stand/walk and play her instruments, not be forced to sit on my lap. Personally I couldn’t see what the fuss was…

However, in hindsight, compared to my NCT group experiences my children were different from their peers even then. I often wondered whether the cluster of behaviours - not latching, colic, early crawling/walking, late talking if taken together - ought not to have been little pink flags on the developmental charts? I’d love to feed into a research project if anyone was doing one on this topic. I think the earlier ASD is identified, the sooner children and parents might get support, and the better the family experience and child’s outcomes. Have had to fight even for assessment and was fortunately enough to be able to pay for this privately after 4yrs on CAMHS and no appointment date in sight.

Sorry - can now see this was a long reply (yep, am also ADHD…)

I read the header and thought, nah, all babies are on the range of very easy to very difficult, you’re just getting confirmation bias.

But for what it’s worth, DD 1 was such an easy baby and hit all her physical milestones early (walking properly at 9 months, rode a bike first time she tried age 3) but slow on talking and potty training. DD2 didn’t sleep through until she was 3, didn’t walk until 22 months, couldn’t be put down and was constantly on the nipple. She had eczema and food allergies from when she was tiny though, so we put the sleeping and discomfort down to that. She was diagnosed aged 16.
We have never sought diagnosis for DD1, but has a significant range of autistic traits, all of them the opposite ones to her sister.

It would be interesting to see some proper research on this.

Didn’t take long for the ‘autism is a label’ bs to come crawling out of the woodwork. Autism can present differently in every person, some with and some without additional learning disabilities and delays. The fact is, there is still a strict criteria to be met for someone to be diagnosed with this disability.

Again, the fact that it is a social/communication disability that can be masked in the early years is what gives people like you the idea that some young people don’t need a ‘label’ if they seems adequately ‘with it’ to you. When these people fail to thrive/function in adult life, especially as they get closer to middle age, it’s the same people who are absolutely confused because ‘you did fine at school/uni’ 🙄.

Interesting thread.

Hmmm I’m not sure. I have two NT babies. Oldest was talking in full sentences by 18 months and walking by 11 months.

My nephew is autistic. He fits the passive baby description you made though.

So I think you can’t use these markers as it can go either way.

As is frequently said, neither of these descriptions are absolute.

I’m also not sure how helpful this poll will be as it seems a lot of the replies are from parents of autistic children who agree. But you would need the equivalent number of parents of NT children to respond to the poll to get a clear picture.

There's the phrase ' when you meet a autistic person, you have met one autistic person' the spectrum is so diverse and individual.

My 2 1/2 year old is currently being assessed for ASD. He isn't an 'extreme' baby behaviourally I.e very good or a nightmare. But what is a key observation in his development is that he is globally delayed in all of his milestones and crucially his communication skills would seem ND. He doesn't interact in anyway even acknowledging existence of his peers or siblings. He has little to no verbal communication. He has digressed using words, shows some non verbal cues such as pointing but only to key people in his life. He has a strict routine he created himself and behaviours which are repetitive like closing all doors, to expressive gestures to emotions such as rocking to display happiness.

His approach to communication has been the greatest indicator. But what I found interesting was an article someone posted earlier on about delayed gross motor skills. Some of the descriptions did link to my son.

I think it's so difficult to diagnose early on due to the immense number of indicators. I was reading a Mary Sheridan milestones book and the list for features of ADHD or hearing loss were finite, however the list of autistic indicators filled a page!

My instincts are agreeing with you OP and generally ND children will be more likely found on the extreme ends of behaviour rather than middle ground.

A bit too outing to go into detail, but when your 18month old child warms their own food up in the microwave along with a beaker of milk, then I'd say that was slightly out of the normal range.

Yes, mine was the second type - didn't sleep (in fact didn't sleep through the night until 6 years old and even now at 9 still struggles to sleep), did not eat, lost loads of weight as a newborn, weaning was a complete nightmare, sensory issues from day one (hated hats and socks), very clingy - could not be put down Just generally very hard work as a baby compared to peers. She was also 'advanced' in terms of development - was the first in NCT group to sit, roll, crawl, walk, and was talking very early - subsequently hyperlexic. Looking back it was clear from very very early days. Diagnosed age 8 but on waiting list since age 6. Of our NCT group there were two that did not sleep, could not be put down etc and the other one has since been diagnosed with ADHD. I'd love to see some research in this area.

Both of my DSs have ASD.

Ds1 diagnosed at 14yo after me recognising indicators and pushing for assessment, nobody at all (including my DH) agreed with me, but he was well within the range for diagnosis. Also has dyspraxia. He needed lots and lots of attention took as a baby, needed me to talk to him or stimulate him all the time, slept pretty well from 3 months, weaned very well, was super sociable, but has always hated sudden noises.

DS2 diagnosed at 3yo and it was a slam dunk, very obvious. But he was a run of the mill baby, definitely cried (but not as much as DS1), slept well, but not as well as DS1 (through from about 5 months), could stimulate himself to an extent as a baby, fine with noise, weaned well, fine with all types of clothing. He just didn’t meet his milestones in terms of receptive or expressive language, and it became clear that there was a difficulty of come nature. As a baby though, he was run of the mill, right down the centre.

I would love to see some sort of study done on this. It is correct that we need a similar cohort of parents of neurotypical babies to report infant behaviours and temperaments.

Although anecdotal, it does appear that a lot of the parents on this thread with autistic children, did experience one extreme or the other. This is also the case with my friends who are SEN parents.

I do maintain that I believe it is the degree of the passivity or unsettled behaviours. A few parents of neurotypical children on this thread have reported their babies were very passive or unsettled, but I would love to hear a list of behaviours and how marked it was. For instance, on the passivity end, which is what I have experience with, can parents of neurotypical children identify with the following before one year of age:

A baby who is so passive they seldom cry or make their needs known. Appears very content as they are very quiet and unbothered. Happy to be left alone or to do their own thing for extended lengths of time (1 hour +). Sleeping for great lengths of time, but even when they have woken up, so quiet in their cot that they do not alert anyone. Not bothered about being looked after by strangers and never experienced any wariness of others - attending nursery without a second glance, for example. Can be taken absolutely anywhere without any fuss or change in temperament, just passive 24/7.

I think there is a good natured baby, who could be described as quiet or passive by their parents, but I’ve not met any parents of neurotypical children who would describe their infant as the above. I have met lots of parents of autistic children whose children match that description.

@rumbanana That made me chuckle. My DC knew how to operate the microwave from a very early age too, including removing the metal cutlery so the microwave didn’t set alight!

I recognise a lot of what you've put there in all three of my children, and in myself, as my mum always says I was a very chilled baby.

None of us are autistic. Honestly I think babies are all different and musings like this do nothing accept give parents neuroses.

My son was bloody fantastic as a baby. Compared to first son, the whirlwind, he was so calm and happy. The occasional rocking could have been a giveaway. But autism wasn't mentioned until he was 8.
He only started his terrible twos at three and I'm pretty sure it was brothers influence.

What behaviours do you notice appearing around the 15 month mark?

My son was diagnosed at 2 I wouldn't say he perfectly fit into either of your descriptions.

He was very content but not a good sleeper. He loved to be with me and his dad but no others. Very smiley and cuddly. He wouldn't copy or mimic. Loved food, this declined from the age of 2 and he is now very restrictive. Always attracted to films and animals on TV. Sensitive to light and sound but sensory seeking with touch. Always laughing.

My dc were the same as yours if not earlier learning to walk but are NT. There is a reason that diagnosis happens later and that's because babies reach their milestones at different times.

Exactly!!😆 That's exactly the kind of information that he would soak up, no need to ever be reminded of again.
And I never even thought to doubt him, because I knew that once told he'd consistently remember.

As he grew though, and it took me ages to realise this, I had to remember to be very careful to watch what I said, because a seemingly small, insignificant comment, said in the spur of the moment, could be taken as a "rule", and I'd realise years later that he'd not been doing things because I'd once mentioned in passing to be careful.

Does PDD - NOS (I think that's what it's called?) still exist as a diagnosis or is everyone just given a diagnosis of Autism now?

I'm not sure why everyone seems to be coming up with quite frankly weird theories about Autism. There was one about sleep on here a few weeks ago too. I'm sure the only known cause is genetics.

My DS is NT. He screamed for hours from day one. Never slept through the night until he was a teenager. Walked confidently at ten months. Huge vocabulary at his first birthday, rode a bike without stabilisers at two and taught himself to read at two and a half.

My DGS is extremely ND. He screamed for hours on end. Still doesn't sleep in his teens. Walked at fourteen months, but on tiptoes. Had a good vocabulary, but it was all echolalia. He could reel off the entire script of his favourite shows, but still finds holding a conversation difficult. Still can't ride a bike or understand money, but his written work, which is only on his obsessive topic, is perfectly literate with the correct use of semi colons etc.

I believe that it's almost impossible to diagnose before two and a half when autistic traits become very noticeable.

Severe autism can be suspected from 12 months possibly younger but higher level forms may not be noticeable until much older. So it's how long is a piece of string territory

@TigerRag This isn’t a weird thread relating to a theory of the cause of Autism. I remember the thread you are referencing, whereby the OP theorised that lack of sleep could potentially cause or exacerbate Autism. I agree with you that in most cases, it is genetic, and one of the parents is clearly neurodiverse.

I am musing over whether or not you can identify Autism / ADHD in infancy. For example, an extremely passive or unusually unsettled baby, who is also hitting milestones too early (or later). Could a child with this sort of presentation be put on some sort of watch and wait list for early intervention from a younger age, rather than at the moment, where many children are missed until years later.