Autism is defined as a condition which affects the processing, integrating and organising of information that significantly impacts communication, social interaction, functional skills and education performance. With this definition comes the implication that autism cannot be detected until such time as your child reaches the age of which these aspects begin to become a part of their life. Thanks to 20 years of dedicated research, this may no longer be true.
Most autistic children have shown signs of their condition since birth, but with the current diagnostic criteria listed in the Diagnostic and Statistical Manual for Mental Disorders (DSM) which is based on a behavioural model, they go unacknowledged. This can be extremely frustrating for a parent whose instinct, which is rarely wrong when it comes to their child, is telling them something isn't quite right. We all know that early detection of almost anything can mean a better chance of prevention or recovery, which makes it even more frustrating when a doctor will not listen to you because of something some manual does or doesn't say.
Research conducted by Osnat Teitelbaum and Philip Teitelbaum PhD shows that autism can in fact be seen in your child's infancy if you know what to look for. They describe the signs of possible autism in 3 main categories: movement, symmetry and motor development which is a completely revolutionary concept, independent of Leo Kanner and Hans Asperger's theory – the men behind the current behavioural diagnostic criteria. They believe that detecting autism in your child's infancy and beginning therapy while their brain and skills are still pliable and developing it is highly possible that the affects of autism will be reduced, if not prevented.
Symmetry
You have to admire the symmetry of nature. Almost everything around us, including furniture, is symmetrical. Without it things would be completely unbalanced and unstable.
The most amazing of nature's symmetries is the human body. We are considered to have “bilateral” symmetry, meaning that one side of the body mirrors the other. It is not perfect and of course some of our organs don't match, but we are very close. If you were to place an invisible line down the center of a perfectly formed human body you would see that those body parts, organs, muscles, bones etc which come in pairs are positioned and in the exact same proportion on each side of the body. Those parts of the body which are singular appear to be centered along that invisible line, hence we are symmetrical.
Our brains are also symmetrical, even though we have only one, but it consists of 2 sides - the left hemisphere and the right hemisphere. These hemispheres are linked, so that they can work together, by a thick bridge of nerve tissue called the corpus callosum which is located at the center of the brain. Each hemisphere controls the opposite side of the body.
Symmetry in the human body is a sign that we are developing and growing equally. It shows that both sides of the brain are developing at an equal rate and that we are able to move and use either side of our body equally. Our bodies grow at the same time and at the same rate on either side. Any persistent evidence to the contrary in your infant, for example, asymmetrical movements (one side is more active than the other), can mean a problem, and in some cases autism. Although humans do tend to have a dominant side, the left or right, this does not make itself known until we are about 4-5 years old, so until then your infant should not show a preference.
So how do you tell the difference between a symmetrical movement and an asymmetrical one? Below are some examples to help you distinguish between the 2.
Example 1 Symmetrical – When a healthy infant is placed on their stomach, they will use both of their arms to push their chests off the floor in order to look around. The arms are both positioned in much the same way – facing forward and placed about their chest width apart, similar to a push-up position in exercise. Asymmetrical - Using the same example as above, an infant exhibiting an asymmetrical movement would be one who uses only one arm to prop themselves up while the other lies trapped beneath them.
Example 2
Symmetrical – If your infant is lying on their back and you hold a toy above them to grab, a healthy baby will make a grab for the toy with either arm. Asymmetrical – An asymmetrical version of this would be if your infant consistently used one particular arm, either the left or the right only, to grab for the toy.
Example 3
Symmetrical – When your infant begins to roll from belly to back and vice versa, a healthy child will roll either way, to their left or to their right, equally. Asymmetrical – If your infant will always roll only one way, this would be asymmetrical.
Example 4
Symmetrical – Your infant is learning to crawl and they move both arms and both legs equally. The way a child crawls is by first moving one arm forward, shift their weight, and then move the opposite leg. They then move the second arm, shift their weight, followed by the second leg. This is the full crawl pattern of a healthy infant, one side mirroring the other.
Asymmetrical – Your infant crawls with one leg but steps with the other. What this means is, that while the crawl-pattern is still in place when they move the legs, one may remain in the crawling position while the other assumes a walking position. Another asymmetrical example may be this: when your baby attempts to complete the crawl pattern, they may shift their weight to the arm without actually moving it to be able to hold the weight, which causes them to topple over. While it may be difficult to actually catch the shift of the weight to a non-stable arm, you will notice that your baby topples over a lot when trying to crawl.
Any asymmetrical movements noted in your baby should be noted and watched. If they continue with these asymmetrical movements for a month or so, it may be possible that your infant has autism. Record your baby's asymmetrical patterns during the period of a month and if you find that they are consistently occuring, take your records with you to a pediatrician. They can help you determine whether the problem is neurological or physiological. Meanwhile you can begin doing the following exercises with your baby which can also be continued even after you have established whether there is or isn't a problem with your infant.
How to Encourage Symmetry
As your baby is still young enough to learn, meaning their brain is still developing, there are things you can do to help stimulate symmetry and negate autistic behaviour.
Throughout the day and at regular intervals, stroke your baby's weak hand in order to get them to grip with it.
Hold a toy, preferably one that makes a sound, out for your baby to grab. Depending on the side you are trying to stimulate will depend on the side you hold it. For example, if your baby doesn't tend to use their left hand, hold the toy more to the left of their body and move it to different spots on that side. This will encourage your baby to not only use the arm they don't use, but will also make them move it around.
When your baby is older, say around 7-8 months, use the same sound-making toy to encourage your baby to move the under-used arm across that invisible line down the center of their body, known as the midline.
Using your hands, gently push one of baby's legs toward their chest then allow them to try to exert pressure to push your hand away. Do each leg individually, and then try them both at the same time.
Reflexes
A reflex is an automatic response generated by the brain to a specific stimuli which has been communicated around the body in a neural loop. It begins with stimulation to the peripheral nerves, which is detected by sensory receptors, and is then relayed to the central nervous system through the sensory nerves. The process then reverses itself sending a command back through different nerves to the peripheral nerve which gives us our “reflex” response. Many of our reflexes are learned by our nervous system after a stimulus has been repeated a number of times, while others we were born with. Some of those we are born with will stay with us throughout our lifetime while others will disappear or become inhibited as our brain develops.
The reflexes your baby is born with are located in the brain stem which controls primitive functions like breathing. At this early stage of a newborn's life their still-developing brain is unable to process the information required to allow them to move or react voluntarily, so their nervous system has been pre-programmed with a set of reflexes – known as primitive reflexes – to enable them to survive.
The reflexes are the same for every baby and are predictable in their approximate time of appearance and disappearance. Most primitive reflexes either disappear or are inhibited (taken over by a higher level of the brain) by the end of their 1st year. As all reflexes are on a pre-set schedule, any significant deterioration of that schedule is said to mean that the reflexes have “gone astray”. When this occurs it is sometimes a sign of neurological damage which may also be a warning sign for autism.
Reflexes that have “gone astray” are those that don't appear or disappear within an appropriate time frame, or when 2 or more reflexes cannot be combined properly to form an allied reflex – like the rooting and sucking reflexes which combine to provide baby with nourishment.
Below is a list of some of the reflexes your baby has with the approximate age they should disappear or become inhibited. Any reflexes listed without an age of appearance means it is one baby was born with.
**Please note: While it is impossible to list all of your baby's reflexes – learned or otherwise – these are the main ones**
The Moro/Startle Reflex: In hospital, baby is tested by the doctor placing a supporting hand under baby's head and neck and raising their back up off the surface. They then quickly lower their hand so that it feels to baby as if they are falling. This provokes the Moro or Startle reflex where baby will throw both their arms and legs out and then pull them back in.
The reflex is also triggered when baby is startled, whether it be by a loud noise, their head falling backward, or a quick change in position.
This reflex usually fades when baby reaches between 3-6 months.
Sucking Reflex: When a finger, nipple or teat is placed in baby's mouth their automatic response is to suck, usually fairly forcefully, and in a rhythmic coordination combined with swallowing.
This will disappear between the age of 3-4 months.
Rooting Reflex: You will notice when something touches a baby's cheek or the corner of their mouth, they will turn their head toward it, open their mouth and search, or root, for the stimulus.
This will usually be inhibited by the time they reach 3-4 months of age.
Asymmetric Tonic Neck Reflex (ATNR): This reflex is triggered when baby is lying on their back with their head turned to one side. As baby turns their head the arm and leg – on the same side they turn toward – extend or straighten while the arm and leg on the opposite side bend. This should occur regardless of which side baby turns their head.
Reflex is usually inhibited by 4-6 months old.
Symmetric Tonic Neck Reflex: When baby's head is extended backwards, baby will straighten the arms and bend the legs. On the other hand, when baby's head is bent toward the chest the opposite occurs – the arms will bend and the legs will straighten.
Reflex usually appears at around 4-6 months of age and disappears around their 9th month.
Blink Reflex: This reflex will stay with baby throughout their life. A natural instinct to close their eyes when a bright light is shone directly into their eyes or they look into one.
Babinski Reflex: When the sole of a baby's foot is stroked from the heel up and across the ball of their foot, baby will hyper-extend their toes, fanning them out.
They will usually lose this reflex by 6-9 months
Galant Reflex: If you were to lightly stroke a finger or other such object down one side of baby's spinal column from their head to lower back, they will automatically curve their back side-ways away from the stimulus.
This reflex is usually gone by the 1st to 6th month.
Grasping Reflex: When an object is placed in baby's open palm, the reflex is to grasp or grip the object. Baby's grip will then strengthen if you attempt to pull the object away from them.
They will lose this reflex usually by about 6 months of age.
Stepping Reflex: This reflex will occur when baby is held beneath the arms, head supported, and their feet allowed to touch a flat surface, such as the floor. The response is to move their feet as if trying to step.
This response is usually gone by the time they reach 2-4 months old.
Parachute Reflex: When baby feels they are falling, they will extend their arms forward as if to save themselves and break the fall. A baby held suspended in the air, will throw their arms out that will protect their head and chest from hitting the floor when you lower them, making them feel as if they are falling.
They will usually begin to exhibit this reflex by the time they are 6-9 months and should disappear by the time baby is 12 months old.
If you believe that your baby has a problem with reflexes which have “gone astray” make notes on what is or isn't occurring and the dates. Take this with you when you go to see your doctor or pediatrician. If you believe your concerns are being ignored or dismissed out-of-hand, then it may be necessary to find a pediatrician who specialises in developmental delays and disabilities.
Motor Development
By the end of your baby's 1st year, or shortly thereafter, they should have reached motor independence – meaning they are able to walk unassisted and have enough control over the different external body parts so as to be able to act and move at will.
There are many stages of motor development that your baby will go through during their 1st year of life, each of them marked by the acquisition of a new skill, known as a motor skill. A motor skill is defined as being an action involving the movement of the body's muscles, and can be separated into 2 distinct groups: Gross Motor Skills and Fine Motor Skills. Gross motor skills refer to the movements made by the arms, legs, feet and the whole body. It is these types of motor skills that the Teitelbaum's believe are the key to the early detection of autism. The fine motor skills, on the other hand, are more the focus of the current method of diagnosis. These are smaller actions usually involving the thumbs and fingers in coordination with the eyes, such as tying a shoe, writing or drawing – skills developed by your child much later.
The transition of physical milestones is referred to as the ladder of development because like the rungs of a ladder, each new skill is a progression of the previous and leads to the next. Each new skill learnt by your baby is more complex than the last and although much of their learning involves a lot of trial and error, the order of the stages or milestones are fixed. Every baby should reach every rung of the ladder, if they don't and skip a rung, it is not considered a sign of intelligence like skipping a grade in school, instead it may signify an overall developmental problem which needs to be addressed.
Below is a brief overview of the physical milestones you can expect from your baby within their first year.
|
AGE |
Most Babies Can |
|
1 month |
* Raises head for short periods of time when on stomach |
|
2 months |
* Head is held at 45 degree angle while on stomach * Will use arms and hands to “peel” their chest from the ground giving freer head movement |
|
3 months |
* Is able to reach for toys while lying on stomach |
|
4 months |
* Head can be held up at 90 degree angle while on stomach * Weight can be held evenly on both legs when standing |
|
5 months |
* Baby should be able to roll over – either way |
|
6 months |
* Roll from belly to back & vice versa * Maintain stability of head when pulled to upright, sitting, position * Sit briefly unsupported * Begin to coordinate arms and legs in readiness for crawling |
|
7 months |
* Sit without support * Reach for toys with minimal over-balancing * Begin crawling |
|
8 months |
* More stable when sitting unsupported * Reach for toys without over-balancing * Pass toys back and forth between hands * Should have mastered crawling |
|
9 months |
* Able to pull self into a standing position * Can stand while holding onto something |
|
10 months |
* Able to crab-walk while holding onto furniture * Wave |
|
11 months |
* Clap hands together * Stand unsupported for brief periods |
|
12 months |
* Walk unsupported - but may still be a little unsteady |
The table above is a guideline only. Each baby is different and will develop at his/her own pace. Babies with older siblings for example may develop and gain their skills faster than an only child. If you feel that your baby has not gained a skill within a reasonable enough time, (eg. Your baby is 12 months old and still hasn't mastered crawling) then it is recommended you seek the advice of a professional. Some doctors may not be open to the theory mentioned here so you may need to push the point or seek a second opinion until you find someone who will take your concerns seriously.
For More Information
The theory mentioned here can be found in more detail in the following book by Osnat & Philip Teitelbaum.
Website
Autism Australia – Coming Soon
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