Question: My 3-year-old has autism, and now I'm worried about my 6-month-old baby because she loves to stare at the ceiling lights. Is this normal?
Answer: So, I think there are two important points here. One is that there's really quite a range of typical behavior in a very young infant such as a six-month-old, and one can't draw from any one observation whether that child is going to develop autism or not. I think that there's really sort of a constellation of things that all parents are aware of in their younger children and, I think, parents of children with autism are often more vigilant to, such as the way the child engages socially, their early vocalization, the kinds of things in the environment and play materials that they find interesting.
The experience of a number of research groups who followed younger siblings of children with autism has been that, although by a year there are often a number of behavioral indicators that do identify the children who are at higher risk, at six months the difference is maybe very subtle, and, even with a very comprehensive assessment, it may be very difficult to pick out those six-month-olds who are most likely to develop an autism spectrum disorder.
I think the most important thing is for parents to feel comfortable with speaking to their healthcare provider -- family physician, pediatrician -- about the concerns that they have to make sure that that clinician is listening and that they have a chance to talk about their observations and to recognize that the conversation shouldn't occur only in one visit, but rather occur over time. Certainly, as that six-month-old gets older, the kinds of observations that the parents will make will kind of help more and more in terms of identifying whether that child is likely to develop an autism spectrum disorder or other developmental difficulties. And even as that child gets older, there will be a period of time where there may be concerns, both by the parent as well as the clinician, that there is some uncertainty about how to establish a definitive diagnosis.
Certainly the experience of the group of researchers working with infant siblings is that, as concerns about things like language development and play and social engagement emerge, there's a lot that can be offered even at a stage before the diagnosis would be confirmed definitively. And, in fact, there are some outstanding intervention approaches that are currently being evaluated in the US and Canada and now in the UK that could really make a fundamental difference to those one-year-olds, 15-month-olds who are showing early difficulties in social communication and perhaps will get them back on track.