Tuesday, April 26, 2005 Parenting Infants can show early signs of autism Study your baby's reactions for clues to a disorder that is on the rise. By Shari Roan / Los Angeles Times Child development experts may one day be able to identify children at risk for autism before their first birthdays. According to the Centers for Disease Control and Prevention, an estimated 1.5 million Americans have an autistic disorder, with the incidence growing by 10-17 percent a year since the early 1990s. Researchers are beginning to study infants who are the younger siblings of autistic children. Earlier studies have shown that when one child in a family has autism, the risk of the disorder in a younger sibling increases by an estimated 10 percent to 20 percent. Even infants as young as 6 months can be screened for potential warning signs, some experts say. For example, while all 6-month-olds like to gaze at objects that interest them, autistic babies may focus solely, and repeatedly, on a single object; their parents may have difficulty redirecting their attention. Also, 6-month-olds ordinarily enjoy gazing at faces, especially their parents', Filipek says. Autistic babies, however, often avoid eye contact. "When you hold a newborn or a 2-month-old, that baby is mesmerized by your face," says Dr. Pauline Filipek of Orange, Calif.. "That baby can stare at your face and will stick his tongue out at you and imitate you. They coo. By age 4 or 5 months, you should be able to have a 'conversation' with that baby." Autism appears to involve problems reading and decoding information from a person's face, says Geraldine Dawson, director of the Autism Center at the University of Washington's Center on Human Development and Disability. In one study of 3-year-olds, Dawson monitored the brain activity of children as they were shown pictures of their mothers and of strangers. Autistic children showed no reaction to their mothers' faces as compared with strangers' faces. "Face recognition is one area we're interested in," she says. "These are behaviors we should be able to pick up early." Researchers also are looking at how babies respond to speech. Babies seem to prefer listening to their mothers' speech more than nonspeech sounds. An autistic child, however, may not show such a preference. "We may not be able to diagnose autism with this, but we could pick up a child at risk," says Dawson. Experts caution that more research is needed before doctors can reliably diagnose autism in infants or babies. Today, most children with autism are evaluated using diagnostic instruments designed for 3- or 4-year-olds. There are no standard criteria for diagnosing the disorder in children ages 1 or 2. Experienced autism researchers can usually determine whether a 2-year-old child is on the "autism spectrum," but they can't predict the severity of the disorder, says Dawson. Besides the wide variation in severity, children with autism can differ in many ways. Some are mentally retarded or have feeding problems or poor muscle tone, while others lack these characteristics. Behaviors to watch The criteria used to diagnose autism are designed for 3-year-olds. Recent research shows certain behaviors in younger children may indicate a higher risk for developing the disorder. No single factor indicates a child may have autism; the presence of several symptoms could be cause for concern. Possible symptoms at 6 months: ¤  Not making eye contact with parents during interaction ¤  Not cooing or babbling ¤  Not smiling when parents smile ¤  Not participating in vocal turn-taking (baby makes a sound, adult     makes a sound, and so forth) ¤  Not responding to peekaboo game At 14 months: ¤  No attempts to speak ¤  Not pointing, waving or grasping ¤  No response when name is called ¤  Indifferent to others ¤  Repetitive body motions such as rocking or hand flapping ¤  Fixation on a single object ¤  Oversensitivity to textures, smells, sounds ¤  Strong resistance to change in routine ¤  Any loss of language At 24 months: ¤  Does not initiate two-word phrases (that is, doesn't just echo     words) ¤  Any loss of words or developmental skill Source: Rebecca Landa, Center for Autism and Related Disorders at the Kennedy Krieger Institute, Baltimore Los Angeles Times