babyshrink.com

There’s a lot of confusion out there about illness, the flu, vaccines, medications, and autism. This poor Mom is terrified that her son may have contracted Autism from a bout of Swine Flu. Here’s her email to me:

Dear Dr. Heather,

Please help. I saw your article on autism, and I am very intrigued and impressed by your knowledge and insight.

I don’t know what to do. I have two beautiful, 91/2 month old identical twin boys who were always very social, smiley, interactive, looking directly into the face, etc. The one I am most concerned about would turn his head and smile at his brother in their crib, smile at everybody, I would play the ‘up’ game with him and he would gaze into my eyes, smile, and giggle… and they both almost always responded by looking when I said their names.

Then one of them got sick with Swine Flu on August 6th. His brother got sick on August 8th. I will never forgive myself as the last time I remember him (the baby who got sick on the 8th) acting distinctly like himself was the 6th when I went to pick up his sick brother at daycare… he looked right up into my eyes, threw up his arms, smiled, and said ‘Mommmmm’…. And I barely paid attention to him, I rushed to his sick brother… I should’ve thrown my arms around him and hugged him and praised him…. I have such guilt and keep worrying/wondering what if that is the last time he ever does that?

They were both put on Tamiflu due to being high-risk (they have asthma symptoms). The baby I am most concerned about didn’t get as high a fever, but the virus infected his eye, and we think he also got a bacterial infection, so he got eye-drops and Amoxycillin as well. He was miserable and cranky for days. I know he can hear (by testing by loud noises, etc.) and he doesn’t have an ear infection, as he’s seen a doctor.

Now he is not himself. I first noticed this as he got better. He is not responding when I say his name, hardly ever. If he does he just looks for a second. He will make eye contact, but only for a second or two. He looks away when I try to play the ‘up’ game with him. He is still babbling, but not as much. He did this weird whisper-babbling this morning and smacked his lips. He is still playing with his toys, but is also playing with non-toy objects like straps and blinds.

The doctor has an ear test set up for him, but I have to wait two weeks just for a call to make the appointment.

Can a virus or antibiotics trigger autism? Does a flu ever attack the ears, eyes, or brain which might cause sudden symptoms? What are the other possibilities might be going on if he doesn’t have an ear infection? This is a very, very abrupt change.

What tests should I push for to find out what is wrong as soon as possible? What are the possibilities?

So far his brother is acting normally, but I am terrified as I’m worried about it affecting both twins eventually.

Please, I would love a response. We have (mega-large HMO) and it is hard to get tests/things done. I am eagerly awaiting your response and guidance.

Very, very sincerely,
Concerned Mom

Obviously, this mom is in a state of desperation, so I responded immediately:

Dear Concerned Mom,

Of course I cannot evaluate your son myself and as such, I can only provide some educational information for you. But I did want to respond right away because you sound so very upset and worried.

First of all, please know that autism is thought most likely to be a genetically-related developmental issue, and I have seen no convincing information that it can be caused by a simple flu or other virus in a child, nor by antibiotics or antivirals. Additionally, the timeframe you mention of the abrupt changes in your son do not sound like the onset of autism. After all, it’s been barely 2 weeks since the onset of his flu symptoms.

A (temporary) step backwards in response to illness
However, it is VERY common to see temporary developmental regression in response to illness. This means that your child can take several steps BACKWARD developmentally — in response to illness and/or stress — and then “bounce back” days or weeks later. It’s all part of the normal developmental process,which is full of starts, stops, and reversals — the old “one step forward, two steps back” thing. Young children don’t understand that the course of illness is temporary; that they will get better. They simply know they feel lousy. They are not up to showing off all their “best” developmental skills. They commonly regress to earlier stages of development, temporarily, until they feel better. And often times, symptoms of illness can linger for WEEKS in children — especially for something as yucky as a flu. If he is showing regression in response to illness, the regression itself can linger for weeks as well, past the time that he gets better. This may vary from child to child and from illness to illness, so his brother may be fine (at least this time).

Personalities vary in response to illness and stress
I don’t know about your husband, but when mine gets sick, he just wants everyone to GO AWAY. (is this a guy thing?) He’s crabby and won’t talk to me and is just a completely different personality than when he’s feeling well. Everyone is different, and your boys also will have different responses to stress and illness. The point is that there are very reasonable possible explanations as to why your son is acting so differently than his usual self, for this relatively short timeframe.

It’s important that you respond in a positive and supportive way, and not convey to him that you’re so worried. He’s able to pick up your anxieties, and internalize the message that “something must be wrong with him”. He needs reassurance that he WILL get better, and WILL feel better, but for now he still feels lousy and needs to be babied — and that’s OK.

As I said, however, I cannot evaluate your child from afar, so it’s important you get your doctors’ advice, as it sounds like you are doing. But since you have to wait for appointments, I would take this time to hang out with your boys in a relaxed way, giving them the chance to fully recover.

Please let us know how you’re all doing in a few weeks’ time.

Aloha,

Dr. Heather
The BabyShrink

Following up on yesterday’s post is an interesting new finding from the University of North Carolina, where researchers are confirming more evidence for an actual structural brain difference in babies with Autism.

Please excuse the “science geek” in me, but this stuff is really important for us to understand. It will help us to better diagnose and help even very young children with Autism-related difficulties, and it will help us to screen out those who SEEM to have Autism, but don’t (see yesterday’s post).

For my non-science-geek, non-shrink parent readers, this is the bottom line here: It’s important to really be watching the quality of your baby’s social development. Your baby’s glances, smiles, gestures and babbles in his first year of life tell you a TON about whether he’s developing normally. The article highlights the importance of “Joint Attention”, which is what your baby does to attract and sustain your attention, in order to share something interesting with you. If he likes doggies, when he sees one, he’ll try to get your attention so that YOU can see the doggie — and get excited by it — too. He’ll want to share his interests with you, even if he doesn’t yet have the words to tell you about them. By the end of his first year, you should see him doing this more and more. Children with Autism have trouble with this — and now we have more information as to why.

If you’re interested in more, check out the summary article here.

And as always, post a comment with your questions or thoughts, if you’d like.

Aloha,

Dr. Heather
The BabyShrink

I’ve written before about the confusion and difficulty around the diagnosis of Autism in young children (before the age of 3).

My regular readers know that I’m a strong proponent of Early Intervention screening, and also of early intervention therapy services. This means having your local Child Development center see your child BEFORE the age of three, should you have any concerns about her development, social interaction, or communication skills.

But you also know that I am loathe to jump on the autism-hysteria bandwagon. I worry that there are many other problems that are being missed because we’re jumping to the Autism diagnosis too quickly. Issues of sensory, cognitive, medical, environmental, or even genetic problems can be missed when a diagnosis is made too quickly. Also, the range of child development is so wide, that what can SEEM abnormal may not be. And I blame my field; many of us are so concerned about the number of developmentally delayed children out there, and so few of us are adequately trained to truly evaluate for Autism in the early years, that too may children are mistakenly diagnosed as Autistic. And then their REAL problems go undetected — and untreated.

If I had a million bucks (or ten) I’d start a training foundation centered on the intensive training of Early Intervention clinicians in the detection and treatment of Autism-related conditions — and other problems that might SEEM like Autism, but are NOT. We need a nation-wide (heck, world-wide) training initiative so that psychologists, pediatricians, speech and language therapists, occupational therapists, special instruction teachers — indeed the whole range of Early Intervention professionals — can get the advanced training we all need in this very specialized area.

In the meantime, you can read this very interesting article at Time.com summarizing some of the newest research on signs of Autism in the very young infant. It also helps to explain why this is truly a very difficult disorder to diagnose in the early years. And if you missed it, there’s also a link to a popular post of mine on the diagnosis of Autism.

Click here for the Time.com article, and

click here for my own article on Autism.

Aloha,

Dr. Heather
The BabyShrink