Key to detecting Asperger’s syndrome, a milder yet little-understood form of autism, lies in analyzing infants’ movements

Jul 29 2004

Home videos of infants' movements can be used to help detect a form of autism in a child’s first year of life, years earlier than the disorder typically is identified, University of Florida researchers have discovered.

The key to detecting Asperger’s syndrome, a milder yet little-understood form of autism, lies in analyzing infants’ movements rather than waiting for them to reveal the disorder through social behavior in school or later in adulthood, according to Osnat and Philip Teitelbaum, a husband-and-wife team of UF psychology researchers whose study will be published this week in the online edition of the Proceedings of the National Academy of Sciences.

“The usual method of diagnosing autism and Asperger’s syndrome relies mostly on social interaction - how the child reacts to peers, how the child gets along with the mother, even how the child reacts to a stimulus like light or noise,” Osnat Teitelbaum said. “But until our work in 1998 and now, no one has looked at these children’s movements when they were infants.”

The advantage of an earlier diagnosis is that a child can be treated sooner when the brain is more elastic, likely resulting in changes to the nervous system and fewer behavior problems.

“The earlier the intervention the better the outcome, not only for the child but, we must stress, for the parents as well,” she said. “The behavior of autistic kids is really tough to control on a daily basis, and having to go from one doctor to another who refuses to take a parent’s concerns seriously can be torture.”

After viewing a colleague’s videos in which older children with severe autism walked with a slight abnormality, the Teitelbaums wondered if differences in movement might be detectable as early as infancy. Using a tactic they had employed successfully in their 1998 research on infants with severe autism, the researchers extended their study to Asperger’s syndrome, asking parents of children with the disorder to send them videos of the children when they were infants. These recordings were solicited at meetings of support groups for the disorder.

In viewing the family videos they received of 16 babies with Asperger’s, the Teitelbaums found disorders in some or all of the milestones of early motor development, including crawling, walking, lying down, sitting and the ability to right themselves. Some of the symptoms were similar to those the Teitelbaums found in their 1998 study.

In the most recent study, the babies showed an asymmetrical pattern in their movements. For example, some children crawled by stepping with the foot of the right leg and crawling with the knee of the left leg, or when lying prone, they extended the left arm forward to support the chest while the right arm was trapped beneath the chest, the Teitelbaums found. In addition, they discovered that when lying on their sides, babies with Asperger’s syndrome would remain stuck there instead of smoothly turning over in a corkscrew fashion, first with the hips, followed by the torso and then the shoulders.

Six of the 16 Asperger’s babies did not sit independently by 6 months, and one baby, in his first attempts at walking, failed to extend his arms in a protective reflex to prevent falling and keeled over vertically like a tree falls over, Osnat Teitelbaum said.

Clumsiness is a trait of Asperger’s syndrome, she said. “From our preliminary observations, we have a strong tendency to believe that some of the clumsy characteristics seen in Asperger’s syndrome are based on infantile reflexes gone astray,” she said. “When these reflexes persist too long or do not appear when they should, the motor development of the infant, and subsequently other aspects of his behavior, will be affected.”

While autism is sometimes characterized by mild to severe mental retardation and extreme social awkwardness, those with Asperger’s are more socially inclined and can have very high IQs, with their intelligence often focused on one narrow field of interest. They are typically diagnosed much later than autistic children because they are able to acquire and use language early, she said.

Typically diagnosis of autism occurs about age 3, compared with age 6 at the earliest for Asperger’s, and sometimes not until the mid-20s or even the 30s, she said.

One simple way to treat children with the syndrome is to swing them in a playground or backyard swing, she believes. This stimulates the inner ear and helps to regulate balance, which appears to be defective in those with autism and Asperger’s syndrome.

“One mother of a 6-month-old baby who couldn’t get any answers from her pediatrician called us and said her child would not look at her or coo when she cooed to him,” she said. “We suggested she swing him, and after two or three weeks of doing this, she (the mother) said the child had changed so much and started smiling at them.”

Wayne Gilpin, president of Future Horizons, a publisher of books on autism and Asperger’s syndrome who has a 24-year-old son with autism, said the study’s findings are important to parents of children with autism. “All the experts in the field are leaning very strongly to trying to determine if a child has Asperger’s sooner because the early diagnosis leads to early assessment and the earlier you begin working with a child there is no question that his progress is much better,” he said.