ASD Symptoms May be Present Before Your Baby First Speaks

ASD Symptoms May be Present Before Your Baby First Speaks

  • Some infants with autism spectrum disorder (ASD), or autism, may exhibit social communication differences as early as 9 months of age, a new study suggests.
  • Compared to their typically developing peers, infants with ASD may show signs such as a lack of appropriate eye contact and inability to respond to attention.
  • However, these signs may not always be as apparent to parents. Hence, getting help from specialists with child development backgrounds could put concerns to rest.
  • The study’s findings also point to a critical window for targeted early intervention that could help children with ASD reach their full developmental potential.

Although speech is many parents’ first concern when spotting signs of autism spectrum disorder (ASD), there may be other forms of communication that could point to autism early on in infancy, a new study has found.

Social communication skills such as eye gaze and facial expressions, for example, develop rapidly in the first year of life for babies — more specifically, between 9 to 12 months.

Developmental gains in these skills before the baby says their first words, generally around 12 to 18 months, may go unnoticed.

“Social communication differences are part of the diagnostic criteria for ASD. Yet, we don’t really know how early in life these differences appear. Beginning at around 9 months of age, typically developing infants use their eye gaze, facial expression, sounds, and gestures to communicate. They also begin to show very early play skills around this age,” said Dr. Jessica Bradshaw, assistant professor of psychology at the University of South Carolina and corresponding author.

Bradshaw said she wanted to determine whether social communication differences were apparent as early as 9 months in infants who had a greater familial likelihood of autism, which is months before they would usually receive a diagnosis.

Published in the journal Child Development, the longitudinal research studied the social development of 124 infants between the years 2012 and 2016.

The researchers then carried out an early social-communication assessment at both 9 and 12 months, measuring the babies’ social, speech, and symbolic skills.

Later, when the babies reached the age of 2, researchers used gold standard diagnostic tools to see if any infants fit the ASD diagnostic criteria.

Infants who were later diagnosed with ASD showed significantly fewer social and early speech skills at 9 months of age, the study found.

And at 12 months, infants with ASD had lower performance scores on almost all measures of preverbal communication.

The infants with ASD showed the following three unique patterns of social-communication development:

  • Their communication with eye gaze, facial expressions, and sounds were “consistently low” between 9 and 12 months.
  • Their symbolic use of objects such as being creative with toys was delayed at 12 months.
  • There was a “growing gap” between typically developing infants and infants with ASD when it came to using gestures and the frequency of communication.

The findings are in line with previous research, which has shown that infants with ASD have specific areas of vulnerability and unique patterns of change that indicate a disorder.

“It was interesting to see that there were distinct patterns of social communication development from 9 to 12 months for infants who later developed ASD. Some skills were consistently low while other skills showed a ‘growing gap’ between 9 to 12 months,” said Bradshaw.

Dr. Mayra Mendez, a psychotherapist and program coordinator for intellectual and developmental disabilities and mental health services at Providence Saint John’s Child and Family Development Center in Santa Monica, California, said she was not surprised by the findings that indicated nonverbal social communication skills differed between typically developing infants and infants who are later diagnosed with ASD.

“The characteristics of ASD may be subtle and are qualitative in presentation rather than directly identifiable as atypical. This means that the quality of interactions and social-emotional presentation of an individual diagnosed with ASD differs from the quality of the same characteristics in typically developing children,” she said.

She explained that this quality is measured by the frequency, intensity, duration, degree, and number of behaviors present.

“In the first few years of life, salient signs of autism include lack of appropriate eye contact and inability to initiate or respond to joint attention that qualitatively varies in everyone. Since ASD does not just suddenly present, rather it evolves throughout the first 2 to 3 years of life with symptom presentation becoming more evident and noticeable from 18 months of age forward, it is not surprising to see that even in 9-12-month-old infants, subtle signs of social-emotional differences may be noticed.”
– Dr. Mayra Mendez

Mendez said the prospect of being able to spot symptoms of ASD as early as 9 to 12 months could empower parents, caregivers, and clinicians working with families, as well as increase awareness of social-emotional development, and support child and family interventions to ensure a child’s developmental is not hindered.

She acknowledged that research was limited on early ASD signs and symptoms before 18 months of age but that there was some anecdotal evidence from parents, such as videos.

“In such parent reports, the difference becomes more evident when language skills are expected to develop and when the expectations for social and relational engagement are anticipated at higher levels than those exhibited by the 2- to 3-year-old who presents with signs and symptoms of ASD,” she said.

Do Mindfulness Interventions Improve Obesity Rates in Children and Adolescents: A Review of the Evidence

Do Mindfulness Interventions Improve Obesity Rates in Children and Adolescents

Mindfulness interventions have shown promise in improving self-regulation, depression, anxiety, and stress levels across all ages. Obesity rates in children are rising worldwide. It has been postulated that through improvements in self-regulation with mindfulness interventions, obesity rates can be improved in children and adolescents. In this review, we attempt to explain how mindfulness interventions may impact obesity rates and obesity-related complications and give the current state of evidence for the following mindfulness interventions: Mindful Eating, Mindfulness-Based Stress Reduction, Yoga, Spirituality, and Dialectical Behavior Therapy.

Over the last 20 years, childhood obesity has become a major public health concern in the United States. According to the most recent data from the Center for Disease Control and Prevention (CDC) in 2015–2016, 18.5% of American youth between the ages of 2 and 19 were classified as being obese using a body mass index (BMI) threshold >95% for age.1

The rate of obesity increases with age in children. Children between the ages of 2 and 5 have an obesity rate of 13.9% as compared to 20.6% in children between the ages of 12 and 19. In addition, obesity has some ethnic predispositions, with obesity rates being most prevalent among Hispanic and Non-Hispanic Black children with no significant difference between the sexes.1

Obesity begins in childhood due to a combination of genetic, social, physical, and psychological factors.2 As children with obesity age, they often develop obesity-related comorbidities including insulin resistance, early onset diabetes mellitus (DM), hypertension, hyperlipidemia, depression, and sleep apnea.3 These medical conditions often persist into childbearing years and adulthood.4 Pregnancies of women with obesity are more likely to have perinatal complications or be stillborn.5 Infants born to mothers with obesity have increased rates of neuropsychiatric disorders including autism, attention deficit hyperactivity disorder (ADHD), anxiety, depression, eating disorders,6 and adult obesity.7 This circular pattern perpetuates, increasing obesity rates in all ages.

With the increase in families with obesity, pediatric medical providers are consistently charged with finding evidence-based treatments. One area of interest is the use of mindfulness interventions to modulate eating behaviors.

According to Jon Kabat-Zinn, mindfulness is a psychological process of purposely bringing one’s attention to experiences occurring in the present moment without judgment.8 Mindfulness activities have been effective in altering human behavior to improve health promoting behaviors.9–11 In addition, mindfulness activities have consistently shown improvements in levels of stress and anxiety and increased stress has been associated with weight gain.9–12 For these reasons, it seems that mindfulness activities may provide value as a treatment option for patients with obesity.

Human Eating Behavior

To further understand how mindfulness may affect obesity, it seems paramount to understand the psychology of human eating behavior. Human eating behaviors are based on the existence of personal and psychological constraints that operate in addition to food availability. Figure 1 was created by Ulijaszek et al13 based on the initial work of Mela et al,14 and describes a mechanism where human body-weight homeostasis may be maintained or lost based on different factors including food availability, energy density of the diet, genetic, psychological, physiological, behavioral and cultural factors.

Through this theory of the psychological contribution of weight gain, it would be a logical deduction that being more mindful of emotions and how emotions affect eating behaviors would allow one to control what he or she eats. As a consequence, there may be decreased consumption of high calorie foods and increased consumption of healthier, low-calorie foods. With time, this change in food preference may lead to weight control or weight loss and decreased amounts of obesity.

Figure 1. This flow chart explains that when one is exposed to high fat, sweet, or highly processed foods combined with learned feeding behaviors, preferences for these foods may be established. The combination these preferences, Increased availability of unhealthy foods, loss of dietary control from social and cultural eating patterns, and emotional eating or eating environments, predisposes individuals to over-consumption of energy dense foods. This in turn leads to overeating, positive energy balance, and weight gain. Low physical activity and genetic predisposition may negatively impact the picture further.

When kids get stressed out by the stress of others

When kids get stressed out by the stress of others

Empathy is our ability to share and understand the emotions of other people.

Most experts agree that there are at least two types of empathy; a more emotional (or “affective”) type and a more cognitive type. Affective empathy refers to experiencing another’s emotional state and cognitive empathy means understanding another’s emotional state.

Both of these processes usually occur together when we empathise.

Our ability to empathise is vital for good social functioning. Research has found associations between increased empathic tendencies and increased altruism.

However, engaging in certain types of empathy in different situations can come with various risks for the empathiser or for those around them. For example, experiencing occupational exhaustion (often referred to as empathic burnout) among professionals like nurses or counsellors may mean that patients do not get the best care.

For many researchers, empathy has been of interest when it comes to mental health because empathic ability is often altered in a range of disorders including Autism Spectrum Disorder, narcissism, as well as anxiety and depression.


Research has already demonstrated that people who experience high levels of ‘empathic distress’ – that is, becoming distressed while sharing others’ negative feelings – can experience higher symptoms of depression.

On the other hand, low levels of ‘cognitive empathy’ (or difficulty understanding others’ feelings), are also associated with depression and anxiety.

But one important gap in our knowledge is whether these relationships exist in children.

Despite a lower prevalence of anxiety and depressive disorders in children, approximately 30 per cent of children in the community might experience at least one episode of ‘internalising’ difficulties, which means they’re experiencing symptoms of anxiety and depression.

Childhood onset of these symptoms increases the risk and severity of disorder in adolescence and adulthood, and relapse and recurrence are common in young people even after receiving treatment.

We know that intervening early is key for good mental health outcomes. And by understanding the links between these symptoms and other key social-emotional traits, we may open up new areas for early detection or intervention.


In our study, we asked 127 nine and 10-year-old children to complete assessments of their cognitive and affective empathic abilities, as well as anxiety and depressive symptoms.

The children rated their own empathic abilities and tendencies. For example, can they easily tell what others are feeling? Or when a friend feels sad, do they begin to feel sad too?

Children who indicated they shared and were distressed by the feelings of others (known as ‘affective sharing’ and ‘empathic distress’, respectively), were also more likely to have elevated anxiety – particularly social anxiety – and depressive symptoms.

When we say elevated anxiety and depressive symptoms in children, we mean symptoms like feeling sad more often than not, having negative self-esteem, physical symptoms (things like changes in eating or sleeping), difficulties with school or friends, as well as having worries or fears that bother the child a lot and make it difficult for them to engage in activities they would like to.

Researchers still don’t know exactly why emotional or affective empathy is related to anxiety and depressive symptoms, but they have a few ideas.

It may be connected to two related concepts known as ‘emotional reactivity’ and ‘emotion regulation’.

Children who are more reactive to emotional states – both their own and others – may be more likely to report both higher levels of affective empathy and high levels of anxiety and depressive symptoms.

Another possibility is that some children may feel more empathic distress if their ability for emotion regulation is not well developed.

High capacity for empathy has been described as a “risky strength, meaning that on its own it’s not detrimental, but when coupled with other potential factors and traits, it may become a risk factor for later anxiety and depressive symptoms. But more research is needed to uncover what these other factors are and how they interact.


Contrary to what has been found in adults, children’s ability to understand the feelings of others (known as “cognitive empathy”) did not relate to their own mental health.

It appears that in children, the relationship between emotional components of empathy and mental health already exists, but the relationship between the cognitive aspect of empathy and mental health is still yet to develop.

Children are able to share the emotions of others from a young age – even babies will cry when hearing others cry – but they take longer to develop the ability to understand what others are feeling.

These abilities continue to develop throughout childhood and even into adolescence, so it is possible that the relationships between cognitive empathy and depression or anxiety might only emerge later in a child’s development.

Creating social access for autistic children, what does it take?

Creating social access for autistic children, what does it take?

Autistic children have indeed potential: most of their emotional abilities improve with age, concludes Postdoc researcher Boya Li in her second Ph.D. thesis on the emotional development of autistic children.

“The development of social and emotional skills is a totally different type of learning. You can’t learn it from books or from your teachers in the classroom, you have to learn it in daily interactions with other people. You can imagine that If you have limited access to social interactions, it is a lot harder to learn these skills. It’s very possible that when you walk into a school, you might see an autistic child sitting in the corner of the classroom, not really playing with other children or talking to teachers. Possibly, this child prefers to be alone at times, which is fine, but also this child needs friends and other social contacts, and social learning. How can we achieve that, and how does this affect their social-emotional development? For this, and in collaboration with the Center for Autism, we followed autistic and non-autistic children in their pre-school years, during three years.”

While Li’s Ph.D. confirms the challenges and difficulties many children with autism face in the emotional domain, her research also gives hope. “Most emotional abilities that I examined improved with age in autistic children. Some abilities even grew at a faster rate than in non-autistic children. I am really excited about this outcome, because now I can show that autistic children have the potential and the ability to improve. People often have a stereotypical view that autistic people cannot change, but also autistic children show a learning curve.”

Stereotypical view of autism

Li herself is also not unfamiliar with the stereotypical view on autism. When she started her Ph.D., she held a ‘medical view’ of autism, but her view has changed drastically by the end of the project. “When I look back at the chapters of my thesis, I feel a little ashamed of two chapters when detecting traces of this medical thinking, as if autism is a problem that should be cured. Just as a lot of researchers in this field, before I saw autistic children as children with deficits and impairments. My original goal for my Ph.D. project was therefore to detect these problems so my findings could help professionals and educators to find a intervention that could help them. But this is not how I look at the issue now.”

“Before I focused on how autistic children recognized facial emotions of non-autistic people and how they reacted in empathy provoking situations compared to a non-autistic person. All behavioral outcomes of autistic children were evaluated based on the standards established by non-autistic people. That is like using Dutch standard to evaluate behaviors of a Chinese child, or vice versa. This clearly doesn’t work. Maybe autistic children have indeed difficulties in recognizing other non-autistic people‘s emotions or reacting in a non-autistic way, but we never thought of the other side of the story.

NWO Schoolyard Project: The other side of the story

Li brings her vision into practice with the Bold Cities/ NWO schoolyard project that she recently joined. This project looks at the development of children with autism from a new perspective. “I love this project because it is a beautiful extension of my Ph.D. research. I want to look at the other side of the story, so not focusing on how autistic children should improve, but on how the other side, the environment of the child, could be improved. For example, we want to see whether there are barriers in the social environment that hinder autistic children from participating, like the attitude of people at school who might not understand autism.”

There is room for improvement in the physical environment of autistic children as well. “We know that autistic children have a different sensory experience. As you know most social interactions take place during breaks when children all rush to the corridor or to the playground. However, that time can be very arousing for autistic children. Instead of chatting and laughing with peers, they may experience anxiety or stress that makes them unwilling to participate. So with the Bold Cities/ NWO Schoolyard Project we want to improve situations like this. As cliché as it sounds, children are the future so we should do our upmost best to facilitate and support them, and to provide all children, with and without autism, the optimal learning environment.”

How my children's autism diagnoses led to my own

How my children’s autism diagnoses led to my own

Do you see a lot of your child in yourself?

Do you share a lot of the same mannerisms? Have similar temperaments? Think of them as a mini me?

This is how I thought of my daughter (my second child) and myself — people would stop me in the streets when she was a baby to gush over just how much she looked the spitting image of me!

So when she started showing signs of autism from the very young age of one, (although it took until she was six years old to finally have her formal diagnosis), it did lead me to start to wonder if I may be autistic myself.

But I didn’t have time for myself at this stage. I had a three-year-old son — my youngest — who was in desperate need of an autism and ADHD diagnosis and support.

Interestingly, once these two were diagnosed I still had no clue my eldest child, my 13-year-old, who had done so amazingly both socially and academically in primary school, could be on the spectrum. When they started high school, everything fell apart, leading us to find out they are also autistic and ADHD.

After all my children had been diagnosed as autistic, I started reading a book I was recommend about autistic girls to help me to understand and support my daughter better. I decided it would be a good idea to highlight anything which resonated with me. Halfway through the book, I’d highlighted most of it and was hit with the realisation that this wasn’t in reference to my daughter at all. It was explaining so much of what life was like for me from when I was a little girl, right up until now. So many things I had no idea had anything to do with autism, I thought they were just things Anthea did, thought or felt.

Things such as being really sensitive to light and sound, which I knew were related to another diagnosis I have of fibromyalgia; however, I didn’t know they are also signs of sensory and emotional overload. I would get this “funny feeling” in shopping centres a lot, my eyes would go blurry, I’d start shaking, could not concentrate and felt nauseous. My children find it challenging to be in crowded, noisy places too.

I was lucky enough to come across an organisation who were able to fund an autism assessment for me because, as a mum of three children with special needs, I would never have saved the money to pay for an assessment for myself. Their needs would always take precedence.

I am so very grateful that things fell in to place and I was able to get an assessment, as it was totally life-changing for me. The best part of this is that I’m able to learn tools and strategies which help to lessen my autism’s impact.

I am finally learning to feel comfortable in my own skin and understand why I do so many things in the way that I do.

I now understand why I really struggle to socialise in groups, why it takes me so long to get jokes, why I physically hurt when a friend or family member is emotionally upset.

If it wasn’t for having autistic children myself, I would never have known I am autistic. I would never have felt like I fit in somewhere in this world.

What is Hyperacusis?

What is Hyperacusis?

Hyperacusis is a hearing condition that causes a heightened sensitivity to sound, making everyday noises, like running water, seem extremely loud.

This can make it difficult to carry out daily tasks in common environments, such as chores at home or workplace responsibilities. In turn, you might try to avoid social situations that could lead to anxiety, stress, and social isolation from exposure to noise.

About 8 to 15 percent of adults have hyperacusis. This condition often affects people who have tinnitus, or ringing in the ears.

Read on to learn more about the symptoms and potential causes of hyperacusis. We’ll also cover treatment options and how each one works.

Hyperacusis is a low tolerance for sound in one or both ears. It’s also known as an increased sensitivity to sound.

The condition affects the way you perceive loudness. It makes ordinary sounds, such as car engines, seem extremely loud. Even your own voice might seem too loud to you at times.

The perception of excessive loudness may cause pain and irritation, resulting in high levels of stress. It can also make it difficult to be in public settings like work or school. This can lead to:

Hyperacusis primarily affects people who:

Adults are more likely to develop hyperacusis since aging is associated with this condition. However, it can affect children, too.

Hyperacusis symptoms can vary. Mild symptoms can include:

  • ordinary sounds seeming too loud
  • your own voice sounding too loud
  • discomfort in your ears
  • difficulty concentrating

Severe symptoms can include:

In children, discomfort due to hyperacusis may cause symptoms like crying or screaming.

Hyperacusis is also associated with conditions like:

It’s worth noting that hyperacusis is different from phonophobia — the fear of loud sounds.

Hyperacusis affects the way you hear sounds. Phonophobia is a psychological condition that involves an emotional response to sounds. It doesn’t involve auditory issues.

However, hyperacusis can lead to phonophobia due to the perceived excessive loudness of certain sounds, so the two conditions may appear together.

Possible causes of hyperacusis include:

  • High noise exposure. Loud noise is a major cause of hyperacusis. Exposure can happen over time (like playing loud music for many years) or a single occurrence (like hearing a gunshot).
  • Head injury. An injury involving the head, jaw, or ear can lead to hyperacusis. One example is getting hit with an airbag in a car.
  • Viral infections. Viral infections that affect the facial nerve or inner ear may lead to hyperacusis.
  • Jaw or face surgery. Hyperacusis can happen if the inner ear or facial nerve is damaged during surgery.
  • Some medications. Certain medications, like some cancer drugs, can cause ear damage and hyperacusis.
  • Autoimmune disorders. Hyperacusis can be caused by autoimmune conditions, such as systemic lupus erythematosus.
  • Temporomandibular joint disorder. The temporomandibular joint attaches your lower jaw to your skull. Problems with this joint may increase your risk of hearing issues, like hyperacusis.
  • Autism. Autism or autism spectrum conditions can cause hearing sensitivities, including hyperacusis. According to 2015 research, about 40 percent of autistic children also have hyperacusis.
  • Emotional stress. High levels of stress, including post-traumatic stress disorder (PTSD), can increase your risk of hyperacusis.