Hello all,
I am a mother of a 4-month-old boy that I worry about. My partner is not very supportive and actually insists that I am suffering from postpartum depression and that there is nothing wrong with my son. However, he spends very little time with him so he wouldn't know. The pediatrician is dismissive of my concerns. I live in Canada, and it's hard for us to get an evaluation, we need to fight the system and to convince the pediatrician to get a referral.

My pregnancy was uneventful, except for 2 choroid plexus cyst in his brain. I had a very difficult delivery - several days in latent phase labour, then they had to induce my labour, break my waters and finally use a vacuum to deliver my son.

For the first three months he had severe reflux, which he is growing out of. He smiled at 1 month, was smiling a lot at the age of 2-3 months, started laughing at 3.5 months, grabbing and holding his toys, then rolling over from back to front, always using his right side, and even somewhat crawling once he hit 4 months - but he crawls with his right leg and drags his left leg behind. He sleeps through the night with no training on my part. So far so good.

When he turned 4 months, he stopped smiling spontaneously - he just gives me a blank stare. I can still get him to smile and laugh, but I have to work hard for it - bounce him or tickle him, make funny noises, or sing, and it does not happen every time. The same with other people. He makes good eye contact when I bottle-feed him (his suck was too weak, and my milk supply dwindled when he was 3 months old) and he can make good eye contact when I sing and play piano while he is sitting in his bouncy chair - but that's about it.

He has always been independent while playing with toys (he only brings them to mouth, doesn't shake rattles or anything of sorts). He loves tummy time, actually sleeps on his tummy, doesn't stay longer than a few minutes on his back but turns over. Well, I can get on the floor next to him, can hold a toy next to my face, make noises, etc. - he looks at the toy past me, he does not make any eye contact with me. The only way I would get him to look at me in this situation is if I start singing - he looks up, give me a very quick smile and turns away. If he is in his stroller, he stares at me and at others with a completely blank expression. He makes noises but it's more self-talk than directed to others, he started making occasional noises like "da" and "ga", but in general he keeps quiet and does not respond with cooing when I or someone else talks to him.

He likes a variety of toys and constantly chewing on them. When he was 3.5 month old, he smiled at his mirror reflection. A month later he stares at it, tries to touch it, then either yells at it or makes an angry face and turns away. It's almost as if he stopped trying to make social overtures at all. He used to smile at his plush toys - not anymore, now he treats them as objects. He can sometimes smile at random things - at my pillow or at a tag on his clothes.

He has never turned to voice - although he may turn when I am singing or if there is a loud noise. He likes watching people but does not seem to initiate any social interaction. I find out that he has had a bowel movement only because he turns and starts looking at me without making any kind of noise, then I know it's time to change him.

Both my partner and myself have larger than average heads. He was born with his head in 25th percentile, but there was lots of swelling after a vacuum-assisted delivery, then at 2, 3 and 4 months he measured in 15th percentile consistently. His head started growing once he hit 4 months - it already grew 1.2 cm in 2 weeks, and I am worried.

There are some glimpses of better functioning - just a week ago he had a spontaneous rare smile directed at a woman who entertained him with bouncing the day before, so obviously he recognized her and smiled at her. He also seems to recognize his surroundings.

My heart is heavy. I am on mat leave until my son turns 1 year old, then I have to go back to work, otherwise we will have nothing to live on. My partner will not be able to support us and he has very limited time to spend with my son to begin with. English is not my first language - I hoped that my son will be bilingual, and was planning to enroll him in a Russian-speaking day home, so that he would learn English later. However, people who run this day home are not familiar with special needs, and I am not sure what would be the best solution for my son. Obviously, he must learn English, too, if he is to live in Canada.

I just bought Dr. Greenspan's materials online, and am planning to order Early Start Denver model manual to work on this stuff at home, as much as I am able to. My pediatrician won't even talk to me about his possible delays until my son is 9 months old for language, and until he is 18 months old for autism.

Could you give me your thoughts or any advice? I regret that my breastfeeding did not work out and that I stopped co-sleeping with him. I was overwhelmed with his reflux - I am his primary and only caregiver - so I was happy to see that he was playing with toys independently and did not try to engage him more often (even though I have read to him, sang to him, played with him every single day - but I let him have his tummy time on his own.) Now he can spend up to several hours playing independently - if I let him, that is, which I don't, I try to engage him.

Obviously I don't know what will happen in the future, but 4 months is way way WAY too young to be worrying at this stage. From your post it sounds like your LO is doing lots for his age. I really wouldn't expect a 4mo to coo back to me if I talk, engage me whenever I speak or play with toys. Most 4mo babies are busy working on head control, holding objects, bringing them to mouth, rolling etc. Googling autism red flags so early will drive you crazy. Try and enjoy him as he will be a toddler before you know it.

Also speaking as someone from Canada who has gone through all that with my son (now 3.5yo), they wouldn't "assess" a 4mo who is developing normally as your son appears to be based on your post. My son was flagged for assessment early due to physical issues - and even then he was 11mo.

My nephew has just been diagnosed as autistic and he is 19 months. It is very, very difficult to diagnose this so early as baby is going through so many quick changes. One of the reasons my nephew did not get diagnosed at e.g 1 year was because even though he was slow to speak, he actually came out with some words and his parents were relieved, but now he has regressed and doesn't speak at all anymore. This, coupled with other behaviours led to them believing he was autistic.

You may find that your baby will suddenly start better eye contact at 6 months or maybe smiles again at 7 months. If you think there is something really wrong with him, then get him checked out but it is unlikely at 4 months that definitive signs of autism are present just yet.

Sun, thank you for your response! Do your remember how your son was behaving when he was 4.5 month old by any chance? Was he able to engage in eye contact when playing with toys and was he smiling back at you - or did his smiling decrease?

Honestly Kristina, please don't worry yourself at this age. I am a total nut case and even I wasn't worried at 4 months. Is it common for you to worry about things like this? For me it is. I spent my whole pregnancy worried about miscarriage, then down syndrome, then premature and still birth and on and on and on. Then it was sids and now autism. If you are like I am, then please don't google anything. You will find something to support your fears no matter how wrong you may be. We can find traits of may disorders is all of us, but it doesn't mean we have the disorder. Your ds sounds very advanced in my opinion- if anything maybe he is gifted! Yes some autistic children army crawl, but keep in mind that children with autism are not known for reaching milestones early. 4 month is super early to be crawling and I wouldn't expect a 4 month old to crawl at all, especially correctly. You seem very on top of it and aware and I am sure that if there are any issues in the future with your son you will spot them early and take action. Right now it is wayyy too early and you haven't said anything that doesn't seem like normal baby behavior in my opinion. Personally I would just keep an eye on milestones and if you notice your son is missing any of them(which he is not right now) then speak with your pediatrician about it. And even then it may turn out to be nothing at all. If you have a problem with worry, then try to listen to those around you. If you are the only one worried then try and let it go. Trust me I know it is hard, but sometime we spend so much effort worrying over nothing and we miss out on just enjoying our child!

i would urge you to try not to think of this at all at such a young age

you should be enjoying your baby as they grow up not obsessing and looking for things that might be wrong, i know it sounds harsh but they are grown before you know it

I'm in Canada too.

Your little guy is still very young At 4 months Claire didn't really do that much either, but neither did any of my friend's kiddos as well. I know it is SO HARD but try not to worry about it. Which I get is frustrating to hear, as parents we want to know what's going on right off the bat.

I think the *earliest* they can start detecting Autism is 9 months but even then that's in more extreme cases I believe.

Claire wasn't flagged until her 2 year well baby check up. What I will say though, is if you can contact any sort of early intervention program in your local area I would do so. The wait is astounding and Claire's RT put her kiddo on the waitlists as soon as he was born. By the time they actually got around to assessing him he was over a year and a half old.

Then they'll be able to detect better if there is something going on, and if there isn't then you are good to go.

Try not to stress, as hard as that can be.

If I were you I would keep a record of everything that you find suspicious. The doctors are not trying to be mean by not diagnosing him yet, they is a higher chance of inaccuracy until he gets a bit older. It is possible that he will outgrow these behaviours, but I would trust your mother's instinct.

Document all of the unusual behaviours (with the date) as well as when/if he is meeting the typical milestones. This will give you more to go on when he gets a bit older. Something to inquire about if you haven't all ready might be his hearing and his eyesight. Both of which can cause odd behaviours if there is a problem.

As for your husband, it is not uncommon for men to be in denial. I wouldn't worry about trying to convince him that there is a problem until you have medical proof that there is a problem.

Check this website out: (I think you will find it very helpful)
http://www.helpguide.org/mental/auti...s_symptoms.htm
It says to seek a second opinion if you are worried and your doctor won't listen to you.

I am not sure that there is much treatment available when a baby is as young as yours so I wouldn't worry or fret about it too much, just be persistent and do what you can. If your gut tells to get a doctor to listen to you, then do everything you can to get your doctor to listen to you.

Good luck!

Four months is far FAR too young to be worrying about it, let alone looking for signs. And even if there were a way to diagnose it, its not as if they can begin intervention to any meaningful level. Enjoy your baby, because if you do get a diagnosis later on, you will honestly look back on that year of "normality" and be glad you had it.

A very good thought Tiff, I contacted early intervention services, and will wait for the assessment - although they told me that the wait is no more than a month! I am in Alberta though, maybe it's different from Ontario.