Impairments of social communication are seen as one of the essential diagnostic features of autism. However, they cannot be considered as primary characteristics because all the ‘communication symptoms’ appear later in life. For example, Knobloch and Pasamanick (1975) reported that children who were referred to them for displaying ‘abnormal social responsiveness’ in the first year of life did not develop autism, whereas those who showed disturbance of social interaction at the age of two were found to have autism on follow-up. One the other hand, there is much evidence for real personal attachment in autistic children and adults (Frith 2003), though it may be expressed unconventionally. Having studied developmental records, Frith, Soares and Wing (1993) found that two thirds of mothers of autistic children were not disturbed by their child’s interaction in the first year.
Interestingly, young autistic children are reported to have more typical behaviour (89%) than atypical behaviour. For example, they gaze at people’s faces, react (turn) toward voices, respond to their name when called, etc. (Gabrielsen et al. 2015). (However, already at the age of 9 months, infants developing ASD were more likely to fail to orient to their names, persisting through 24 months; and infants who consistently fail to respond to their names in the second year of life may be at risk not only for ASD but also for greater impairment by age 3 years (Miller et al. 2017).
However, there are early signs that can indicate autism (and specifically, problems in social communication development typical for autism), such as lack of joint attention and gaze-following (e.g., Dawson et al. 2004). Intriguingly, non-social symptoms in infants (that are noticeable very early) can indicate later problems in speech and language development in babies later diagnosed with autism; for example, delays in posture development and in fine motor skills (Bhat et al. 2012; Libertus et al. 2014; Nickel et al. 2013). It does make sense, because in typical development the emergence of sitting skills correlates to receptive language vocabulary size at 10 and 14 months (Libertus & Violi 2016); infants’ advances in locomotion relate to advances in communication while increased presence of early gross motor delay from 5 to 10 months may indicate problems in communication development (LeBarton & Iverson 2016). On the basis of their research of posture development in infants with high versus low risk for autism, Nickel and colleagues (2013) hypothesise that a slower development in sitting and standing postures may trigger negative cascading effects in the communicative domain as well.
Chinello and colleagues (2016) explored the relationship between the persistence of primitive reflexes and the motor repertoire in 12 to 17-month-old infants. In typical motor development the use of goal-directed actions and communicative gestures depends on the inhibition of primitive reflexes, especially those involving the hand and mouth. As difficulty in performing skilled movements and poor gesture repertoire may be continuously distributed in the general population, they also researched the relationship between the persistence of primitive reflexes of the infants and the subclinical autistic traits in the parents. Results showed that irrespective of infant’s age, the persistence of the primitive reflexes correlated with motor repertoire, and it was greater among infants whose parents had more subclinical autistic traits. The authors conclude that ‘the persistence of primitive reflexes might alter the developmental trajectory of future motor ability and therefore their evaluation might be an early indicator of atypical development’.
Thus, research has produced a growing body of evidence showing that motor abnormalities in individuals with ASD are the rule rather than the exception: developmental motor delays during early childhood may also be important predictors of autism and paediatricians and other specialists should consider the possibility of ASD in infants with motor delays or other concerning motor behaviours (Harris 2017).
Sensory and movement differences may include difficulties in starting, stopping, continuing, combining and switching motor action, speech, thought, memory and emotion (Donnellan et al. 2010). Some of sensory issues are noticeable very early in life (like, for example, gross motor problems, others (gestalt perception, fragmented processing, etc.) are ‘invisible’ but playing an important role in the child’s trajectory of communication and language development.
Bhat, A.N., Galloway, J.C., Landa, R.J. (2012) ‘Relation between early motor delay and later communication delay in infant at risk for autism.’ Infant Behavior and Development, 35, 838-846.
Chinello, A., Di Gangi, V., Valenza, E. (2016) ‘Persistent primary reflexes affect motor acts: Potential implications for autism spectrum disorder.’ Research in Developmental Disabilities, http://dx.doi.org/10.1016/j.ridd.2016.07.010
Cliford, S.M., Dissanayake, C. (2008) ‘The early development of joint attention in infants with autistic disorder using home video observations and parental interview.’ Journal of Autism and Developmental Disorders, 38, 791-805.
Dawson, G. et al.(2004) ‘ social attention impairments in autism: Social orienting, joint attention, and attention to distress.’ Developmental Psychology, 40, 271-283.
Donnellan, A.M., Hill, D.A., Leary, M.R. (2010) ‘Rethinking autism: Implications of sensory and movement differences.’ Disability Studies Quarterly, Vol. 30, No 1.
Frith, U. (2003) Autism: Explaining the Enigma, Oxford: Basil Blackwell.
Frith, U., Soares, I., Wing, L. (1993) ‘Research into the earliest detectable signs of autism: What parents say.’ Communication, 27 (3), 17-18.
Gabrielsen, T.P.et al. (2015) ‘Identifying autism in a brief observation.’ Pediatrics, 135, e330-e338.
Harris, S.R. (2017) ‘Early motor delays as diagnostic clues in autism spectrum disorder.’ European Journal of Pediatrics, doi: 10.1007/s00431-017-2951-7.
Knobloch, H., Pasamanick, B. (1975) ‘Some etiological and prognostic factors in early infantile autism and psychosis.’ Pediatrics, 55, 182-191.
LeBarton, E.S., Iverson, J.M. (2016) ‘Associations between gross motor and communicative development in at-risk infants.’ Infant Behavior and Development, 44, 59-67.
Libertus, K., et al. (2014) ‘Limited fine motor and grasping skills in 6-month-old infants at high risk for Autism.’ Child Development, 85, 2218-2231.
Libertus, K., Violi, D.A. (2016) ‘Sit to talk: Relation between motor skills and language development in infancy.’ Frontiers in Psychology, doi: 10.3389/fpsyg.2016.00475.
Miller, M. et al. (2017) ‘Response to name in infants developing autism spectrum disorder: A prospective study.’ Journal of Pediatrics, 183, 141-146.
Nickel, L.R. et al. (2013) ‘Posture development in infants at heightened vs. low risk for autism spectrum disorders.’ Infancy, 18, 639-661.