Wednesday, October 25, 2006

on polar bears and autism

Parents are bombarded with messages about autism and that unfortunately fuels worry and speculation. It also fuels early diagnosis which is never bad.

I was recently observing an infant who has some motor delays and the parent was very worried about some atypical repetitive behaviors. The baby would sit and stare at the carpet while running his fingers through the carpet pile. Over. And over.

Repetitive and non-purposeful behaviors always need to be assessed. However, this child has excellent play and social interaction skills - so the parent did not understand why he would engage in this very autistic-looking type of behavior.

To some degree children thrive on repetition and adults will become bored by an activity long before a child will. So, a child may repetitively place a ball through a series of ramps and watch it over and over as it rolls to the bottom - but this is just a way that they learn about cause and effect. This doesn't mean that they have autistic-like behaviors, and these must always be distinguished from normal repetitive play tendencies on infants and toddlers.

This carpet-rubbing behavior was not play-like and would last long past the amount of time it should otherwise last. So we needed to consider other options. Most notably, the behavior would only occur when toys were removed from the immediate reach of the child. The child has motor delays and is not yet functionally mobile, so I considered that the likely cause of this behavior was boredom and a desire for stimulation when there was no stimulation (toys) present in the immediate environment.

There is always risk in bringing up animal models when discussing human behavior but I admit to liking the simplicity of animal models. The child's behavior reminded me of the polar bears at the zoo. I recall visiting the zoo before all the studies came out about enriching zoo environments to improve the health and reproductive interest of the animals for conservation efforts. The polar bears used to pace back and forth in their environments, repetitively, for hours. I recall logging polar bear behavior over the course of several years in different zoos and in non-stimulating environments the pacing behavior was almost always repetitively present. However, when they gave the bears some barrels and floating 'ice cube floats' in the water for them to interact with the pacing behavior immediately decreased. I know that I am not an animal behavior specialist and this is by no means a scientific study but it is my observation.

So when I moved the toys within reach of my young friend his rug-rubbing behaviors stopped immediately and he went right back to appropriate interaction with the toy.

This is not to say that there are not concerns to monitor and issues to address for my young friend, but they are probably not autistic concerns. Rather, this underscores the importance of understanding how motor delays in young infants may lead to non-productive and even stereotypical play behaviors. Seems like an idea for a good study - although I would limit it to children within the 0-2 age range (sensorimotor period of development) because I imagine that long term motor restriction in children who have functional language leads to a different set of sometimes atypical behaviors (relatively increased verbal scores on classic IQ tests) - but that is another set of ideas.

So I hope the mom feels a little better with my description of 'primary' autistic signs and 'secondary' autistic-like behavior. We'll watch and see what happens.

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