Yep, its still Autism Awareness Month :)

http://www.youtube.com/watch?v=hhScvPYXunc

I get a lot of questions, mostly from parents of young children, about how or when I knew that William might have autism. I think they are looking for the warning signs...either so they know what to look for, or to put their minds at ease over some nagging concern. Truth be told, there were several times in his young life that I had concerns that SOMETHING was wrong, but the thought of autism never came to me on my own. When William was 3, I was discussing concerns with my younger sister about his speech and lack of attachments to others, and she was the one who first mentioned the word "autism" to me. I will forever be grateful to her and applaud her courage for doing so.

But like I said, even before that day, and WAY before he was ever diagnosed, I had nagging feelings that there was something going. And upon reflection during his diagnostic process, well, as they say, "hindsight is 20/20." Here are just a few of the things that cause concern, most of which I actually spoke with his pediatricians about, and most of which I dismissed and 1st time parent paranoia and over-analyization. This list is in no way complete:

• As a newborn, William never cried. Sounds like heaven right? And it was wonderful to have such a great baby! But it still made me wonder. Even in the hospital on the day he was born, he just barely cried. When they released us to go home, I asked a nurse why his hands and feet were blue and she said, "because he hasn't really cried to help increase the circulation to his extremities." This continued throughout his infancy...hungry, wet, sick, tired...no crying.
• Along those same lines, typically, a baby in a room full of other babies that are crying will have an "empathy" response and begin crying as well. William never did this. His nursery workers LOVED him and would ask on a daily basis things like "Is he always this quiet?" and "Does he ever cry?" I witnessed this first-hand one day when I picked him up early. 7 other babies were all crying their eyes out...and my sweet boy was laying still, staring straight ahead. He did not respond when he saw me come to pick him up. In hindsight, it can be assumed that he was "zoning out" because of the extreme sensory input of all the babies crying.
• I once thought he might have hearing problems. He always had ear infections, so I became concerned about his hearing once when I realized he wasn't really responding to his name, or many other noises. His hearing was checked and he was fine. This is actually a common occurrence for kids on the spectrum. To this day, he often won't respond when someone calls his name.
• He didn't care for his infant swing. He wouldn't cry, but when he was in it, he would ALWAYS look up and to the right. I have photographic evidence. It always seemed so strange to me. Again, he was probably either zoning out or focusing on one small moving mechanism at the top of the swing. He does not like to swing in a traditional back-and-forth motion to this day!
• He lost speech. Well, actually, it just kind of "changed" and sounded worse. He went from saying "dat do" for "thank you" -- 2 very distinct words that were similar and age appropriate, to something that sounded like "dow" where it was all just run together. There were others too.
• Speech delay was a big one. I started asking everyone around me about his speech from the time he was 18 months old. I just knew he was behind. His "classmates" at preschool were all talking circles around him, and much clearer. Everyone said I was crazy. At his 4 year check-up, the pediatrician was still hesitant to have him evaluated, but said that since I had been concerned for so long, we should take him just to see. He tested in the 3rd, that's right THIRD, percentile for kids his age. He was dropping almost every middle and ending sound and was only understood by me. He was looking to me to talk for him when people didn't understand him. (We've come a long way, baby!)
• He didn't make "connections" with people. He never seemed to notice or care about people coming into and out of his life. He never really went through the "separation anxiety" phase that kids go through. Though he was/is affectionate, he just didn't seem to connect on any level. Even I was concerned and frustrated that I felt as though he didn't seem to care whether I was around...and I am his MOM!
• On those same lines, he never sought attention. Most babies/kids want attention...all the time. They are constantly talking and pointing and tugging and crying and, well, you get the idea. William has never been like this. He actually tends to avoid attention.
• Oh, my, the obsessions. He always has at least one. They occupy his every waking, and sometimes sleeping, moment. The first one we noticed was Buzz Lightyear. It lasted for quite a while. Then there was Spiderman, Pokemon, Polar Bears, Ben 10, etc. He will talk, fantasize, role-play, draw, write about, watch, read his obsessions for hours on end. And don't try to distract him with something else...it won't work. He will even name all pets, stuffed animals, even friends after it. I think we had 6 fish named "Spiderman" at one point.
• Difficulty with social interactions. This is a big one, and the one that took me the longest time to notice. When he sees a group of kids he wants to play with, he will just walk up and stand right next to one of them. Doesn't say anything, just stands. And his idea of a conversation, unless it involves one of his current obsessions, is to take turns telling jokes or naming your favorite animal. He is learning "scripts" in speech therapy...questions that are polite to ask, how to respond, how to start and stop conversations, etc. and so what we are seeing now is that he will ask these questions ("How was your day?"), but not wait for the answer before changing back to the topic of obsession or jokes.
• He doesn't interpret tone of voice, facial expressions, or gestures correctly. If you say his name and he actually responds, he will almost always think he is in trouble. He doesn't always understand if you try to kid around with him. He takes what you say very literally...if you say "cut it out," he may just go get some scissors. :) He also won't pick up on things like a friend not wanting to be hugged ('cause they're tough guys, ya know), and may not stop playing a game if someone gets hurt.
• He over-reacts or under-reacts to almost everything that happens to or around him. Tantrum or oblivion...take your pick.
• He has a very HIGH pain threshhold most of the time. He would have SEVERE ear infections. He's probably ruptured one ear drum or another at least 6 times. And never once did he so much as complain. He didn't run a fever with it either. It's as if his brain just didn't understand what his ears were telling it. He also didn't have the same reactions to pain that were expected after his tonsillectomy/adenoidectomy. When he cut his head open to the skull, he stopped crying as soon as he couldn't see the blood anymore. Luckily, I've gotten pretty good at being able to tell he is ill just by the way his eyes look.
• Say it with me now, "echolalia." Look it up. :) When I first learned about this as a symptom of autism, I thought, "yea!, one he doesn't have." I was wrong. He will repeat the same phrase or question over and over until he gets the response he wants, not just any response, but the one he wants. He sometimes ends every sentence he makes with "right?" and you have to agree before he will move on. In play, his "character" will say the same thing repeatedly, or repeat conversations from a TV episode verbatim. When he talks about something he learned in school or from a book, it will be word-for-word the way he heard it or read it...every time he says it.
• DON'T MAKE CHANGES TO THE PLAN!!! If you say we are going to school, then Target, then home, don't even think about adding a trip to the bank in there, or asking if anyone wants to go for ice cream...that wasn't part of the plan, man! And things better always happen the same way, too. Every visit to the grocery store has to include getting marshmallows, every visit to Grandpa Chip's has to include the trampoline, every trip to the gas station will be met with, "can we go in and get bug juice?," every ride to OT has to include a conversation about what birds you like the best. If he played LEGOS with you the first time he came over, guess what you're supposed to play EVERY time he comes over? :)
• Can you say SENSORY ISSUES? Since day one. Liked to be wrapped TIGHT (I know, what baby doesn't?--remember the whole 20/20 thing :) Hated jeans...called them "hard pants." No finger painting please...nothing that gets the hands messy. No swinging, sliding, twirling, throwing in the air. Nothing that gets those 2 feet from being firmly on the ground. He even hated walking up and down ramps (like wheelchair ramps). Chews on EVERYTHING. If it's in his hand or near his face, it will end up in his mouth. He doesn't notice when his face is messy, clothes are twisted, underwear is on backwards, someone is touching his shoulder. Doesn't like to have his face touched...ever. Doesn't like his mattress...would rather sleep on his hard floor in a very cramped space with the fan blowing on him. He says its more comfortable. Hates noise (seems to hear things no one else can). And crowds...nothing will set off the stereotypical autism behaviors in him like crowds.

Wow. There's way more I could write, but I'll stop because I've already gone on way too long. Any questions? :)