Is Infant Diagnosis of Autism Possible?

An Interview with Philip and Osnat Teitelbaum

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Research Suggesting Markers for Autism in Infants

Is it possible to diagnose autism in an infant? While Dr. Philip Teitelbaum and his wife Osnat don't claim they can actually diagnose autism in a child of two or three months old, they do believe that they have found a key to early detection. In fact, they say they found that key back in 1998.

Philip Teitelbaum is a professor of psychology at the University of Florida.

His research was unrelated to autism, but he had an idea based on animal research that he wanted to explore. He put out a call to families with children with autism, asking for videotapes of the children's' earliest days. Then, together with his wife, a researcher, he went over each tape with a fine-tooth comb, using a specialized system of observation and measurement of motion.

The couple found that the infants in the tapes had a set of easy-to-detect physical "aberrations" which set them apart from typically developing infants. For example, if the children were held at an angle they didn't right their heads. They also had a differently shaped mouth, and other oddities. Based on these findings, the Teitelbaums published a paper, and then another paper. But since then, no other researcher has picked up on their research - and while the Teitelmans themselves have promoted their work, they haven't proceeded to verify their claims through additional research.

The Book: Putting The Process in the Hands of Parents

Appearances on television and articles failed to attract much interest, but the Teitelbaums decided to write a book intended for parents. Says Osnat: "We hope that parents will demand that the medical establishment respond, and we are quite certain that they will."

The book, Does Your Baby Have Autism? is subtitled "A Revolutionary Theory for the Early Diagnosis of Autism," and it recommends a variety of actions on the part of parents to determine whether a child has the telltale signs of autism. Yet the Teitelbaums make the point "We are not in the medical profession; we can't make a diagnosis." Which I think may lead parents to wonder why the book seems to encourage parents to make their own diagnosis based on a set of line drawings. In fact, that's an excellent question, especially since there's no way for any medical professional to confirm a parents' concerns until the infant is old enough for conventional evaluation.

In my interviews with the Teitelbaums and their publisher, Square One Publishers, I found they likened themselves to Jonas Salk, who was ridiculed for his invention of vaccines until he proved himself through radical experiments. But neither of the Teitelbaums are neurologists, and neither claims to have the ability to treat autism.

Both make it plain that they are not clinicians, and while they recommend treatment in their book, they have no research to show that the treatments are likely to slow or lessen autistic symptoms.

Has this couple discovered the key to a massive change in autism diagnosis and treatment? 

Q: Why did you write this book?

A: The medical community didn't pick up on our work, so we decided to write a book for the parents. In that way, we have pediatricians and others start paying attention to all this. This is only a first step, and we will start collecting data from parents in order to continue and advance our research.

All diagnostic measures are now based on the child's social behavior: eye contacts, social interactions.

No one talks about autism as a purely neurological condition. Way before the child starts to talk and interact socially, he is already talking to us with his body and his movements. When you understand this, you can nip this thing in the bud.

Q: Is it your theory that, by intervening in physical development, parents can slow or stop the development of autism?

A: Our research focused only on early detection. We've been doing it for almost 20 years. We have seen over the time different interventions and therapies that can lessen the severity of autism. So our attitude is that when you catch it early and you start treating it early, the better will be the outcome.

Mothers are the best diagnosticians. They see something wrong at a very early age. This book will give a way to express objectively what they are feeling. We also repeatedly suggest to mothers that they keep a photo diary or video diary of the baby in order to show the issues to the pediatrician.

If the phenomena we're describing keep showing up week after week, there's definitely neurological damage.

What we're showing in the book is not something weird. These movements are not subtle. If a child doesn't crawl it's not normal. Persistent asymmetries are not normal. A normal child will not lie there with his arms trapped under him.

If you see any of that there is something wrong; if they start to add up, there may be a possibility of autism. Not just one symptom by itself, but all of them become a collection of evidence that may point to autism. We are not diagnosing babies with autism. We are saying those movement patterns are precursors to autism.

Q: How did you develop these theories?

A: The videos we got were from parents whose children were now diagnosed by a medical professional. The way we are working, the work on that research took many many years for various reasons. To work from videos and analyze movements took years. Our focus is on the research part of all of this: early detection and precursors. Not on the treatment side. In our setting at U Florida, I am a research scientist and my husband is a professor. Others around the country have not picked up on this work for various reasons. All of our work is retrospective. We have not looked at children in a clinical setting. We developed the list of aberrant movements which have not been defined by the neurological community.

Q: What kinds of treatments do you recommend?

A: We suggest treatment at home - start doing simple things. Maybe you will help him. Swinging may help. It is my own opinion that the big swing provides better vestibular stimulation. We have seen in the centers for autism that autistic children love vestibular stimulation and we think it might help. Parents have told us that it helps. Right now, these are still early anecdotal reports. We have a questionnaire in the back of the book, and we are waiting for responses.

The Bottom Line

I feel it is impossible for a lay parent to know whether the Teitelbaum's theories hold water, and it is almost as difficult for a lay parent to make useful judgments about their child's movements on the basis of a set of line drawings. What's more, even if a parent actually creates a video record of his infant's movements and presents them to a pediatrician, the pediatrician is unlikely to have any experience or knowledge of the significance of these movements relative to the Teitelbaum's research.

Even if a pediatrician does agree that there's cause for concern, the most likely outcome is that he will recommend that parents "watch and wait" until the child is older - something that's very frustrating indeed to parents, who want to take action right away. The book does suggest some possible treatments, such as swinging and other physical activities, which parents can try - but there is really no good reason to believe these techniques will be effective. What's more, some of the other treatments suggested in their book, including auditory integration therapy and facilitated communication, are not only controversial but are also inappropriate for an infant.

At best, at this point, it seems that these techniques might alert a parent or pediatrician to the possibility of autism or related delays - and urge greater awareness as the child develops. Of course, parents who are really excited about the Teitelbaums' findings certainly have the option of pushing for further research, funding further study, or otherwise agitating for the development of treatment options for infants. Until that time, however, it's hard to believe that this book will have a significant positive impact. In fact, I feel it's much easier to believe that it will create even greater anxiety among parents - and even more of a push to treat children as early and often as possible, with or without a diagnosis.


Interview with Philip and Osnat Teitelbaum, April 2008.

Teitelbaum, P, Teitelbaum O. Does Your Baby Have Autism? NY:Square One Publishers, 2008.

Teitelbaum O, Benton T, Shah PK, Prince A, Kelly JL, Teitelbaum P. Eshkol-Wachman movement notation in diagnosis: the early detection of Asperger's syndrome. Proc Natl Acad Sci U S A. 2004 Aug 10;101(32):11909-14.

Teitelbaum P, Teitelbaum O, Nye J, Fryman J, Maurer RG. Movement analysis in infancy may be useful for early diagnosis of autism.Proc Natl Acad Sci U S A. 1998 Nov 10;95(23):13982-7.

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