Doctors checking babies for mental disorders

updated 4:53 p.m. ET May 14, 2007

CHICAGO - Within days of their birth, healthy babies will look you in the eye. By 4 months, they will delight in others. And by 9 months, they will exchange smiles.

Jacob Day did none of those things.

"We used to say it was like it burned his eyes to look at you," said his mother, Tamie Day of Antelope, Calif. "It was like a physically painful thing for him. It wasn't just that he wasn't looking at us; he was purposefully looking away."

Day, who has a psychology degree, suspected her son might have autism. She enrolled him in a study, published in April, that found that babies like Jacob are indeed at high risk for autism if they do not respond to their names by 12 months of age.

At 18 months, he was formally diagnosed with autism, about a year earlier than usual. Before he turned 2, Jacob began daily intensive behavior treatment designed to help him lead a more normal life.

He is part of a growing field in psychiatry called infant mental health. Doctors and scientists are increasingly looking for early signs in babies of autism, attention deficit disorder and other mental problems that just a generation ago, scarcely anyone thought could appear in children so young.

Some scientists even believe that intensive treatment in some susceptible babies can actually prevent autism, attention deficit disorder and other problems.

Rewiring the brain
An influential Institute of Medicine report in 2000 helped energize this idea. The report emphasized the plasticity of babies' brains. It also explained how interacting with babies can change their brain wiring.

"We used to say `nature versus nurture,' but now people really think it's 'nature through nurture,'" said the University of Chicago's Dr. Lawrence Gray.

Tamie Day noticed the first ominous clue the night she and her husband, Chris, brought Jacob home after his birth.

Rich Pedroncelli / AP Jacob Day swings upside down as his mother, Tamie Day, watches in their home in Antelope, Calif.

"We walked in the door and he wouldn't stop looking at our ceiling fan," she said. "The next day, that's all he would look at."

Babies typically begin making eye contact soon after birth, and "understand at a basic, perhaps hardwired level, that eyes are special — they look more at eyes than at other parts of the face," said Sally Ozonoff, an autism specialist at the University of California at Davis' MIND Institute.

When his mother expressed her autism concerns at Jacob's 6-month checkup, the doctor said "we were being a little overzealous," Day said.

Still, there was no pointing, no clapping, no shared smiles, and when Jacob would laugh, it seemed like his own private joke. So his parents sought out UC-Davis specialists, who gave them the heartbreaking diagnosis.

Jacob, now 3 1/2, has made meaningful progress thanks to treatment, his mother said, including a breakthrough moment at age 2. It still makes her cry to recall it.

She was giving Jacob a bath, playing the "itsy bitsy spider" finger game, when he looked up and really gazed into her eyes. "He was smiling up at me and I realized that was the first time he had done that," she said. "He has gorgeous blue eyes, and I was like, `My God, your eyes are so beautiful.'"

Interest in infant mental health has been boosted by awareness of the prevalence of attention deficit disorders and autism, which government officials said in February affects 1 in 150 U.S. children and may be more common than previously thought.

In April, researchers from the federal Centers for Disease Control and Prevention and the Interdisciplinary Council on Developmental and Learning Disorders presented a report emphasizing earlier diagnosis and treatment.

The report said that about 17 percent of U.S. children have a developmental disability such as autism, mental retardation and attention deficit-hyperactivity disorder, but that fewer than half are diagnosed before starting school.

The authors say warning signs include failure to:

• focus on sights and sounds by 2 months.
• initiate joyful behavior with parents by 4 months.
• exchange smiles and sounds with parents by 8 to 9 months.
• take a parent's hand to find a toy and point to objects by 12 to 16 months.

Last year, the American Academy of Pediatrics recommended that pediatricians routinely evaluate children for developmental problems such as autism starting in infancy, and begin testing at age 9 months.

"Waiting until a young child misses a major milestone such as walking or talking may result in late rather than early recognition ... depriving the child and family of the benefits of early identification and intervention," the academy said.

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