Case Study of the Development of an Infant with Autism from Birth to Two Years of Age.

This report describes a case study of the development of an infant with autism who was observed closely by professionals from birth and to whom a comprehensive psychological evaluation was administered at approximately 1 and 2 years of age. During the first 6 months of life, this infant displayed difficulties in oral motor coordination and muscle tone that fluctuated between hypotonia and hypertonia. He startled easily, had poor state regulation, and was hypersensitive to touch. Notably, however, during the first 6 months, this infant vocalized and responded socially to others by smiling and cooing. During the second half of the first year, he continued to demonstrate diffuse sensorimotor difficulties and diminished oral motor control. Hypersensitivity now extended to a wider range of stimuli. He had problems in sleep regulation. Motor stereotypies, including rocking, head banging, and toe walking, were observed. Difficulties in the domain of social interaction began to emerge during the second 6 months, including poor eye contact, failure to engage in imitative games, and lack of imitative vocal responses. By a little over 1 year of age, this infant met diagnostic criteria for autism based on the Autism Diagnostic Interview. There were several domains in which this toddler with autism did not show impairments. In the areas of immediate memory for actions, working memory, response inhibition, and speech perception, this 1-year old with autism displayed no evidence of significant impairment on the tests administered. This case study offers clues regarding the nature of autism at its earliest stages. Understanding early development in autism will be important for developing early screening and diagnostic tools.