Q&A: hand and foot twirling in an 8-month-old

Erin writes:

"Since my son was about 6 months old he started twirling his hands and his feet in a circular motion when he’s excited or frustrated. It seems to happen a lot when he’s in his car seat or in his high chair when he can’t move around as much.  I was a little concerned about this movement, but my husband said it’s just his way of expressing himself. When I took him to see his pediatrician last week she noted some concern about the movement. I asked her if I should be concerned and she said sometimes babies w/ autism have strange hand movements so she would like to keep her eye on him. Even though he seems completely normally in all of his development (laughs, smiles, recognizes his own name, babbles, does all physical skills for a baby his age), this really scared me and I can’t think about anything else. My husband is a neuroscientist and knows a lot about autism. He said in babies this young they usually look for an absence of developmental skills rather than unusual movements. I’m mad at our pediatrician for even hinting that it could be a sign of autism.

What I would like to know is have you had other parents ask about this same type of movement? Did their kids end up of having autism? Do you have any suggestions for how I can stop worrying about this?"

Your pediatrician is an ass. What part of "First, do no harm" doesn't she understand?

Your husband, the neuroscientist, is correct (of course). This is a normal stage of development, and both of my kids and most of the babies I've seen have gone through some version of circling or flapping in excitement. The connection with developmental disabilities is that kids sometimes get stuck in these circling/flapping stages. So what's totally normal for a baby or toddler could be a symptom of a delay or issue in an older kid.

The real issue here is how you're going to deal with this with your pediatrician. Just switch practices without telling her why? Write her a letter expressing your disappointment at her misinformation that caused you to worry needlessly and asking for an apology and that she do some further investigation on circling and flapping so she doesn't misinform other patients? Express your concern in person that she's giving misinformation as medical advice? Egg her house? It's a crapshoot.

Readers, I'm looking for three different kinds of responses, so post any and all that you have: 1) My kid circled/handflapped and passed through that stage. 2) My kid has autism and is a great kid and we're meeting the challenge. 3) My kid's pediatrician gave me bad info and this is how I handled it. (I'm going to assume that no one actually egged their ped's house.)

Comments

[Lisa]

Your pediatrician needs some education here. You rightfully should be perturbed by her suggestion that this completely normal behavior is anything but completely normal, particularly in light of how everything else is completely normal. It's not your responsibility to educate her, and she may or may not be responsive to your attempts. If it will stress you out, skip it and find someone else; if it will feel empowering, include some references in your letter requesting your child's medical records for her next pediatrician. Or maybe you are part of larger practice and you can switch within the practice and let your new pediatrician know why and *they* can educate her.

Both of my kids handflapped and twirled and did so with glee and are most definitely not autistic. (And my pediatrician smiled the first time she saw it and said to my daughter: "oh, you're doing my favorite pinwheels! My favorite [pointed look at me]: completely normal pinwheels!")

And on this subject of educating pediatricians, you pick your battles. Because she also said to my daughter on her one year visit: "Yay! You're one! No more bottles!" to which I smiled and inwardly thought, meh. I'll do what I want.

[Shandra]

I just want to point out that doctors and pediatricians are prone to societal trends just like everyone else. With so much out there about autism and increased rates of autism diagnosis, combined with the idea that early intervention is key...I just think some professionals are a bit off the rails.

I say that because I had an ultrasound tech bring up autism about my (normally quite social) son's behaviour - while looking for appendicitis, which accounted for his lack of affect, thanks-a-bunch. He was also concerned that my son was in a night diaper at 6 am (4 years old). That's what happens when the on-call nurse says you have an hour to get him to the hospital.

If you hear a vague hint of grumpiness trying to be tinged with understanding for people in medicine, you're right.

I'd tell your pediatrician straight up that she has caused you a lot of anxiety and see if she apologizes. Maybe she spent the morning with a family talking about autism or something, but she needs to get it under control. It may have been a vague 'mental note' for her, but it's not for you!

[MLB]

3 kids - all circled/hand flapped. None have autism or are on the autism spectrum. My understanding is that at 8 months they are supposed to do this. I think all babies do. Very bad advice. And switching peds is always an option. I did it when my second was 2 months old.

[Camilla]

This strikes me as a fairly minor flub on the part of the pediatrician: in most cases with a concern like that, "autism" is the elephant in the room. If the parent was already thinking it, they'll be glad the pediatrician acknowledged it as a worry.

It's also human nature for a parent who's worried about a bunch of subtle developmental signs, to bring up the more physical and less stigmatized signs first. It's a lot easier to say to the doctor "hey, he flaps his hands funny" when what's actually more worrisome is "he doesn't seem to love me" because the latter may be deeply cloaked in parental denial and harder to put your finger on. The pediatrician may have a perfectly reasonable bias if she assumes that an expressed parental concern about a minor behavioral quirk is actually the tip of the iceberg. She's not so worried about the hand flapping, but is worried that you reported it to her.

I liked the book _The Girlfriend's Guide to Toddlers_ for a bunch of anecdotes as to how weird and frustrating normal toddler behaviors can be.

My husband worried about the baby-bird flapping that our son did, and then we all worried about his lack of expressive language (no words at 20 months), and then he caught up to normal (threeish).

[thebigmeow]

My son has autism and he never hand flapped or twirled.

We have been working through a therapy program for a year now and the results have been amazing. He goes to preschool at a mainstream school and his teachers love him.

He is amazing, and all the autistic kids I have met are amazing.

Having said that, there is a quick checklist you can use the determine whether or not further testing is required. I would say that your husband has already done this in his head and you have no cause for concern.

I would definitely complain to the paed. I complained to one who missed my son's ASD.

[Medley]

It surprises me, but I think some doctors just really do NOT realize how much casual comments they make can stick with patients. I'm a good listener and wanted every scrap of insight or info our docs could offer during my pregnancy and now with my son. And I remember everything, including the nurse who examined my day-old baby and said she could tell he was going to have man-boobs (my paraphrase) as an adult (whut?).

Late in my pregnancy I was going past my EDD and (since I'm old) going in for extra ultrasounds and so forth. And one of the doctors in my practice made a casual comment about how they like to check frequently at this stage because they sometimes mysteriously see babies "die on the vine."

And that phrase pretty much haunted me for the rest of the pregnancy echoing repeatedly: "die on the vine" "die on the vine" "die on the vine." And I can still hear it in my head sometimes.

In this case, given all the attention to spectrum disorders (my god-niece is autistic, so I have some familiarity), I don't *completely* fault the doctor for noting the possibility and wanting to keep an eye on it - although she could probably work on how she presents such cautionary info. I also think sometimes the pedes lose track of what's what at which developmental stage. They see so many kids, I find myself reminding them that my (very big) kid is only X-months old and therefore should he really be doing Z yet?

My 2-yo was running around a grassy area flapping his arms one day, and I had the thought "Flapping! bad! omg!" and then he's all "I'm a plane!" And I tried to chill out.

It's hard, though. 8-months-old are still figuring out how to work their little limbs - it sounds normal to me, fwiw.

[Katie]

If the doctor had not mention autism we would be up set and now we are upset because the doctor did?

My son had some repetitive movements from 6 months on. He has been seeing an occupational therapist for sensory processing disorder/ sensory integration disorder.

[wealhtheow]

My friend's daughter is a hand-flapper--totally normal kid, but at 3 years old that's still how she expresses excitement. Her ped told her mom that if she doesn't grow out of it by 4 they'll just work on helping her control it (for social reasons). Actually, this girl isn't QUITE normal--she's pretty ahead of the curve, so maybe it is just a sign of brilliance?? :)

[Susan]

I do feel like the ped is taking quite a beating in this post, and I think this may be a bit of an over-reaction. I don't think the pediatrician is "an ass." She didn't say that he DID have autism, she just said that she wanted to keep an eye on him. That's better than just dismissing your concerns, right? It would have been frustrating for her to say, "Oh, that's nothing" when it really had you concerned. I don't think you need to give her a talking-to. If it were me, the next time I saw her I'd say I've been watching the hand-flapping and here is how it has changed/not changed since the last appt. Also, I had looked up early symptoms of autism, and the baby doesn't seem to have any of them. How concerned does she think I should be about autism? She'll probably tell you there's no need for concern, and it sounds like that's what you're wanting from her.

[Erica]

My daughter, who just turned two, has been doing this since she was about 2 months old. As you said, it is usually when she is confined (in a high chair, stroller, or car seat) and always when she is excited. We call her our little conductor. She absolutely is not anywhere close to the autism spectrum. She is a happy, healthy, socially active, very intelligent little girl. She actively expresses her feelings and speaks in full sentences 80% of the time. Please do not worry.

[Raia]

If my pedi saw something that concerned her, I would want her to tell me. That, after all, is why we are there. I think saying, "I noticed this, it may or may not be a problem, but let's keep an eye on it," is a perfectly reasonable thing to say. The alternative is to wait until the pedi is absolutely certain of a problem, which is later than optimal and you could miss other early signs of problems by completely ignoring the first one. The trick that is easier said than done is to keep this minor concern in context. 'Watching' something is not a diagnosis.

[Raia]

Oh, forgot to say that my son 'flapped' but is highly social and not on the spectrum.

[Katy]

My son flapped his arms from a very young age when he was excited - especially in his high chair. Other than that he was happy, smiley, made eye contact, played appropriately, etc.

It wasn't until 9 months when other delays started cropping up (no real word sounds or communication, no pointing or waving) that we began to suspect autism. Our pediatrician wanted to put us off until the 18 month check up but we pushed on our own for an evaluation with a local autism center, got an autism-spectrum diagnosis (PDD-NOS) and B was able to start in an awesome school program at 15 months. Now he's doing wonderfully: he's in pre-K, talking up a storm, socializing etc. He still flaps his arms when he's excited though.

All this to say that I wouldn't be worried about flapping on its own - many of the behaviors of kids with autism are exhibited by typical kids too (lots of typical kids flap, or line up cars, or obsess over one toy etc.) - it's when multiple autistic-like traits emerge that it's worth getting things checked out. So for right now I'd file it under "nothing to worry about right now, totally typical behavior, we'll just keep an eye out to see if anything else crops up - THEN we'll look into it a bit more closely."

As for your pediatrician, I fault ours for not hearing our concerns and acting on them sooner - early intervention IS key. So while I might criticize her "bedside manner" in talking in an insensitive way about a remotely possible problem, at least she's vigilant and proactive. I personally would rather have that in a doctor.

[Erin]

My two year old started raising his hands over his head and circling them around in frantic gestures of giddy joy just before his second birthday. He never did this as a baby, and does not have autism. He just gets excited, and it's super cute.

Re: being proactive vs. ignoring signs. To me, these are both sides of the same coin in a pediatrician. In both cases, the ped is missing something important - either overdiagnosing or underdiagnosing. While I can understand Katy's frustration with her ped, it would be equally enraging to have a ped say something is wrong with a child, test him endlessly (and perhaps painfully) only for everything to be OK. In this country, we're generally taught that overtesting is OK because we should all just be happy that nothing is wrong. But really overtesting can cause a great deal of physical, emotional, and financial hardship.

I thank God every day for our amazing pediatrician, who is vigilant and cautious; he notices everything but generally takes a "wait and see" approach. He also gives all his patients 45 minute appointments so he can really watch the children.

[mom2boy]

My original ped missed a rather significant diagnosis caught by another ped in the practice when I made an appointment for something unrelated. It unnerved me enough to switch to a different practice altogether. I'm much happier with the new pediatrician. On my way to finding her I went to one other pediatrician whose advice on my son's condition was to wait it out because "children in third world countries can have this and have no option but to wait it out and are sometimes fine." All doctors are not created equally.

[lucee]

Get a new pediatrician. And don't look back. Beginning a diagnosis of autism at 6 months? From hand twirling?
I was apparently a hand and foot twirler; my son was a hand twirler....we both did it as we sang and talked jibberish. Along with babbling its expression. Yes flapping is an early signifier of autism, but not in a baby. What's next saying that the balancing jerk babies repeatedly make on their backs is autism? Babies make repetitive seemingly pointless movements that often have very important impacts on the synapses of the brain.Its all related. The sparkplug dance articles on the left hand side of Moxie's site are a wonderful intro to how baby's movements work on the brain. Your hubby might love it too.

[Eva]

As a baby, our older son held his arms straight out to the sides and twirled them...constantly. Even now at age 5.5 he does a more mild version...usually down at his sides, but still twirling. He also rocks his head from side to side to put himself to sleep, but is otherwise completely and totally "normal". I am a bit worried that he will ALWAYS rock his head to fall asleep, as I'd feel quite sorry for his future spouse ;), but have realized that it's completely normal/natural for him and not a reflection of any developmental hiccups.

[Wilhelmina]

My 2 and 2/3 year old DD still flaps away when excited. She twirled and circled and flapped away in her first and second year, and now she does it still for joy and excitement. With hands and feet.

Complete strangers are overjoyed to see her enthusiasm. And she's very much not autistic. It is true that trends rule for professionals and lay-people alike. DH and I are ancient parents and DH is very much a classic computer geek and DD has advanced fine motor skills and baby perfectionism going on and questions have been asked about the autistic spectrum. Not so much now she's older and talking and obviously not.

We did have one family doctor, the UK equivalent of paediatrician declare DD developmentally retarded with poor muscle tone when she was 15 months. Actually she had fluid in her ears.

I'd like to say I egged and floured the doctor's office but actually I went along with the referral to a neurologist. Who wanted to do gruesome tests and said DD was probably declining-terminally.

If I may say so that was just plan HELL. And actually obvious nonsense. Once one got beyond the emotion of course.

Then I went back to family doctor and staged a sit in protest to get referred to the ear specialist.

The OP's paediatrician does sound a horse's patoot. Happy expressive hand-circling is a happy thing to see. Not a stereotypic movement.

For what it's worth my friends DS is autistic and he never was expressive that way as a baby. Which is so not scientific at all. But what a horrible thing for a doctor to say..........

[Wilhelmina]

Sorry about the second post here. I do agree the doctor can't win, in the sense that not noticing and mentioning autism doesn't help when there are signs. Ditto it doesn't help to notice one thing and then mention autism without asking other questions.

Here I get the impression that all babies and toddlers are watched for autism particularly without the noun being mentioned.

Parents do listen to casual remarks and take them to heart. People skills are important for a family doctor, vital really.

[the milliner]

First, I will say upfront that I am not the most knowledgeable about the warning signs of autism, and when to be concerned. I'll echo some of the posters in saying that it sounds (from the outside) that the ped was more reacting to @Erin's amount of concern rather than the actual hand and foot twirling in question.

Our doc always tells me that he's much more concerned if I'm concerned about something and he often says 'let's keep an eye on this. If 'x' doesn't (or does) happen in x amount of time, come back in to see me'. I find this re-assuring as it seems to be a levelheaded approach and not dismissive nor alarmist.

Granted, I can understand how much more worrying this is when we're talking about autism vs. say, language development - our latest concern. And, even if the ped had @Erin's best interests in mind, she still could have totally screwed up the delivery of her message.

We've noticed that if we're more explicit in our knowledge about something, our doc is more likely to speak to us in a way that addresses what we really want to talk about or at the level we want to discuss it (as opposed to staying very general in his comments, which I tend to find annoying).

Of course, all this being said, I also agree with other posters that if you are not comfortable with this ped overall (and have other issues/dislikes), I would definitely look for a new one and deal with it in the way that causes you the least amount of stress. If this is the only incident, I would be inclined to talk to her about it and see how things are handled going forward.

[Mia C]

I know your husband reassured you, but you don't seemed convinced, so...

Go to this website and watch the videos- esp. the first page and the social page. You can do these same exercises with your child and see what you see. It will show you the differences between a neurotypical child and an autistic child.

http://www.autismspeaks.org/video/glossary.php

Click login and create an ID and you can see them. It should be reassuring. I know if I had seen these videos when my son 8 months, esp. the one on joint attention, I would have pushed for an earlier diagnosis. My son has high functioning autism.

Yes, the signs were visible at 8 months, but hand flapping didn't manifest until later- maybe another year. He did not respond to his name immediately every time, he loved to watch ceiling fans, he didn't smile at us when we walked in a room, but if we did something physical like make a face he'd smile. Or laugh. He got upset and frustrated easily. There was no joint attention.

I think your ped is right to be concerned over ANY odd behavior. You can't believe how many won't even talk about it when it's a 2 1/2 year old who is standing in their office spinning for ten minutes straight. This is not someone who is going to blow off your concern.

If you are still concerned developmentally, you can have your state early intervention come out and evaluate him for free. They would be happy to come out every 6 months if you want them to.

[the milliner]

Oh, and one more point. I agree with @Lisa about picking your battles. Our doc was so insistent on DS not drinking from a bottle after 1 year. Thanks to posts and comments here on Ask Moxie, I had decided that this was something I was not going to be concerned about as DS was drinking from a toddler style bottle (soft sippy cup style nipple) as well as drinking from a cup. I kind of know where we and our doc differ in philosophy and for things were there is widly varying opinion and shades of grey (like the bottle issue), I just let some things go. Is he our ideal doc? Hmmm, no. But it is SO hard to get a family doctor here that I'm willing to stay with ours for now as overall we like his approach and DS likes him (and he's good with DS).

[rosie]

1. my daughter did that and is totally fine!

2. my son did not do that, has autism and is a great kid. it is difficult, don't get me wrong, but he is such a fantastic being.

3. when my twins were babies, another ped in our practice said some horribly wrong things about nursing and made me feel like the worst mother in the world (after a difficult ivf, twin pregnancy and birth) when my two were a few days old and we were struggling. we hated to do it but we switched and never looked back. our first great parenting decision.

bet you didn't think i had info on all 3!

[Bobbe]

My older son has autism, is a great kid, and didn't flap till he turned five. My younger son is eight months, seems likely to be mostly neurotypical (but it's called a spectrum for a reason), and hasn't started flapping much, but will wave his arms up and down repetitively. Just another data point for you all. :)

Mostly, I take any forum I can get to mention that my son with autism is a great, great kid.

[Carole]

Hmmm, it's difficult. Would you rather not know that the doc is "keeping an eye out" for certain things? I guess that's what they do. But of course it's enormously worrying whenever a doctor says something is a possibility. One told me just as my extremely small and premature baby seemed to be out of the woods that they wanted to check him for a rare form of dwarfism. Yeah, because I was really missing having something to worry about....

But actually he just had a largish head (from me) and short legs (from his dad). Which the geneticist noted immediately.

[SarcastiCarrie]

Your pediatrician actually sounds great to me.
So, for the three questions:
Q: What I would like to know is have you had other parents ask about this same type of movement?
A: According to the above commenters, lots of kids of all varieties do it. In and of itself, it's not a bad thing.

Q: Did their kids end up of having autism?

A: Some did, some didn't but it wasn't the hand movements that wound up being the deciding factor.

Q: Do you have any suggestions for how I can stop worrying about this?"

A: The first is education. Watch the videos at Autism Speaks. Print out an M-CHAT (with the really helpful scoring info with the bonus questions so you know what kinds of play and behaviors you're looking for). The M-CHAT is for older kids/toddlers. But, you will know what kind of play and milsetones are coming up so you know what to expect, what to prod, etc.
The second way to relax about it is to trust your husband.
The third is wine. Your son either will or will not be autistic. If he is, you'll do the therapy, and he'll continue to be a great kid. So even the "worst-case scenario" isn't that bad.

[Charisse]

How about "my bright, social 6-year-old STILL sometimes flaps her hands if she's bursting with excitement".

[Cathy]

If you decide to stay with the doc, I would add in more follow up questions, like "What else should we look for?" or "At what age would this be a concern?" Part of the problem is that you had incomplete information - it's hard to tell if it's because that's all you caught or because that's all that was said.

Also, my normal, delightful 7 year old had something we called "happy feet" when she was an infant. It sort of tapered off as she got older, and you didn't see it that much after she turned one.

[Karen]

I agree with Medley that doctors sometimes don't realize that their casual comments are received in a serious way by patients. Perhaps people with loose tongues (blurters) should think twice about becoming doctors?

My father is a physician and realizes the weight of his words when he speaks of medical issues. He has a completely different cadence of voice when he is in doctor mode. He slows his speech down, selects each word carefully and uses medical terms in place of lay terminology, almost as if he were being recorded or were on the record in a court proceeding. I think that in medical school someone must have taught him the power of his words as a doctor and he has done it, consciously or unconsciously, ever since. Sounds like Erin's pediatrician needs to learn how to differentiate casual speech from medical speech.

[momofthree]

Babies with with autism sometimes do have unusual movements, and noticing those movements can help early diagnosis, and therefore intervention. There is a great book called Does My Baby Have Autism? that describes typical and non-typical movement and development of movement, including some really subtle stuff. If you concerned, you could check it out. I am sorry I can't remember if it said anything about twirling being neurotypical or not.

[Anon this time]

I have a 5 year old and a 1 year old, both did the hand flapping and twirling, and neither have had autism come up at the pediatrician's office.

I think it's good that the pediatrician brought it up, but I think they should have noted it in the chart instead of freaking the parents out.

I completely agree with Karen about doctors choosing their words carefully. But that being said, I'd rather have a pediatrician that was very thorough and gave me more information and made me hyperaware of what to watch for in my child, than one that didn't say anything or just wasn't proactive about my kids' health.

[Kris]

I would actually be annoyed at my doctor for NOT mentioning possibilities like that. The ped didn't say it was a definite sign, just that it's something to keep an eye on IF the baby doesn't get past this developmental stage or has any other symptoms. Early diagnosis is so important with autism. My niece (10yo now) did arm circles constantly at 1-2 years. It may or may not have been related, but she was later found to definitely be autistic. Her ped mentioned autism as a possibility when she started the arm circles, so when my niece started exhibiting other signs, they acted right away and started speech and behavior therapy. She's a fantastic kid and between her own hard work and the therapy, she is ready for mainstream school. I don't know if she would be this far if they hadn't caught it so early.

[Mama Fuss]

My incredibly social (I've had professionals comment on how amazingly well-spoken and social she is) toddler still does the hand flapping thing when she is really revved up about something. And she's a great talker, so it's not even always that she can't tell me what is going on, which is what I would associate that with in an 8-month-old.

I'm having issues w/ my own pediatrician right now, as she is constantly undermining my ability to breast feed my children, she doesn't pay attention to what my toddler is saying (just blows it off and half-asses a guess at what she is talking about even though many times her speech is incredibly clear) and am thinking about leaving for another practice. I would likely tell the nurse I love (I actually like all the nurses a TON, so I'm sad to leave the practice because I'm sad to leave them) why I am leaving, but I don't know if I'd bother to talk to or write the Drs. I don't really feel they'd pay it much mind. Still deciding, but I am incredibly frustrated with them at this point.

[janel]

My son did this around that age and is a normally developing 3.5 year old now. So glad no one put it in my head that this was something to worry about - at the time I just thought it was a cute way for him to tell us he was excited about something.

Your ped's remark was insensitive at best. Plus, if there's one thing parenthood has taught me, it's to not worry about problems I don't have yet.

[PP]

Yes, it was an insensitive remark, but before you break out the pitchforks and torches to storm the ped.'s office, I'd think about it from a different perspective.

That doctor was likely covering her backside. There have been a number of suits against pediatricians who did not recognize/acknowledge/alert parents to certain conditions and this doctor was probably thinking "if I don't at least mention this to the mother and the child presents on the autism spectrum in another 18 mos, I could end up in a nasty lawsuit."

I think doctors are more sensitive to their being sued for not at least mentioning the one in a billion possibility that there might be a problem down the road.

[Emily]

My daughter's daycare provider told me she thought my daughter had autism because she didn't interact with the other kids. It wasn't that she wasn't social - it was that she wasn't moving at 18 months (she was a preemie and walked and crawled VERY late), so unless kids came to her, she really couldn't play with them. She is a very social kid now, and even at 18 months, when they thought she had autism, she was speaking in full sentences. Luckily for me, my ped. told me he wasn't worried. I think with the increase in the instances of autism, people are thinking about it more, so it comes up.

[MemeGRL]

@Mia--you are awesome.
@Original Poster: hand in there. If there are no other signs, hand flapping (or twirling) isn't likely to stick around. A common part of kids (people) on the spectrum is developmental delays--or developmental "stuckness" for lack of a better term. (I liked how Moxie put it and will start using that myself. I hear "delay" and think of something not starting, but a delay can be something not stopping either.) Our 20 year old autistic nephew has hand flapped his whole life. Both our neurotypical sons did it when they were little. Neither did it past the age of 4, and even then it was very very very rare, so neither did it often at all after they were verbal. (And come to think of it only tended to do it post-words at a moment when they couldn't/shouldn't talk--church, a rare minute when they were actually waiting for me to get off the phone before telling me something, etc.).
Finally, I always try to bring my husband or a friend to doctors' appointments for me or my kids because I have learned that even though I don't feel torqued, I clearly am--there have been several instances where I misremembered how a conversation went. OP, if you will never trust this doctor again, you need to leave and find a new one. But if you seek out the kinds of doctors who will discuss every possibility with you, maybe bring a friend or your husband to hear the doctor out and see if it was a bad day, or if her style is just not a match for you.
Good luck!

[Lumberjack]

@MiaC, thank you for that link. Can you clarify when you noticed those behaviors in your son? You wrote that you noticed behaviors s early as eight months, but was it not until a year that you noticed the not responding to his name, staring at ceiling fans, not smiling when you entered the room?
Thanks Mia, pretty sure that link's gonna get a lot of hits because of you. I know early intervention is key.

[crescentgirl]

My son was diag. with autism and is not now autistic, not for anything we did, but diagnoses can vary with age and development.

She should, IMO, go to a qualified autism center and have them eval him NOW. The sooner he gets assistance, whether he is or isn't autistic, the better his longterm prognosis.

Yeah, I'd change pediatricians. Just b/c it's a harebrained way to assess a situation and reassure a parent. That said, two of my pediatricians were clueless and it took an inspired preschool teacher to get medical attention for him. Then they came around (after Yale diagnosed him ...)

My other best advice is: Love your son, who he is now and don't worry about labels. What he needs is appropriate care, and love is what he needs most from her.

Good luck to her.

[Mary]

Oh the hand twirling. I miss that so much. My little guy started doing that about 8 months old and has stopped now--he's 26 months old now. I don't know when he stopped but man, it was so adorable.

Obviously at 2, I cannot tell you he turned out ok, but so far there are no troubling signs.

[SarahG]

Oh man, have I ever been there!

When DS (now 3 yrs 4 mon) was around 2 he started overreacting to loud noises. He'd scream, run from the room, cry, wail until the noise stopped or we could get him away from it. Vacuum, fireworks, loud trucks, etc. First question he'd ask of new things: "Is it loud?"

Mentioned to our Dr and she - being the type of doc who takes parents concerns and really evaluates them, observes the child, runs tests, says what's on her mind - suggested that there may be a link to Autism (a tiny part of a lengthy discussion), which I immediately latched onto. I didn't hear a lot of what else she said... and went home immediately to start Googling and book follow-up appointments and hearing tests in a panic.

End result = DS is not anywhere the spectrum, he's a typically developing and happy nearly 3.5 year old, who isn't fond of loud noises. (We're teaching him coping strategies... I have to vacuum.)

So on the one hand I was upset with my doc for worrying me unnecessarily, but now in retrospect I can appreciate her candor and her concern. If he HAD turned out to be Autistic, I would have been thrilled to find out so early, you know?

I learned I am a person who likes to have all the information I can get (even just a thought off the top of my dr's head), but I do tend to worry about things too much. It's a catch-22... but we're sticking with the Dr because she is so proactive and forthcoming.

@janel - SO true about not worrying about problems you don't have yet (but so hard to do!)

[hush]

What @Mia C said, and what @PP said.

@Moxie - Honestly, I could not disagree with you more: "Express your concern in person that she's giving misinformation as medical advice? Egg her house?" Wow...

[Cloud]

@Hush, I think Moxie was joking about egging the pediatrician's house.

I can't honestly remember if we saw any twirling/hand-flapping. SO if we did, I guess it didn't register with me.

On what to do with the pediatrician- if you're not going to feel comfortable with her, then you should switch. Since babies can't talk, you have to work together with your pediatrician to diagnose any problems. If you don't really trust the pediatrician, that isn't going to work well.

[Moxie]

@Hush, the egging comment was a joke. I thought that was pretty clear, since what adult would actually egg someone's house, but obviously not.

FWIW, my former nephew has an extremely serious developmental disability and it took years to get a proper diagnosis. My anger at the reader's pediatrician stems from how casual she was at looking at that one symptom which doesn't correlate strongly with autism and attaching that diagnosis to it. It seems she doesn't know much about what to look for in autism or what hand-flapping means: double misinformation. Who knows what she's missing if she's attaching importance to the wrong things? And how could she possibly take saying "it could be autism" lightly? It's not responsible behavior from a medical professional.

[Slim]

But she didn't say "it could be autism."

"I asked her if I should be concerned and she said sometimes babies w/ autism have strange hand movements so she would like to keep her eye on him."

I'm all for getting a new pediatrician if you don't feel in tune with your current one and if changing is possible. But "Your pediatrician is an ass" in response to the situation as described seems, to me, inappropriately harsh.

[sfsaf]

My post doesn't address 1, 2, or 3 of the posted questions.

Instead I'm writing to let you know that as small child...I rocked. I rocked back and forth in the car. I rocked in my chair. I rocked back and forth. Back and forth. My aunt once thought something was wrong with our car. Nope, just me rocking in the back seat.

Today, that would be major cause for concern. When I asked my mother about it she said, "we hadn't even heard the word autism back then (late '60s, early 70's). She said she never talked to a doctor about it and I eventually just outgrew it. No other "behavioral problems" (well except the normal teenage stuff) and certainly no neurological problems.

It was, for me as a little kid, a self-soothing behavior. It just made me feel good. I still like a good rocking chair when I can find one!

I hope that helps!

[SJ]

Sorry, I'm with Slim...Erin's question doesn't even have anything to do with her pediatrician, she was wondering about the behavior her son was displaying. Jumping all over the ped is unwarranted here, IMO.

and btw, I have an autistic son, and my ped consistently blew off my concerns.

[ACJ]

Totally clueless about autism, but very familiar with worrying and anxiety.

Learning how to Not Worry About This is going to be a very helpful lifeskill for any mother, and particularly those of us who are prone to obsessive thinking and anxiety.

My own best coping skill is Making A Plan. And in this case, I would go back to the pediatrician and ask her to help with that plan. How she responds to your confessed fears is going to tell you more about whether you have a workable future relationship, than how she diagnoses your child.

"Dr. Mademeworry, at our last appointment, you mentioned that the twirling hands might be an indication of ASD and I've been terrified ever since. I can't get it out of my mind and it's starting to impact how I parent Baby Awesome. Can you tell me what else you're going to be looking for, and how we'll move forward to either eliminate this as a possibility, or confirm it as a diagnosis? I need to know what the plan is so that I can relax and get past this paralyzing fear."

If Dr. responds by dismissing your fear - "don't worry about it, I didn't mean it, I'm sure it's fine" - then you may want to see if you can track down a better fit. However, Dr. does what mine does, which is say "Oh, I'm sorry you've been so worried. So here are the 3 things I'll be looking for at our next appointment. If we see 2 of those things, I'll be referring you to XYZ and ordering ABC tests. I think a 3 month timeframe gives us lots of room to be proactive in seeking treatment if it was required but also lets us see how the rest of his development is coming along. Does that help with your worry?"

The key is that you have to be responsible for saying your part outloud - I am afraid. I need help managing my anxiety. You and Dr are hopefully longterm partners in managing your child's health - you've got to be as careful with that relationship as you are with any of your other partners. It's not fair to expect them to get it all right without all the information.

Good luck.

[marci]

my son did it, especially when in the high chair eating. it was sort of like a dance & quite cute. it didn't bother me much, and he pretty much doesn't do it anymore at 3 1/2.

but, yeah, right now he's on the spectrum - pdd-nos. who knows if it's lingering preemieness or damage from the vent or meds or tpn or just the way he'd be even if he'd been born at term...i'm just glad he's here for me to worry about.

the specialist ped at the preemie clinic was starting to become concerned when he was 2, but no actual diagnosis until 3 1/2. and yeah, she wasn't the best communicator, either. i'm over that part.

what was hard for me was everyone talking about wonder weeks and other stuff that was so far from him that it was meaningless, so if your baby is pretty much doing wonder weeks 'by the book', let that ease your mind a bit. if not, keep watching & pursuing answers.

thanks, @miac, for the link!

[KatieV]

Sounds like you've gotten some good comments here, but I'll add my 2 cents.

Our oldest had an autism diagnosis (moderate to severe) and is a great, great kid. (Yes, I did say he *had* the diagnosis. We've changed his diet dramatically and made other changes, and now he's doing so well he no longer qualifies for a diagnosis.)