Baby's poor head and neck control may be an autism clue
May 17th, 2012
01:49 PM ET

Baby's poor head and neck control may be an autism clue

Early research suggests that if a 6-month old baby has "head lag," or weak head and neck control, it may be an early sign of autism or another language/social developmental delay.

The test is simple - babies who are lying on the floor are pulled up into a sitting position. If the baby's head is not moving forward as you pull the baby up, it's a sign of weak head and neck control.

Researchers already know that head lag could be an early sign that a child's nervous system is not developing correctly. They've seen this in children with cerebral palsy and preterm infants, for example. But so far it had not been documented in children with autism.

Researchers at Baltimore's Kennedy Krieger Institute looked at a small sample of babies who were already at high risk for autism because they had a sibling with autism. If a couple already has one child with an autism spectrum disorder there's a nearly 1 in 5 chance that the second child will have autism too. According to the latest CDC estimates, 1 in 88 children in the United States has an autism diagnosis. It's 5 times more common in boys than girls.

A group of 40 babies were tested at 6 months. Ten children were later diagnosed with ASD at the age of 3. Nine of those 10 babies had head lag when they were 6 months old.

More than half of the children (54%) who were later diagnosed with language or social developmental delays but not autism also had head lag at 6 months, says Rebecca Landa, one of the study authors and the director of the Center for Autism and Related Disorders at Kennedy Krieger.

In a second study that compared 20 high risk babies to 21 low-risk babies, 75% in the high risk category showed signs of head lag at six months compared to only 33% in the low-risk group.

Landa acknowledges that this research, presented Thursday at a meeting of the International Society for Autism Research in Toronto, is very preliminary and needs to be confirmed in larger studies.

She also cautions that weak head and neck control doesn't automatically mean your baby will develop autism. But, Landa says, if you already have a child with autism and your baby is showing this kind of problem, you should take the child to see a specialist.

"If you don't have a family history of autism, and your child had head lag at 6 months - it might be something else, or might be nothing, but it's important to check it out," she says.

The goal is to identify a child with autism as early as possible so therapy can start early.

"We don't want to wait until children are 1 or 2 when they are more likely to show symptoms of autism."

Alycia Halladay, director of research for environmental sciences at the advocacy group Autism Speaks, says this is a very important study and deserves replication. She says it's too early to consider head lag a diagnostic marker, it's one of many red flags that parents may notice very early in development and something a doctor can easily check out.

Halladay, who was not involved in the research, says "this provides something that parents can bring to their doctors beyond just a concern."

Landa says she doesn't want to scare every parent into thinking their child may have autism because their little one has poor postural control, especially because in some children the problem goes away.

However, this is a simple test that doesn't cost anything, doesn't hurt a child, and - if a child were referred to therapy - doesn't hurt a child but can enrich their development, with or without a subsequent autism diagnosis.

Landa says parents can easily be trained to help their baby improve head and neck control. She suggests Googling "tummy time," which can lead parents to a lot of good information on fun and supportive tummy time exercises to help build their baby's neck muscles.

She also suggests sitting babies up, holding babies at the hips and slowly rocking them from side to side - just enough so that the baby leans to the center, which she says activates the core muscles so the baby stays balanced. Babies love it, especially if you sing a song while doing this.

soundoff (26 Responses)
  1. Katie Wright

    As a parent of a severely affected ASD child I must say how disappointed I am with this study. Almost 2 million people in this country have autism. Those w autism, not aspergers, will likely be affected their entire lives. It is a very debilitating disorder. There are no approved interventions outside of ABA- which was developed almost 30 yrs ago! Science has stood still in terms of treatment.

    To make matters worse over 50% of those w ASD have terrible GI pain often accompanied by immune dysfunction. My son rapidly developed autism at the age of 2, losing all his language and skills. We spent the next few yrs in and out of hospitals as he developed seizures, severe infections and suffered from a frightening low T cell count. Almost no doctors knew how to help my child because so little good research is being done on non behavioral clinical interventions. It was suggested my son take anti-psychotics – he isn't psychotic – he is sick. The autism research community has ignored kids like mine preferring to stay in the safe, non controversial zone of "learn the signs" and early intervention. Guess what my son got early intervention- dealing with autism is not that simple.

    Autism research is saturated in learn the signs and early intervention research. What happens when you learn the signs, get ABA and it doesn't work? It am so disappointed that AS is not doing more to help children living now with autism.

    May 18, 2012 at 11:54 | Report abuse | Reply
    • Anne

      Hi Katie. Our children have been on a similar path. Have you gotten your son Biomedical treatment? Our son also was diagnosed as autistic with severe immune, ibs, allergy, migraines... You likely already know this, but there are a few doctors out there treating autism as a disease. A developmental disability CANNOT be an epidemic. It has to be disease related, and thus it can be treated. Our child has made signifgant progress with biomedical treatment. Check out the NIDS.net website.

      May 18, 2012 at 16:39 | Report abuse |
    • Lora

      So sorry to hear about your son. Such misery autism and similar have brought to our dear families. The medical world is doing something wrong. This should not be happening to our children. Many feel autism has increased with vaccines as vaccines cause an auto immune response against the babies own brain cells. Did your son lose his speech within 21 days after any vaccine? You can report vaccine injury to http://vaers.hhs.gov/resources/vaers_form.pdf

      August 14, 2012 at 07:18 | Report abuse |
  2. Ann Kinder

    Did they control for head size? it's well-established that children with autism have larger heads and larger brains. Perhaps neck control in infancy is merely correlated with head size, not autism.

    May 18, 2012 at 13:34 | Report abuse | Reply
  3. Aly B.

    Have they researched stiffness possibly coinsiding with autism? Every infant I have seen that was later diagnosed with autism was very stiff in their first to 9 months of age. They would not seem to sit up, they were just stiff as a board. Two out of three had cradle cap and exema. I dont know if that makes a difference, but if it helps, let it be said.

    May 19, 2012 at 00:57 | Report abuse | Reply
  4. Ange

    Katie W. – You mentioned your son's low T cell count which reminded me when I went to a Lyme disease specialist one of the tests used to monitor treatment was T cell count as it is every low to non-existent in Lyme infected patients. At one point while I had Lyme my count was zero! That doctor told me that women with Lyme disease will almost always give birth to autistic children and both mom and child should get treatment for Lyme. I'm not an expert, but just sharing this info as you might want to research it.

    May 19, 2012 at 12:01 | Report abuse | Reply
    • Maya

      I just want to say, I absolutely LOVE rdinaeg all of your entries.This is my answer:Autism, to me, is a part of who my child is… for better or worse, beautiful or ugly. Yes it causes extreme temper tantrums, misunderstandings, dietary issues and more… but it also shows me a side of life that I would have never seen before otherwise. A whole new profound way of looking at the world.Autism makes it very hard for my child to know what other people may be thinking… a look on their face and body language aren’t enough. Autism also makes it very hard for my child to understand the concept of time. To tell me about a year ago, he refers to it as “a lot yesterday”.It’s because of Autism that my son will kick and throw things as he enters a rage filled meltdown that is completely beyond his control.Probably what hurts most, however, is the looks and comments and judgments that others make while we’re in public. Whether it be a meltdown at a grocery store or even a physical activity where my son clearly isn’t as “in control” as the other children. Being different, to most people, is a negative thing.It’s for this reason, that Autism to me, has become my purpose. Actually, my son (both of my boys to be honest) are more important than Autism itself, but they’ve given me my purpose in life… to not just raise awareness of Autism but to try to help others to understand it better and to accept those that have it.Perhaps if I can reach enough people, those looks and comments and judgments will begin to go away. If I can reach people in my own community, I can help people accept my child.. if I can reach people around the world.. I can help many children.And not just children… but teenagers in high school that are being bullied or even beaten… and adults too that may still be living with their parents or at the very least, struggling at keeping jobs and a social life.Since my son has been born, and more so, since we’ve received his diagnosis, I’ve learned so very much about Autism and yet I still have far far more to learn.And this is my meaning in life… this is my purpose.Not to change my child because my child is wonderful, amazing and every bit as deserving of a everything that you and I have as we are.My purpose is to change the world around him… by talking to anyone that will listen. By giving them just a little bit more understanding… and hopefully, helping them to accept my son and everyone else with Autism.That’s what Autism is to me.

      December 17, 2012 at 15:46 | Report abuse |
  5. Mallory

    I would like to work with the special needs kids in the future and I find this interesting that they are finding ways to catch it so early. It is good because te parents of the child can prepare and be ready for challenges ahead of them.

    May 21, 2012 at 15:00 | Report abuse | Reply
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  8. Merrie Weckerly

    cradle cap can be treated also with topical niacinamide since it reduces inflammatory response and also increases skin healing.^

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    January 8, 2013 at 23:19 | Report abuse | Reply
  9. Treena Gubler

    Cradle cap is not caused by a bacterial infection, allergy, nor from poor hygiene. Cradle cap is also not contagious. Doctors do not agree on what causes cradle cap, but the two most common hypotheses include fungal infection and overactive sebaceous glands. Cradle cap is an inflammatory condition.;,;..

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  12. Gopi

    Hi All,
    My boy baby Head Not fixed even after six months of birth? still his head shake and he's not able to stay head in fixed position? Please tell me how long it takes to head fix stay?


    December 22, 2016 at 14:57 | Report abuse | Reply
    • Mukunth

      Even for my son also after 7.5 months, still not able to hold his head. Initially doctor suspected it due to HIE (hypoxic Ischemic Encephalopathy), due to oxygen deprivation during birth. Did you check with your pediatrician? Pls let me know

      April 26, 2017 at 01:27 | Report abuse |
  13. Mohsin

    My almost 8 month old baby have partial neck control.she has small head and stiffness in as all 4 limbs she is not crawling also no eye hand coorditaion developmental delays and unable to grasping objects she uses medicine lerace, baclofen, nootropil and vidaylin drops and we also attend OT clinics 2 times a week. What should I have to do and give me the guidance and treatment advice so that my child recover fastly and be able to be independent.
    Thanks and waiting for suggestion.

    March 17, 2017 at 09:46 | Report abuse | Reply
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  15. Tshimangadzo

    my son is 7 months old and he is not seating alone and he had problem on his neck he doesn't hv strength

    November 12, 2017 at 14:44 | Report abuse | Reply
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  17. joseph

    My baby boy is ten month old he suffered jaundice and was treated but his neck is still not strengthen and can't sit,he hardly laugh and play,he does not react when u are approaching him but knows u are around when you touch him,he doesn't show any sign when u are lifting him up from bed but only when you touch him...please i need your help...

    October 9, 2018 at 14:35 | Report abuse | Reply
  18. joseph

    My baby boy is ten month old he suffered jaundice and was treated but his neck is still not strengthen and can't sit,he hardly laugh and play,he does not react when u are approaching him but knows u are around when you touch him,he doesn't show any sign when u are lifting him up from bed but only when you touch him...please i need your help...

    October 9, 2018 at 14:35 | Report abuse | Reply
    • Henry

      My baby boy is ten month old he suffered low brain developmental and was treated but his neck is still not strengthen and can't sit,he hardly laugh and play,he does not react when u are approaching him but knows u are around when you touch him,he doesn't show any sign when u are lifting him up from bed but only when you touch him...please i need your help...

      November 19, 2018 at 07:31 | Report abuse |
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