Jun 14, 2009

When your infant doesn't make eye contact

“Have that baby that won't look at your face, even if standing on your head? Will look at your mouth or nose, yet not your eyes, especially when you are holding them? That baby that won't snuggle deep in your arm? That baby that you just don't FEEL cares if you are around or not, or seems to care until you pick them up? Doesn't cry or coo? Frets and whines a lot? Very withdrawn or passive? Has poor muscle tone? Slow to creep, crawl or sit up? Is called a "too good baby?”” While some may state that if your infant shows these behaviors that your infant has, “signs of attachment disorder, this may or may not be true. The prescription to hold such a child even if the child does not want to be held may actually be damaging to your infant. Such advice falls into the all too common error of making a “diagnosis” based on only on behaviors.

Why might a child have difficulty making eye contact, be irritable when snuggled, fret, have poor muscle tone, be slow to creep, crawl, or sit up? Certainly chronic maltreatment, such as neglect, abuse, or institutional care may be one cause. Such care may create attachment difficulties. However, such care may also cause sensory-integration difficulties. Furthermore, the behaviors mentioned may also be caused by prenatal exposure to alcohol or other chemicals, neurological disorders, or other causes. In each instance, the appropriate and effective intervention is different. Forcing a child to look at you or forcing physical contact when a child has a sensory disorder may actually make things worse. With a sensory-defensive child you would want to begin gently encouraging and facilitating a variety of sensory experiences. In addition, you would probably be implementing a number of sensory exercises under the direction of an Occupational Therapist who is SIPT (Sensory Integration Praxis Test) certified. If your child’s difficulties were caused by prenatal exposure to alcohol or other chemicals, then you would want to begin an early intervention program. The important point I’d like to make is that before your assume that your child has an attachment disorder and then treat that disorder, that you get a thorough assessment. This way you can be sure that you are treating the actual cause of the behaviors and not merely the symptoms, which as I described, can stem from many different causes and which require different interventions.

Where to start? Well, one place is to discuss the problem with your pediatrician. You may then want to consult with a developmental pediatrician or a pediatric neurologist. A good place to start is with your regional Children’s Hospital or University Hospital Pediatric Department. For sensory-integration concerns you will want to consult with an Occupational Therapist who is SIPT certified. Be sure that the professional you consult with has significant experience and training evaluating infants such as yours (from an overseas orphanage, chronically abused or neglected, prenatally exposed to alcohol, etc.).

1. The Out of Sync Child by Carol Stock Kranowitz, 1998.
2. The Out of Sync Child Has Fun by Carol Stock Kranowitz, 2003.
3. Understanding Your Child’s Temperament. William Carey, 1997.
4. Becoming a Family. Lark Eshleman, Ph.D., 2003.

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