Is Feet Twirling in Infants a Sign of Autism?

Autism Spectrum Disorder (ASD) – commonly referred to as autism – is defined as a broad range of conditions that create challenges with speech and communication, social skills, repetitive behaviors, regulating emotions, sensory processing, and more. According to the Centers for Disease Control, approximately 1 in every 44 children in America is affected by autism.

Autism is a Spectrum: the symptoms and condition depend on the individual.

Usually, no single symptom or tendency indicates Autism Spectrum Disorder. A series of behaviors helps diagnose the condition.

There is no one type of autism, and as it is so aptly named, individuals with ASD each present with their own unique combination of symptoms, strengths, and challenges from a spectrum of possibilities. Additionally, the development and severity of these characteristics and challenges can be influenced by both genetic and environmental factors. People with autism think, learn and develop differently, and their ability to think, problem-solve and communicate effectively can range from being highly skillful to significantly impaired. Some autistic individuals will require daily support throughout their lives, while others are able to live independently, with little-to-no support.

It is common for autistic people to experience sensitivities to sensory experiences, as well as gastrointestinal disorders, sleep issues, and seizures, as well as a range of mental health challenges such as depression, anxiety, and ADHD (Attention Deficit Hyperactivity Disorder).

Initial signs of the development of autism generally surface by the time an infant is three years old, although a diagnosis can be made as early as 18 months. Research demonstrates that early diagnosis and intervention are key to optimal outcomes in the long term regarding the quality of life and severity of symptoms.

Common signs of autism in infants

Any doting parent can relate to paying close attention to our children’s development, especially as babies. Many parents with autistic infants notice the warning signs early on, and while they don’t always necessarily result in an ASD diagnosis, any developmental delays should be explored with a family doctor or pediatrician. The most common signs to look out for in infants include:

Minimal eye contact

One of the earliest indications of autism is often a lack of making and maintaining eye contact. For most infants, making eye contact becomes common at around three months of age. Babies who continue to avoid making eye contact after six months of age should be seen by a pediatrician for further investigation.

Delayed development of motor skills

Parents should expect their infants to start rolling over unassisted by seven months of age, and crawling between six to ten months. At the same time, these infants should be reaching and grabbing for objects. Even if they aren’t successfully grabbing at anything, gesturing towards objects and people in order to communicate is an important developmental behavior and the absence of it may indicate a delay in social skills, which is a common sign of autism.

These motor skills and social developments are crucial milestones, and any baby showing delayed progress in these areas should be seen by a medical professional.

Reduced facial expression

We all love to see a baby’s first smile, and typically this occurs quite early, usually by the age of two months or so. If your baby either appears to lack the ability to smile, or you notice that their smiles are significantly decreasing in frequency, consult with your doctor.

Delayed babbling

Babies typically love to babble before they can talk, and this ‘baby talk’ usually starts at around nine months of age. It is uncommon for a healthy baby to delay in babbling, particularly past twelve months, so if your baby isn’t making these sounds, they may have language delays that could signal autism.

A lack of imitation behaviors

As infants develop, they increasingly engage in imitation behaviors as a way of learning and connecting with others. When babies show little interest in copying the gestures, words, and sounds of their primary caregivers, it can be a sign of autism.

Unresponsive to name

By the time a baby turns one year old, they are typically beginning to respond to the sound of their name, and a delay in this responsiveness could signal a language delay common in ASD.

Unusual bodily movements

Autistic children commonly display unusual body movements, such as flapping their hands or arms, twisting their wrists, stiffening their arms and legs, and rocking.

What about feet twirling?

Feet twirling in infants is not generally considered to be a sign of ASD. Conversely, twirling of the wrists is an identifiably common movement in autistic children, as is the stiffening of their arms, legs, and possibly feet. 

That said, the twirling of wrists and the stiffening of limbs don’t always result in an ASD diagnosis, as every case of autism presents in a different way to the next. Twirling of the feet isn’t in itself a common sign that autism may be present, but in combination with other identifiable signs, such as twisting wrists and stiffening limbs, it should certainly be checked out with a family doctor.

Keeping an eye out for regression of skills

Not all developmental issues begin with delays in progress – for some infants, initial development is within normal range, followed by a noticeable decline in skills such as smiling, babbling, responding to their name, etc. As an infant grows, it can become easier to identify the signs of autism. Common signs and symptoms to look out for include:

• Monotone speech patterns
• Lack of eye contact
• Lack of facial expressions, such as smiling
• Absent or delayed speech development
• Repeating words or phrases without the intention of communicating (Echolalia)
• Repetitive movements, such as hand flapping, spinning, or rocking
• Unusual play rituals, such as lining up toys in orderly rows instead of playing with them
• Hyperfixation – intense interest in objects other than toys
• Intense resistance to changes in routine
• Persistent gastrointestinal issues

None of the symptoms listed guarantees that ASD is present, but if your child displays any of these signs, particularly in combination, it is highly recommended to consult with an expert in child development health.

Early intervention is key

According to a wide body of research, and as recommended by the CDC (Center for Disease Control and Prevention), any child that displays symptoms of Autism Spectrum Disorder should be seen by a medical professional for screening as soon as possible. While there is no cure for ASD, a number of therapies have been shown to significantly improve a child’s development, and early intervention can make a great difference in the long-term quality of life for the child.

^{[1] A Systematic Review of the Link Between Autism Spectrum Disorder and Acetaminophen: A Mystery to Resolve, interpreting data from Parker SE, Collett BR, Werler MM: Maternal acetaminophen use during pregnancy and childhood behavioural problems: Discrepancies between mother- and teacher-reported outcomes. Paediatr Perinat Epidemiol. 2020, 34:299-308. 10.1111/ppe.12601).}

^{[2] Paracetamol use during pregnancy—a call for precautionary action, Bauer, A.Z., Swan, S.H., Kriebel, D., Liew, Z., Taylor, H.S., Bornehag, C.G., Andrade, A.M., Olsen, J., Jensen, R.H., Mitchell, R.T. and Skakkebaek, N.E., 2021. Nature Reviews Endocrinology, 17(12), pp.757-766.}

^{[3] A Systematic Review of the Link Between Autism Spectrum Disorder and Acetaminophen: A Mystery to Resolve, interpreting data from Parker SE, Collett BR, Werler MM: Maternal acetaminophen use during pregnancy and childhood behavioural problems: Discrepancies between mother- and teacher-reported outcomes. Paediatr Perinat Epidemiol. 2020, 34:299-308. 10.1111/ppe.12601).}

^{[4] Paracetamol use during pregnancy—a call for precautionary action, Bauer, A.Z., Swan, S.H., Kriebel, D., Liew, Z., Taylor, H.S., Bornehag, C.G., Andrade, A.M., Olsen, J., Jensen, R.H., Mitchell, R.T. and Skakkebaek, N.E., 2021. Nature Reviews Endocrinology, 17(12), pp.757-766.}