Head Lag a Red Flag?

Example of an infant showing a head lag. 

Weak head and neck control at six months may be another sign of increased risk for autism, according to the early findings of a study led by a member of Autism Speaks Baby Siblings Research Consortium [1] (BSRC).

“Our findings show that the evaluation of motor skills should be incorporated with other behavioral assessments to yield insights into the very earliest stages of autism,” says Rebecca Landa [2], Ph.D., the study author and director of the Center for Autism and Related Disorders [3] at the Kennedy Krieger Institute [4], in Baltimore. Landa presented her results at the 2012 International Meeting for Autism Research [5] (IMFAR) last week.

Early detection of autism spectrum disorder (ASD) typically focuses on social and communication development. The so-called “head lag” noted by the researchers may lead to greater understanding of autism’s relationship to early motor development. Motor delays are common among young children on the autism spectrum.

The researchers monitored for head lag by gently and carefully pulling infants by the arms from lying on their backs to a sitting position. Head lag is noted if a baby’s head fails to stay in line with the spine.

Landa’s team looked at two groups of infants. The group of 40 babies all had older brothers or sisters on the autism spectrum. Ninety percent of those who went on to be diagnosed with ASD at 30 to 36 months had exhibited head lag at 6, 14 or 24 months. This was also true of 54 percent of the babies diagnosed social/communication delay, and 35 percent of the babies whose social and communication development was normal.

In another group of 22 infants, researchers tested for head lag at six months. They found that 75 percent (15) of the baby siblings of children on the autism spectrum exhibited head lag. By comparison, the researchers noted head lag in just 33 percent (7) of six month olds from families unaffected by autism.

Having weak head and neck control does not indicate a diagnosis of autism, notes Autism Speaks Director of Research for Environmental Sciences Alycia Halladay, Ph.D. Halladay helps coordinate the BSRC’s research activities. This symptom is a known red flag for a variety of developmental delays, including those associated with cerebral palsy and prematurity.

“However, if further study with more infants confirms this finding, monitoring postural control in infants as young as 6 months could be a simple, efficient method of identifying children at risk for developmental disorders, including autism,” Halladay says. “Meanwhile, parents who have concerns that their child may have autism can bring up this potential red flag, should they see it, with their pediatrician.”

The study was supported in part by a grant from Cure Autism Now, now Autism Speaks. An additional Autism Speaks grant [6] is allowing the team to develop and test reliable diagnostic criteria for autism in toddlers.

For more information on early signs of autism, please see Learn the Signs [7], Diagnosis [8] and the Modified Checklist for Autism in Toddlers [9], on this website. For more news and commentary from IMFAR, please see our 2012 IMFAR page [5].