Sunday, September 4, 2016
Worried About Whether Your Baby Looks at You? Take a Developmental Perspective
Dr. Seuss was so right when he said “a person’s a person, no matter how small.” But he forgot to say that a person who is small is not exactly the same person he will be when he gets bigger. Remembering that fact can help parents of young babies who get worried sick when their babies don’t behave in ways that are much more characteristic of older people. To know what’s going on with any big or small person, we need to know where that person is developmentally.
Every week or two, I get a query from a frantic young parent who is terribly concerned that her baby, somewhere in age between birth and three months, does not make enough eye contact or even seem to be interested in looking at the parent. Mothers particularly seem inclined to jump to a conclusion that a young baby will not look at the mother because he does not like her face.
The anthropologist Ashley Montague recognized that babies in the first few months do not pay a lot of attention to what is going on around them. He referred to the first months after birth as a period of “exterogestation”-- when babies continue to develop along the lines they followed in the uterus, but now do their developing outside the mother’s body. Montague pointed out that in fact humans, with our large and complex brains, need a year to develop after conception, but have to be born too early because our big heads could not otherwise fit through the mother’s pelvic bones, thickened as those bones are by our walking upright. Other authors, like Margaret Mahler, have referred to this period as one of “normal autism” because young infants seem to be so self-focused and inattentive while they continue through their first months of development.
During this early period, infants’ behavior is very much affected by what is called their state. This term refers to the effects of a group of variables in the nervous system that determine what behavior a baby is likely to carry out. We adults have “states”, too, but we usually think of them just as being asleep or being awake—though we may also understand differences between REM (rapid eye movement) and non-REM sleep. For babies, there are six states that make a difference to behavior. These are 1. active or REM sleep, 2. quiet or non-REM sleep,3. drowsy awakeness, 4. quiet but alert awakeness,5. fussing and high activity, and 6. crying. Of these six states the fourth, quiet alert awakeness, is the one in which attentiveness and learning are most likely to occur.
For very young babies, states shift rapidly and are poorly organized. There is a lot of sleep, and periods of quiet alertness, when looking at faces and interacting with people might occur, are brief. It can be hard to get a baby’s attention even during one of these brief quiet alert periods, even if some parenting “tricks” like opening eyes and mouth wide while moving toward the baby’s face are deployed. After about three or four months, babies spend more time in the quiet alert state and are more attentive to adults. Their vision also improves over this period of time and they are more able to see in low-contrast situations like dim light or light coming from behind a person’s face.
State issues mean that young babies do not spend much time looking around them, at people or -in looking at other things, but this fact needs to be interpreted in light of the reality that they do not spend much time looking at anything. This changes with further development-- they look more, and it’s more evident that they like faces, as time goes on.
Most of us feel that we’re aware of a special experience when someone makes eye contact with us—a sort of “zap” that’s different from how it feels when they just look in our general direction. But that “zap” is not necessarily a good way to measure whether a young baby has actually looked at somebody. It used to be difficult to measure and record whether a baby did look at a face, so for a long time we did not have really good information about the developmental progress of this behavior. Nowadays, though, there are much better baby-friendly devices that can measure where a baby is looking.
Writing in the publication Child Development Perspectives, the Finnish psychologist Jukka Leppanen recently reviewed what is known about developmental changes in babies’ looking at faces(“Using eye tracking to understand infants’ attentional bias for faces”, Child Development Perspectives, 2016, Vol. 10 (3), pp. 161-165). The review reported that when babies were given several things to look at, 4-month-olds looked at a face only on 15% of the exposures, but by six months the proportion was 50%. (Adults looked at the face preferentially 90% of the time, not 100%.) Three-to-six-month-olds did not look particularly at faces when face pictures were given in shades of grey. At 6 months, when looking at faces rather than other things 50%, babies did not act as if everything besides faces was the same-- they also showed a lesser preference for looking at upside-down faces, at pictures of body parts, and at animals.
Leppanen also reviewed information about how long babies looked at faces once they had noticed them. Before five months, babies easily move from looking at a face to some other interesting and distracting object. For 5-month-olds, continuing to look at a face when something distracting comes into the picture is done, and happens in the same way whether the face has a neutral or an emotional expression. By 7 months, babies look longer at a fearful face even though some other interesting distracting sight is available. Compared to what a newborn can do, these older babies show great progress in finding faces visually and continuing to look at them without getting distracted.
Parents who are worried about what they think is a delay in looking at faces have often been influenced by Internet material warning them of signs of autism. As we have seen here, it is quite typical for young babies not to look much at faces or “make eye contact”. It’s not until six months or more that this kind of looking becomes more like what adults do and expect, so it’s best not to be too concerned about whether young babies seem to look at faces or eyes.
As for detecting autism in those early months-- well, there is work being done to try to measure whether there are characteristics of very early looking that can tell us whether a baby is likely to be diagnosed as autistic a couple of years in the future, but the work is not finished yet, and this may not prove to be possible. While we wait, let’s just remind ourselves that babies of all kinds benefit from having cheerful, affectionate caregivers who understand that a small person is not exactly the same as a bigger one.