Do Babies With Autism Smile? Yes, But Differently

Autism Spectrum Disorder (ASD) is a developmental condition that is characterized by challenges with speech, non-verbal communication, and social interaction, as well as repetitive behavior and obsessive interests. With newer and more sensitive screening methods, autism is being diagnosed earlier, with the CDC stating that autism can be diagnosed at 18 months of age or younger. Common symptoms first picked up include lack of eye contact, not responding to their name, and not showing joint attention.

There are some misconceptions about emotional expressions in autistic children. A common misconception is that people with ASD do not have emotional expressions. While it is true that some autistic people have a very flat affect, people with ASD do show facial expressions and emotions. However, due to differences in how people with ASD pick up, process, and display emotions, they sometimes display emotional expressions that differ from those used by neurotypical people. For example, infants and children with ASD show differences in their smiling behaviors. Specifically, they may show delayed smiling, and reduced frequency and duration of smiles.

For this reason, it is important to closely observe babies with autism as their feelings may not be expressed as obviously or clearly as with neurotypical babies. Monitoring for behavior patterns and triggers will be more useful than relying on facial expressions to help assess how a baby is feeling.

Understanding Autism in Babies

ASD is what is considered a spectrum condition as it looks different with each person and covers a wide range of diverse symptoms. It is very common to find multiple people sharing the autism diagnosis and presenting completely differently. With new screening methods and technology, ASD is being diagnosed earlier than ever.

According to a study in 2018, parents are the first to notice autism symptoms in 80% of the cases at the age of 2 years old. In this study, parents expressed concerns in 3 main areas: Communication, repetitive and restrictive interests and behaviors, and other general concerns. Within the communication domain, parents reported no response to names, the overall appearance of deafness, no joint attention, and a lack of social engagement. In the repetitive interests and behaviors, parents observed their child showed no interest in toys and games but did show a high level of interest in random objects. Moreover, parents observed stereotyped and repetitive behaviors, difficulties with changes, and noise sensitivities. Finally, under other concerns, parents noted high frequencies of crying and tantrums, delayed walking, issues with sleeping and feeding, hyperactivity, and random screaming.

Developmental monitoring is the continual process of monitoring a child’s development and comparing it against typical milestones. Parents or caregivers should look out for delays in playing, learning, speaking, behaving, and moving. However, as autism is a spectrum, there is a large variability in how these milestones present. For example, one infant may have strong eye contact but poor play skills, while another may have strong play skills but show a high level of rigid behaviors.

If you notice any signs mentioned above or just have a general feeling that something may be amiss, the child’s pediatric neurologist and developmental psychologists will be able to help and guide you towards a diagnosis as well as provide you with a treatment plan.

Smiling as a Developmental Milestone

Autism-babies-milestones


Smiling is an important developmental milestone to keep track of. Typically developing babies will exhibit smiling behaviors by around 6-12 weeks of age. Before this time, babies typically show “reflexive smiling” behaviors. These are smiles that arise as a response to bodily functions, such as gas, sleeping, bowel movements, etc, as well as babies exploring their facial muscles. Reflexive smiles are short and sporadic. These typically stop occurring at the 2-month mark.

At around 6 weeks, babies will begin to show what is known as “social smiling”, which are smiles that occur in response to other people. For example, a social smile might occur when a baby hears their mother’s voice or sees their father. At this point, a baby’s vision and social recognition are improving and they also begin to express feelings such as contentment or excitement.

Find an ABA Therapist Near You

I agree to receive text updates about my ABA services

Message & data rates may apply. Message frequency varies. Reply HELP for help and STOP to cancel. Privacy Policy & Terms
  • Therapists Available
  • No Wait List
  • Medicaid Accepted
  • Quick Response programming-hold-laptop

We serve Indiana, Nebraska, Arizona, Texas, and North Carolina

Autism and Smiling

Children with autism present with developmental delays, which extend to their smiles and facial expressions. Babies with autism often exhibit social smiles much later than typically developing infants. For instance, it will take longer to see the progression from reflexive smiles to social smiles towards and in response to people. Also, when babies with autism begin to show these social smiles, they are often shorter in duration and less frequent than typical babies.

There are three main reasons why this delay occurs, including sensory sensitivity, challenges with social interaction, and communication difficulties. Sensory sensitivities may make it difficult for a child to smile during a typical situation because they may be experiencing issues with the sound, smell, or look of a stimulus. For example, a game of peekaboo may be stressful for babies with autism due to loud noises or visual stimulation. Social interaction and communication challenges relate to delays in communication development and present with later than usual and less frequent social smiling, as well as sporadic social smiling which may be directed at objects more than people.

Facial expression recognition (the ability to see a facial expression and correctly interpret what it means) and generation (producing a facial expression) are developed from infancy in typically developing infants. There are several studies examining the early development of facial recognition and generation in babies with and without autism. Shortly after birth, typical infants begin to focus more on face-like stimuli and can begin to make basic facial discrimination skills.

At 6 months of age, typically developing babies can begin to discriminate between familiar and nonfamiliar faces. Emerging research is showing differences in how babies with ASD process facial stimuli. One study that examined video recordings showed that 6-month-old babies who were later diagnosed with ASD spent considerably less time looking at facial stimuli than their typically developing babies. Interestingly, there was no difference between the groups regarding how long they observed non-social stimuli, suggesting there is a specific reason why autistic babies avoid looking at faces.

This is still observed by 12 months of age, with a larger gap between autistic and non-autistic infants regarding the time spent looking at people. One study examined brain activity and compared the neural reactions of 3-4-year-olds with and without autism and their reactions to non-familiar and familiar faces and toys. The typical children showed more brain activity when presented with their familiar toys and faces, whereas the autistic children only showed differing brain activities with their toys. All these suggest innate differences in the way autistic toddlers and children process faces and expressions.

These differences will also affect how children diagnosed with autism present their facial expressions. One study suggests, compared with neurotypical peers, autistic children have muted emotional expressions regarding threatening or scary situations, and more intense anger but no differences regarding joy or happiness.

Another study video-recorded the facial expressions of autistic children and children with developmental delays during preschool activities. This study found that children with autism displayed less positive affect than the developmentally delayed children and when they did display positive expressions, they were more likely to be during alone activities than directed at peers.

Another study compiled research from multiple different studies and found people with autism produce facial expressions for less duration and frequency than neurotypical peers and produce facial expressions differently from neurotypical peers. Interestingly, this difference decreased with age and IQ, suggesting a learning component to copying socially appropriate facial expressions.

Parental Observations and Experiences

Parents can still foster emotional connections with their babies despite the challenges with their emotional expression. Parents need to stay open and receptive to their babies and meet them where they are. What that means, is that parents must think outside the box and be creative and observant of their child to bridge the gaps.

For example, if parents notice children are smiling more towards objects than directly at them, they can include themselves in play with those objects and encourage smiles when they occur. How their baby connects with the world may be different and that is okay. Parents should not push their babies to behave in typical ways, as this may create stress and tension, but instead should practice inserting themselves into their baby’s world in fun and supportive ways.

Encouraging Emotional Expressiveness

Understanding the question "Do babies with Autism smile?"


Once your baby starts emitting social smiles and other expressions, it’s important to encourage these to teach social skills. One of the most important social skills parents can begin to teach is eye contact. There are a few ways to do this and will depend on what each baby finds enjoyable. For example, if a baby makes eye contact, the caregiver can immediately provide attention by returning the eye contact and giving tickles. However, another baby may not enjoy tickles, so using a different reward such as shaking a musical toy while reciprocating eye contact would be more useful.

Parents can also act as models to teach and encourage facial expressions in their children. For instance, during play, parents can engage in exaggerated facial expressions. Similarly to the above, you can encourage the baby by praising them when they copy a facial expression or spontaneously produces one.

It’s also important and helpful to model for children when each expression and emotion is appropriate using multiple examples. For example, when children are in early intervention, it is typical for them to first learn to identify facial expressions from pictures. Once they have mastered this skill, they learn when each expression takes place using different modalities, such as short stories, pretend play, role-play, as well as naturally occurring scenarios.

In this way, it is important to consider that social smiling toward people may not be an innate skill for your baby. Because of this, social smiling may be a skill that needs to be actively taught. To promote social smiles, use the techniques outlined above to teach the baby that smiling at people produces great results, such as attention, tickles, toys, etc. This will help the baby learn the association between smiling and positive emotions and outcomes.

As mentioned earlier, it’s important to make these learning opportunities fun and always acknowledge each baby’s individuality. Creating a nurturing and supportive environment for your baby will increase the likelihood of smiling and prosocial behaviors. Even if your baby is not showing typical facial expressions, they will still be reacting internally to their environment and will be bonding with you, so don’t feel discouraged.

Professional Evaluation and Support

If, after reading this article, you feel your baby is not meeting their milestones in terms of social smiling and facial expressions, share these concerns with your pediatrician. Social smiling on its own is not an indication of autism, and could be a sign of other conditions, such as vision problems. However, if your child receives an autism diagnosis, early detection is the first step to early intervention, which can be lifechanging.

A study examining early intervention found that those who received early intervention therapy showed overall improved cognitive abilities, social skills, and less severe stereotyped behaviors. The children who were diagnosed and began early intervention before 24 months of age showed the most reduced symptom severity and were more likely to be integrated in less restrictive environments than those who received no or late therapy, highlighting the importance of acting on an early diagnosis and beginning early intervention.

Professionals will use different rating scales and parent interviews to diagnose autism and check the baby’s development. They will examine their communication skills, social interaction, play skills, etc. Typically they will assess for eye contact, joint attention, responding to name, and social reciprocity, such as smiling and playing.

It’s always important to remember that whether you receive an autism diagnosis or your child is simply a little delayed in hitting their milestones, you are not alone. There are multiple support groups, either online or in person that you can join to discuss with other parents who are going or have gone through a similar journey as your baby and you. There are also multiple educational materials online tailored for parents, such as Autism Speaks, The Center for Disease Control and Prevention, and The National Autistic Society which offer useful resources and tips.

If your pediatrician recommends therapy, also use your treatment team as a resource for training, knowledge, and support. You are your child’s biggest advocate, so arm yourself with as many tools and information as possible to improve their outcomes.

Conclusion

In this article, we discussed some differences exhibited by neurotypical and autistic babies regarding smiling behaviors. Babies with autism may orient less toward people and tend to show more smiling behaviors toward preferred objects and activities. As mentioned, delays in smiling may not be indicative of autism but should be brought to your pediatrician’s attention as a precaution.

Children with autism are all very unique and individual in their presentation of symptoms. It’s okay for your child to be developing at their own pace. There is a wealth of information available to help support your child’s development. Continue to accept your child for the individual they are and find enjoyable ways to jump into their world and teach them fun ways to express themselves. Just because your child is not smiling on the outside, it does not mean they are not smiling on the inside with you.

Leave a Comment