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The sooner a child is diagnosed with autism and receives appropriate treatment, the better the outcome for that child. Every parent should be educated about the early signs of autism, so they can seek help from professionals who specialize in this disorder if they notice their child is exhibiting any of these signs.
What Are the Early Signs of Autism?
The following are considered to be red flags for autism spectrum disorders:
- No response to his or her name by 12 months of age
- No babbling or pointing by 12 months
- No single words by 16 months
- No two-word spontaneous (not just echolalic) phrases by 24 months (for example, “more cookie”)
- Any loss of any language or social skill at any age
Recognizing signs of autism
Social differences in children with autism
There are five key differences in social skills for children with autism
- Their view of and responses to their surrounding environment differ from the norm
- Their ability to start and maintain a conversation is affected
- They sometimes interpret verbal and nonverbal cues differently than other children
- They may on a limited range of topics
- They may have difficulty understanding another person’s perspective
Communication differences in children with autism
Children with autism may experience challenges in being able to communicate, or understanding what others are communicating.
These difficulties can include:
- being non-verbal
- having delays in speech and language development
- having trouble initiating conversation
- not making eye contact when talking to someone
- speaking in a flat tone, or having unusual intonation (rhythm and melody)
- using scripted language instead of spontaneous speech (e.g. repeating lines from films or TV shows)
- being unable to follow simple instructions
- not understanding the non-verbal aspects of communication, such as gestures and facial expressions, or being unable to use these themselves
Behavioral differences (repetitive & obsessive behaviors) in children with autism
- hand flapping, rocking back and forth or spinning in circles
- repeating words or phrases over and over (echolalia)
- becoming disturbed at the slightest change in a routine or being placed in a new or overly stimulating setting
- repetitive movements, such as opening and closing doors or flipping light switches on and off hundreds of times a day
- obsessive attachment to unusual objects
How to distinguish a child with autism from other typically developing children
In order to identify a child with autism spectrum disorder (ASD), it is important to recognize that children with autism display behavior, social and communication differences from typically developing children.
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) lists three primary domains of impairment:
- Social communication – verbal and nonverbal
- Restricted interests and repetitive behaviors
- Symptoms must be present in early childhood (but may not become fully manifest until social demands exceed limited capacities)
At 12 Months
Children with autism are less likely to have experienced shared attention at 12 months of age than children without the disorder, a new study finds.
The findings suggest that shared attention may be a risk factor for autism and that promoting it may be a way to prevent the disorder.
Shared attention refers to focusing on an object or person together with another person. It is an important precursor for social interactions.
For each child in the study, researchers used video recorded at 12 months of age to calculate how often his or her mother made eye contact, talked and smiled at him or her. They also measured how often the mother looked at a toy and how much time the child spent looking at either his or her mother or a toy.
At 18 Months
Researchers are working toward earlier diagnosis of autism spectrum disorder. A new study of 18-month-old infants suggests that a very early diagnosis is possible, and that brain responses to speech may help predict the development of language impairment.
In the study, published in Nature, researchers at the University of North Carolina at Chapel Hill tested 18-month-olds in two behavioral experiments: one to measure visual attention and another to measure brain responses to speech sounds. This was followed by annual assessments of the children’s cognitive and social abilities for five years.
The researchers focused on a group of high-risk infants who had an older sibling diagnosed with autism spectrum disorder (ASD). The older sibling acts as a genetic marker because he or she shares half the younger child’s genes. The results revealed that this group is particularly sensitive to changes in tone of voice, but slower to react to shifts in visual attention.
“We found that children with ASD were able to attend selectively to speech sounds when they were 18 months old,” said Elise McMillan, PhD, a postdoctoral fellow at the Carolina Institute for Developmental Disabilities and lead author of the study. “However, we also observed differences in their brain responses compared to typically developing children.”
At 24 Months
Children with autism spectrum disorders (ASD) show delays in socialization and communication from the first year of life. However, it is not until after 24 months that the full phenotype of autism becomes apparent.
We found an increase in the frequency of the communication symptoms (3.9% to 5.6%) and the restricted & repetitive behaviors (2.0% to 4.6%) between two time periods: 1992-1994 and 2006-2008 respectively, whereas there was no significant change in prevalence of social symptoms in children aged 24 months
The increase in prevalence of autism is likely due to a combination of factors including changes in diagnostic criteria, diagnostic substitution, heightened awareness and surveillance, as well as possible true increases in risk factors.
How Pediatricians Screen for Autism
Starting around 18 months, pediatricians are supposed to start screening toddlers for autism. That’s when the first symptoms of autism tend to emerge, but often parents don’t notice them at first because they don’t know what to look for, says Dr. Amanda Bennett, a developmental behavioral pediatrician in Philadelphia.
The American Academy of Pediatrics now recommends that children get screened for autism twice — once at 18 months and again at 24 months. The AAP is also pushing doctors to screen kids who may be at risk because of language delays or other developmental problems.
The AAP recently developed a “Learn the Signs, Act Early” campaign to raise awareness about how autism can be identified early and treated.
How parents can spot the warning signs
Parents are often the first to notice signs of autism in their child. But knowing what to look for can be tricky, especially because some early warning signs are very common in young children.
According to the Centers for Disease Control and Prevention (CDC), about 1 in 68 children have been identified with autism spectrum disorder (ASD). However, according to a new study published in the journal Pediatrics, up to 1 in 45 children may have ASD. And, prevalence rates appear to be on the rise.
Most children are screened for developmental issues before they turn 2 years old. But even if your child has passed a screening test, keep an eye out for any signs that could indicate an underlying problem. If you have any concerns, don’t hesitate to talk to your pediatrician or another health care provider.