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How Do I Know If My Child Has Autism?

According to the most recent statistics from the Centers for Disease Control and Prevention, nearly 1 in 54 children are diagnosed with an autism spectrum disorder.  This neurodevelopmental disorder is characterized by deficits in social communication and restrictive, repetitive behaviors.  These characteristics can lead to significant impairment in social-emotional and daily living skills.  While some children are not diagnosed with autism until they enter school, symptoms are often present during the early childhood years. In this article, we will examine the characteristics of autism spectrum disorders in young children and explore what parents or caregivers can do if they suspect their child has autism. 

 

Deficits in Social Communication

            Persistent difficulties with social communication are a distinguishing characteristic of autism spectrum disorders.  Individuals diagnosed with autism frequently experience delayed development of expressive and receptive language.  Some young children with autism may even lose previously acquired speech and social skills.  Others may never develop spoken language and will need alternative and augmentative communication.   Many individuals diagnosed with this disorder also have difficulty understanding and using nonverbal language, such as interpreting facial expressions or recognizing gestures.  

These language delays are further complicated by social-emotional challenges.  Young children with autism spectrum disorders have trouble interacting with family members and peers. They may avoid eye contact and prefer being alone.  Some children may even exhibit an aversion to affection from familiar caregivers.  Individuals with autism spectrum disorders frequently have difficulty recognizing other people’s feelings, which can result in awkward or unsuccessful social interactions.

            Parents and caregivers may see signs of autism in infants as young as six months old.  The following are signs of possible autism spectrum disorders in infants and toddlers.

  • The child engages in little or no eye contact with caregivers.
  • The child rarely or never responds to caregivers with sounds, smiles, or other facial expressions.  
  • The child rarely or never babbles or coos.  
  • The child shows little or no response when their name is spoken.
  • The child rarely or never uses gestures to engage caregivers, such as pointing, reaching or waving.
  • The child says/signs few or no words by the age of 16 months.
  • The child uses few or no meaningful two-word phrases by the age of 24 months (e.g., “car go” or “bye-bye mama”).
  • The child loses previously acquired speech or social skills.

 

Restrictive, Repetitive Behaviors

            Another hallmark of autism spectrum disorders is the display of restrictive or repetitive behaviors.   Young children with autism spectrum disorders may exhibit repetitive motor movements, such as hand flapping, rocking, or spinning.  These repetitive movements may also include objects such as incessantly flicking light switches on and off or spinning the wheels on toy cars.  Other individuals might exhibit echolalia, which is the act of repeating the same word or phrase over and over again.   Parents and caregivers may observe these behaviors in most, if not all, young children from time to time, but children with autism engage in these behaviors with such frequency and duration that the repetitive behaviors may begin to interfere with day-to-day activities.

Individuals with autism may also exhibit unusual or intense interests.  Many typically developing children display strong interests in a variety of topics ranging from dinosaurs to dolls; however, those interests tend to fade and change over time.  However, young children with autism may develop unusual or intense preoccupations that are uncommon for other children their age.  For example, a young child with autism may acquire an extreme interest in coffee makers or public transit schedules.  

In addition to unusual or intense interests, young children with autism may exhibit unusual sensory responses.  They may overreact or underreact to the sights, sounds, and smells around them.  Individuals with autism may avoid certain tastes, textures, and smells.  They may become overwhelmed in certain environments, such as a crowded store or a noisy playground.  

These restricted, repetitive behaviors may result in an extreme need for sameness.  Many individuals with autism spectrum disorders exhibit an intense reliance on routines.  Minor changes in their daily schedules or environment can cause extreme anxiety.  Some young children with autism have been known to experience a meltdown when parents rearrange the furniture in their home or when caregivers change their hairstyles.  

The following are signs of restrictive, repetitive behaviors associated with autism in young children.

  • The child shows a strong preference for being alone.
  • The child incessantly repeats the same words or phrases.
  • The child displays extreme resistance to even minor changes in their daily routines or environment. 
  • The child exhibits unusual or intense reactions to sounds, smells, textures, lights, colors, or tastes.
  • The child engages in repetitive behaviors, such as rocking, flapping hands, or spinning.
  • The child shows limited or intense interests that are unusual for their age.

 

What If I Suspect My Child Has Autism?

Autism spectrum disorders often encompass language delays, intense interests, repetitive behaviors, and social-emotional difficulties.  Despite these shared characteristics, individuals diagnosed with autism spectrum disorders vary greatly.  In the following quote, Dr. Stephen Shore, a leading researcher in the field of autism, highlighted the diversity among individuals with this diagnosis, “If you’ve met one person with autism, you’ve met one person with autism.”  Some young children with autism spectrum disorders may need very limited supports in their day-to-day lives, while others may require extensive caregiver support across most of their day.  This variation can make it difficult for parents and caregivers to recognize the early signs of autism spectrum disorders.  

In fact, some of the characteristics associated with autism can result from other conditions and childhood disorders.  Screening tools have been created to help parents, medical professionals, and other early childhood providers recognize the early signs of autism.  One of the most widely used autism screeners is the Modified Checklist for Autism in Toddlers-Revised (M-CHAT-R).  While the M-CHAT-R is not designed to diagnose a child with an autism spectrum disorder, parents and other professionals can use this checklist to determine if a young child exhibits enough signs of an autism spectrum disorder to warrant further evaluation.  

The American Academy of Pediatrics recommends screening for autism at well-child exams when children are 18- and 24-months old. Thus, most healthcare providers likely include autism screening as part of a young child’s regular checkups. If not, parents can use the results of the M-CHAT-R to discuss concerns with their child’s healthcare provider.  

In upcoming articles, we will explore in greater depth ways parents and early childhood educators can support the needs of children with autism spectrum disorders.

 

References and Resources

American Psychological Association. (n.d.).  What is autism spectrum disorder?  https://www.psychiatry.org/patients-families/autism/what-is-autism-spectrum-disorder

Autism Speaks.  (n.d.).  Learn the signs of autism.  https://www.autismspeaks.org/signs-autism

Center for Disease Control and Prevention. (2020, September 25). Data and statistics on autism spectrum disorder.  https://www.cdc.gov/ncbddd/autism/data.html

Child Mind Institute.  (n.d.).  Parent’s guide to autism.  https://childmind.org/guide/parents-guide-to-autism/