Autism, or autism spectrum disorder (ASD), can include a broad range of strengths and challenges. People with autism may suffer difficulties with social, speech, and communication skills and may exhibit some repetitive behaviors.
In a study recently published by Pediatrics, it was found that the current prevalence of parent-reported ASD is 1 in 40 children. That’s a significant increase from the 1 in 59 that was previously documented in a 2014 report from the Center for Disease Control and Prevention. Based on this new finding, we may conclude that ASD is reported in 2.5% of children — that’s 1.5 million kids between the ages of 3 and 17.
There is no specific cure for autism, and we do not know exactly what causes it. What we do know is that the earlier it is identified, the earlier intervention can start — and early intervention is key to a positive outcome.
How will you know?
As a parent, you may be wondering how you would know if your child had autism. Identifying autism can be tricky because it is often not characterized by the presence of atypical behaviors. Rather, it is characterized by the absence of typical behaviors.
The earliest signs of autism can be apparent in what babies don’t do. As such, parents should educate themselves on the expected milestones for child behavior and development. There are many books, apps, websites, and parenting programs that can help you understand what to expect … and what to do if the standard expectations are not met.
Remember that developmental milestones go beyond just the physical milestones of rolling, sitting, and walking. Language/communication and social/emotional milestones are just as important, if not more so, in determining whether a child has autism.
Early social signs of autism
Babies are social creatures from the day they are born, using eye contact, non-verbal behaviors, and body language to express themselves. They are always watching, observing, learning, and taking in everything they see and hear to make sense of the world. Even though babies cannot talk, they are usually very interactive and skilled at making their needs known. This is often the first breakdown we see when autism comes into play.
Early indicators of autism can begin to surface as early as 12 to 18 months, as this is the developmental period in which babies become more engaged and interactive. Even though babies at this age are not able to say many words, they communicate through eye contact, gestures, smiles, sounds, and body language. Babies at this age are typically waving hello and goodbye, reaching for people and toys that they want, and maintaining eye contact with caregivers.
If you feel like you have a healthy bond with your baby but are not seeing this connection by 12 to 18 months, bring it to the attention of your baby’s healthcare provider.
Other early signs
Some other early signs of autism include not responding to cuddling, not imitating facial expressions, not responding to names or familiar voices, and not following objects visually by 12 months. By 24 months, babies are usually speaking at least 40 words (and often more than 200). If your child is not speaking by this age, it may be a reason to investigate further.
As babies get older
As babies get older, some signs to watch for are a loss of previous skills, purposeful avoidance of eye contact, a preference for being along, repetition of words or phrases, delayed language development, repetitive behaviors such as flapping hands, rocking, or spinning, and restricted interests. If just one or two of these things are present but not severe, if could just be the child’s personality shining through. However, if several of these signs are present and interfering with the child’s functioning, talk to your child’s healthcare provider.
Of course, not all babies reach all developmental milestones on the precise day that books and charts suggest. Babies develop at their own pace. However, it is important for parents to know what to expect and to keep track of developmental milestones so that mini milestones can be noted continuously. When parents are informed, they can be vigilant for regression or long plateaus in developmental milestones. If a regression or plateau is noted, the pediatrician should be consulted.
Each child is different
Each child with autism looks different from every other child with autism. Put simply, autism has a unique manifestation in each individual. This high degree of variability makes it difficult to diagnose.
The first thing you can do if you’re concerned that your child might have autism is take a simple online screening tool called the Modified Checklist for Autism in Toddlers (MCHAT). This is a 20-question behavioral screening that can help you determine if you should bring your concerns to a healthcare provider.
If your child’s healthcare provider shares your concerns, she might observe your child in the office or decide to also administer the MCHAT. In fact, many pediatricians and nurse practitioners do this routinely between 18 and 24 months as part of the well-baby exam. But well-baby visits are usually only several minutes long, and during a visit, the healthcare provider sees only a snapshot of the child’s behavior. Since it can be hard to identify a delay in this short period of time, it’s helpful for you as the parent to make written a list of your own observations and concerns to share.
Pediatricians and nurse practitioners are typically not able to make a final diagnosis. If your practitioner has a concern, she will probably refer the child to a specialist for a full developmental assessment. The assessment will likely involve other early intervention specialists: occupational therapists, physical therapists, speech and language pathologists. During this phase of investigation, there will likely be a developmental assessment, a hearing assessment, a review of medical records, and a language evaluation.
If you have concerns about autism, do not be afraid to bring them up at your baby’s next well-baby visit. Research tells us that many children with autism are not treated as early as they could be. When concerns are brought to light early, intervention can occur when the child’s brain is still able to be molded. During the first three to five years, it is much easier to remediate problems. For example, a preschooler who shows signs of possible autism may qualify for occupational, physical, and speech therapy. The professionals involved can help provide strategies for families to deal with autism so the child has the best chance for success.