Symptoms of Autism Spectrum Disorder
Does my child have autism spectrum disorder?
According to the National Institute of Child Health and Human Development's Autism Facts, "a doctor should definitely and immediately evaluate a child for autism if he or she:
- Does not babble or coo by 12 months of age
- Does not gesture (point, wave, grasp, etc.) by 12 months of age
- Does not say single words by 16 months of age
- Does not say two-word phrases on his or her own (rather than just repeating what someone says to him or her) by 24 months of age
- Has any loss of any language or social skill at any age.
"There are a number of things that parents, teachers, and others who care for children can look for to determine if a child needs to be evaluated for autism. The following "red flags" could be signs that a doctor should evaluate a child for autism or a related communication disorder.
- The child does not respond to his/her name.
- The child cannot explain what he/she wants.
- Language skills or speech are delayed.
- The child doesn't follow directions.
- At times, the child seems to be deaf.
- The child seems to hear sometimes, but not others.
- The child doesn't point or wave bye-bye.
- The child used to say a few words or babble, but now he/she doesn't.
- The child throws intense or violent tantrums.
- The child has odd movement patterns.
- The child is hyperactive, uncooperative, or oppositional.
- The child doesn't know how to play with toys.
- The child doesn't smile when smiled at.
- The child has poor eye contact.
- The child gets "stuck" on things over and over and can't move on to other things.
- The child seems to prefer to play alone.
- The child gets things for him/herself only.
- The child is very independent for his/her age.
- The child does things "early" compared to other children.
- The child seems to be in his/her "own world."
- The child seems to tune people out.
- The child is not interested in other children.
- The child walks on his/her toes.
- The child shows unusual attachments to toys, objects, or schedules (i.e., always holding a string or having to put socks on before pants.)
- Child spends a lot of time lining things up or putting things in a certain order. (Return To Top)
"Doctors should do a developmental screening" at every well-baby and well-child visit, through the preschool years. In this screening, the doctor asks questions related to normal development that allow him or her to measure a specific child's development. These questions are often more specific versions of the "red flags" listed above, such as Does the child cuddle like other children? Or, Does the child direct your attention by holding up objects for you to see? The doctor will also ask if the child has any features that were listed earlier as definite signs for evaluation for autism.
"If the doctor finds that a child either has definite signs of autism, or has a high number of red flags, he or she will send the child to a specialist in child development or another type of health care professional, so the child can be tested for autism. The specialist will rule out other disorders and use tests specific to autism. Then he or she will decide whether a formal diagnosis of autism, autism spectrum disorder, or another disorder is appropriate." (Return To Top)
"Several symptoms can be seen by 18 months of age, such as poor eye contact, trouble with pretend play and imitation, delayed communication skills and problems with "joint attention." Joint attention occurs when a child points or otherwise tries to get someone to look at the same thing he is observing. Children with autism often don't point or show joint attention.
"Nonetheless, the average age of diagnosis is about three years old. Parents and doctors often are alerted to a problem when the child doesn't develop speech around age 2.
"Studies also show that a subgroup of children with ASDs experiences a 'regression,' meaning they stop using the language, play, or social skills they had already learned. This regression usually happens between the first and second birthdays.
"Researchers are still learning about the features of regression in ASDs, and whether the features differ from those shown by individuals who show signs of autism in early life." (Return To Top)
"According to the Individuals with Disabilities Education Improvement Act of 2004, the child's primary health care provider is required to refer the family to an early intervention service. In addition, children age three and older are entitled by law to a free and appropriate public education. In some states, the law extends these services to all diagnosed children from birth to age three.
"These services vary by state, but include special education and related services or treatment programs. If the child is under age three, the family should consult the zero-to-three service system in their community. The local school district can provide services for a family if the child is three or older. In either case, the local school district, the state education agency, and the local or state health departments should provide referrals for the necessary services....
"There are a number of parents' organizations, both national and local, that can provide information about education and treatment services and how to get these services for a child. For a listing of these organizations, go to Medline Plus, or check the local phone book."
AutismWeb Commentary: See our EDUCATION page for reviews of the most widely used teaching methods for young children with autism spectrum disorders. Several resources include:
Could It Be Autism?: A Parent's Guide to the First Signs and Next Steps. Nancy Wiseman explains how to find out if your child is developmentally delayed as early as four months of age. Wiseman provides checklists, discusses screening tests, and, if your child has autism, tells you how to design an effective treatment program. She says taking action is better than a wait-and-see approach. AutismWeb agrees.
- Also by Wiseman: The First Year: Autism Spectrum Disorders: An Essential Guide for the Newly Diagnosed Child.
See the government's "Learn the Signs, Act Early" web site for a list of developmental milestones by age.
Overcoming Autism: Finding the Answers, Strategies, and Hope That Can Transform a Child's Life by Lynn Kern Koegel Ph.D. and Claire LaZebnik. Dr. Koegel describes a "child friendly" treatment that parents can use at home. Her book has chapters on teaching communication, breaking the cycle of meltdowns, repetitive behaviors like flapping, social skills, battling fears and fixations, school placement and family life.
AutismWeb Commentary: Sometimes a pediatrician will disagree with you about whether there is a developmental problem. He may have a "wait and see" philosophy about developmental delays, preferring to see if a child catches up on his own. Or, he may not be familiar with milder forms of autism.
If you believe there's a problem, you may refer your child for an evaluation at your local Early Intervention office. You can find this office by calling the local health department or school system. Or, you can check this state by state list of Parent Training and Information Centers for help finding the office in your community. The developmental evaluation is free. So is any treatment if your child is found to have significant delays.
It is better to start treatment earlier rather than later to give your child the best chance. Whether or not your child eventually will be diagnosed with an autism spectrum disorder, the Early Intervention Office can start helping him with developmental delays now.
The National Research Council makes a strong argument for beginning an intensive educational program as soon as autism is suspected in Educating Children with Autism. The book identifies the characteristics of effective preschools, schools and teaching methods for autism.Information in quotes is reprinted from portions of Autism Facts by the National Institute of Child Health and Human Development. Resource information and labeled commentary are by AutismWeb.com.