Buzz
Autism is a pervasive developmental disorder, meaning that children with autism can show a variety of behaviors or signs of the condition in different ways. Children with autism experience brain development disorders, often reflected in difficulties or differences in intellectual abilities, social interactions, verbal and non-verbal communication, and self-stimulating behaviors. Although each child with autism is unique, it is crucial to recognize the signs and symptoms as early as possible to enable early intervention, helping you and your child lead the happiest life possible.
Steps
Recognizing Social Differences
Interact with the child. Typically developing infants have an innate social instinct and enjoy making eye contact. An infant with autism may not appear to engage with parents or seem like they are "not paying attention" to them (parents are not autistic).
- Eye contact. A typically developing child can respond to another person's gaze at 6 to 8 weeks old. A child with autism may avoid making eye contact or may not look at you at all.
- Smiling at the baby. A non-autistic child can smile and show joy when they are about six weeks old or younger. A child with autism may not smile, even when interacting with their parents.
- Playing face-mimicking games with the child to see if they copy. A child with autism may not engage in mimicry games.
Calling the child’s name. A typically developing child will respond to their name by the age of nine months.
- Normally developing children may say "dada" or "mama" by 12 months old.
Playing with toddlers. At the age of 2 – 3 years, a typical child will be excited to play with you or others.
- A child with autism at this stage may display signs of withdrawal from the outside world or become lost in thought. A typical child will draw you into their world by pointing, showing, reaching, or waving at 12 months old.
- A typically developing child may engage in parallel play until the age of 3. Parallel play means they play next to others, enjoying company but not necessarily needing to collaborate in the play. Don't confuse parallel play with a child with autism who doesn't engage in social interactions.
Considering differing opinions. By the time they are 5, a typical child understands that you may have different opinions about things. Children with autism often struggle to recognize that others have distinct thoughts, viewpoints, and feelings.
- If your child loves strawberry ice cream, tell them that you love chocolate ice cream and see if they argue or get upset because you don't share the same opinion.
- Many children with autism understand this concept more theoretically than practically. They may understand that you like the color blue, but not comprehend that you'd be upset if they ran into the street to chase a balloon.
Assessing mood and emotional outbursts. Children with autism may experience extreme emotional outbursts or meltdowns similar to tantrums. However, these outbursts are not intentional and are highly distressing for the child.
- Children with autism face numerous challenges and try to “hold back” their emotions to please caregivers. These emotions may become overwhelming, and the child may become so distressed that they harm themselves, such as banging their head against a wall or biting themselves.
- Children with autism may experience more distress due to sensory issues, mistreatment, and other problems. They may become more agitated to defend themselves.
Observing communication difficulties
Whisper to the child and see if they respond. Listen to the increasing sounds and babbling as the child grows. Children typically start speaking around 16 to 24 months old.
- A normal child may engage in back-and-forth sound exchanges, like chatting, by the age of nine months. A child with autism might not communicate verbally at all, or may have previously had speech but lost it later.
- A typical child will begin babbling around 12 months old.
Talk to the child. Discuss your child’s favorite toy and pay attention to their sentence structure and conversational skills. Normally developing children will have a growing vocabulary by 16 months and may form two-word phrases with meaning by 24 months, speaking in full sentences by the age of 5.
- Children with autism often mix up word order in sentences or simply repeat phrases or sentences from others, known as echolalia. They may confuse pronouns, for example, saying “Does mom want to eat cookies?” when trying to express that they want cookies.
- Some children with autism skip the “baby talk” phase and may develop exceptional language skills. They may learn to speak early and/or develop a large vocabulary. Their speech may differ greatly from their peers.
Try using different expressions. Determine if the child understands statements literally. Children with autism often misinterpret body language, tone of voice, and expressions.
- If you sarcastically say, “Nice!” when seeing a child cover the living room wall with red marker, a child with autism might think you are genuinely complimenting their work.
Assess facial expressions, tone of voice, and body language. Children with autism often have very unique non-verbal communication. Most people are accustomed to typical body language, which may sometimes lead to confusion.
- A robotic monotone, a sing-song voice, or an unusually childlike voice (even in adolescence or adulthood)
- Body language that doesn’t match emotions
- Limited facial expressions, exaggerated expressions, or odd facial expressions.
Identify repetitive behaviors
Observe whether the child exhibits unusual repetitive behaviors. While all children enjoy playing repetitive games to some extent, children with autism tend to show stronger repetitive behaviors like rocking, clapping hands, organizing objects, or repeating sounds, known as echolalia. These behaviors may be necessary for self-calming and relaxation.
- All children engage in echolalia until around age three. However, children with autism may do so more frequently, even after the age of three.
- Some repetitive behaviors are known as self-stimulatory behaviors, meaning they stimulate the child’s senses. An example of this could be a child wiggling their fingers in front of their face to stimulate their vision and entertain themselves.
- Some self-stimulatory behaviors happen when the child hums to match the pitch of external sounds (known as auditory stimuli), like the buzzing of bees, the sound of a lawnmower, the sound of a saw, or a vibrating phone.
Pay attention to how the child plays. Children with autism are usually not interested in imaginative play and prefer arranging objects (e.g., arranging toys or building a city for dolls rather than playing with a dollhouse). Imagination occurs in their minds.
- Try breaking the pattern: rearrange the dolls the child is setting up or walk across the child’s path while they are trying to walk in a circle. A child with autism will likely become frustrated by your interruption.
- Children with autism may be able to play imaginative games with others, especially when the other child leads. However, they typically do not initiate such play on their own.
Recognize the child’s interests and favorite objects. Intense, unusual obsessions with certain household items (such as a broom or a string of beads), or later, with objects in general, can be a sign of autism.
- Children with autism may develop a strong interest in a specific topic and acquire detailed knowledge about it. Examples could include knowledge about cats, baseball statistics, fairy tales, puzzles, or board games. The child is often 'enthusiastic' or eager when asked about these topics.
- The child might have one or more special interests at once. These interests may evolve as the child learns and grows.
Note the child’s need for routines. Many children with autism have a strong need for consistency and routines, and they may strongly oppose any changes in their routines. For example, if you usually take the child to school by a specific route, try changing this routine. The child with autism will resist this change.
- Routines can involve the order of daily activities, but they can also relate to speech (such as repeatedly asking the same question), food (only eating foods of a certain color), clothing (only wearing clothes made from specific fabrics), the arrangement of objects in the home, and more.
- Routines provide a sense of comfort for children with autism. The world may seem unpredictable, confusing, and frightening to them, and following routines helps them feel more in control and stable.
Observe the child's sensory sensitivities. If your child seems unusually bothered by light, texture, sounds, smells, or temperature, consult with a doctor.
- Children with autism may have an 'overreaction' to certain sounds (e.g., loud, sudden noises or the sound of a vacuum cleaner), textures (like itchy socks or wool sweaters), etc. This phenomenon happens when certain senses are heightened, causing discomfort or actual pain.
Evaluating Autism Spectrum Disorder by Age
Knowing when to recognize signs of Autism. Certain symptoms become more evident when children reach ages 2 to 3. However, children can be diagnosed at any age, particularly during transitional periods (such as moving to high school or changing homes) or during stressful times. Excessive pressure in life may cause someone with autism to "regress" as a coping mechanism, prompting concerned family members to seek a diagnosis.
- In some children, signs may be noticeable as early as one or two years old.
- Others may only be diagnosed during college when their atypical development becomes more apparent.
Understanding adolescent milestones. While there are some differences, most children reach developmental milestones in common patterns. Children with autism often reach these milestones later. In some cases, they may develop earlier, and parents may view this as a sign of a gifted child struggling or retreating.
- By age three, children typically can climb stairs, play with simple toys, and engage in pretend play.
- By age four, they can usually tell their favorite stories, scribble, and follow basic instructions.
- By age five, children generally can draw pictures, recount daily activities, wash their hands independently, and stay focused on tasks.
- Older children and adolescents with autism may follow strict routines or patterns, develop intense interests in topics that may not be age-appropriate, avoid eye contact, and be highly sensitive to touch.
Pay attention to skills that may be lost. Speak to a family doctor if you're concerned about any aspect of your child's development. Don't delay if your child loses the ability to communicate, perform self-care tasks, or engage socially at any age.
- Most lost skills are still "there" and can be regained.
Advice
- While it is not advisable to self-diagnose your child, you can still search online for information.
- It is believed that autism is more commonly diagnosed in boys than girls. Experts note that autism in girls is often overlooked in diagnostic criteria because girls tend to be "better behaved."
- Asperger's syndrome was once considered a separate disorder, but it is now categorized under the autism spectrum disorder umbrella.
- Many children with autism also experience other conditions such as anxiety, depression, gastrointestinal disorders, seizures, sensory processing disorders, and pica syndrome, which involves cravings for non-food items (aside from the normal developmental phase where toddlers put things in their mouths).
- Vaccines do not cause autism.
