By Benison Anne O’Reilly, co-author of The Complete (formerly Australian) Autism Handbook
The early signs of autism spectrum disorder (ASD) are usually present by 12 months of age, sometimes earlier. Unfortunately, these can fly under the radar for many parents if their child is sitting, crawling and walking to plan.
Parents often first become concerned when their child reaches the age of 15 to 18 months. This may because their child is not talking much (or at all) but also because they start comparing their child to other toddlers and notice how their behaviour is somehow ‘different’ to the norm.
“When my son was 18 months old, a friend brought her nine-month-old baby round to our house. I had so much fun with the baby; there was constant interaction between us. I realised that this was completely absent
withmy own little boy.”
Quote reproduced with permission from The Complete Autism Handbook
Some parents notice their child loses words and/or stops pointing and waving. This is commonly referred to as ‘regression’. Frequently, however, this is preceded by subtle signs of ASD (such as an intense focus on objects) that probably seemed unremarkable at the time.
For verbal children with milder symptoms (those of the ‘Asperger’s type’) ASD may even go unnoticed until they reach school age, when teachers pick up difficulties in how they interact with their peers.
So, what are the early signs of autism? What should parents and carers look out for?
This is not an exhaustive list, but some of the early signs to look out for in a child include:
- Few or no ‘social smiles’ — usually when someone smiles at a baby or talks to them they will smile back, or coo or try to imitate their partner’s facial expression.
- Not turning when their name is called (but responding to other sounds).
- Not sharing enjoyment in something with an adult, such as a toy, by looking back and forth between the two.
- Avoiding or reduced eye contact.
- Not following an adult’s gaze or point (for example, if their parent points out a dog on the street).
- A general preference for being alone.
- Not bringing objects of personal interest, like toys or books, to show to a parent.
- Little or no babbling by 12 months.
- Not using gestures such as pointing, reaching or waving by 12-14 months.
- Very few or no words by 16 months.
- Very few or no meaningful, two-word phrases by 24 months (not including echoing — see below).
- Echoing what others say without understanding the meaning (‘video talk’).
- The loss of previously acquired speech, babbling or gestures at any age.
Speech delay by itself is not a sign of ASD. The difference is a child with an isolated speech delay will point, gesture, or use facial expressions to make up for their lack of talking. That said, both conditions will benefit from early intervention and should be investigated.
- Resistance to minor changes in routine or surroundings.
- An oversensitivity to tastes, smells and touch.
- Unusual behaviours such as flapping, rocking, spinning, and waving their fingers in front of their eyes.
- Lining up toys or other objects, rather than playing with them in a ‘pretend’ way.
- Playing with toys the same way every time.
- Playing with parts of toys instead of the whole toy, such as spinning the wheels of a toy truck over and over again.
- Looking at things from unusual angles.
- An insensitivity or oversensitivity to pain, heat or cold.
It’s important to remember that ASD is a spectrum. Not all children will show all of these early signs, whereas some children might display a number of these symptoms. That’s why if you’re worried about your child, you should discuss your concerns with a health professional, who can refer you on for a professional assessment.
It’s not always black and white. Many children with ASD will look at you and occasionally smile, but when their parents compare their child to typically developing toddlers they come to understand that it’s the frequency and nature of eye contact and smiles that distinguishes the child with ASD.
That’s where new video assessment tools can help. These compare the social behaviour of
typically developing babies and toddlers and children with ASD, demonstrating these often-
subtle differences. Examples include the Australian-developed app ASDetect and US
resource AutismNavigator – About Autism in Toddlers. Both of these tools are free to the public.
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