Autism spectrum disorder rates continue to rise. The latest data from the CDC, the most comprehensive surveillance of diagnostic rates in the U.S. to date, reveals that 1 in 59 8-year-olds were diagnosed with autism spectrum disorder in 2014, up 15 percent from 2012 and up 150 percent from 2000. Naturally, the results triggered much media debate: Do the ever-increasing rates of autism diagnosis reflect the fact that more children are being born with autism or that experts and parents are getting better at recognizing the symptoms?
Whatever the answer, one thing is clear: Many, many families and communities are touched by autism spectrum disorders, and a more inclusive approach needs to be adopted. The human brain is unique, every child is unique, and autism is not a bad thing that warrants a “fix.”
But to ensure every child gets the care and support they need, it helps to be aware of the early signs of autism.
Wendela Whitcomb Marsh spent a decade as a school psychologist evaluating infants and toddlers age 18 months to 3 years when autism was suspected to determine eligibility for autism programs. “Although often, children are not tested for autism until they reach preschool- or school-age, there are signs that parents can be aware of in children who are only 1 or 2 years old,” she tells SheKnows.
According to Marsh, these are some early signs of autism to look for.
Lack of interest in faces
Typically, babies are more interested in looking at people’s faces than they are in looking at other objects. If your baby usually avoids looking at you when you are smiling, talking or playing peek-a-boo, this may be an early sign of autism. A child might occasionally prefer looking at an interesting object when you are trying to get their attention, but it should not be the norm for your child to ignore you when you try to interact playfully with them.
Inability to share attention
Most children, even babies, will share attention with another person. This can include responding to joint attention by looking at what you’re interested in or initiating joint attention by showing you something they are interested in. For example, if you turn to look at something across the room and point at it, saying, “Look at that!” does your child follow your gaze or finger to look at what you are trying to show them? If so, they are responding to joint attention. On the other hand, do they look at your finger instead of what you’re pointing at or consistently ignore your overtures altogether? This suggests a limited response to joint attention.
One way you can look for joint attention is by blowing bubbles as a surprise while they are playing without letting them see what you are about to do. When the bubbles float into their view, how do they respond? Are they delighted with the bubbles and ignore the other people in the room? Or do they glance at you or another person, even briefly, as if to share their enjoyment of the surprise bubbles? Usually, but not always, little ones who will later be diagnosed on the autism spectrum are more likely to go straight for the bubbles without referencing another person, while most children seek to bring another person into the experience, at least momentarily, while enjoying the bubbles.
Lack of direct communication
How does your child let you know what they want or need? Do they point at the toy on the top shelf and look back and forth between you and the toy? This is typical nonverbal communication, which most babies use before they can talk. On the other hand, a child with autism might just scream — without looking at anyone or gesturing to indicate what is wrong. Then, parents have to play a guessing game: holding up a toy, a bottle, crackers, etc. until the child stops screaming, which is the only indicator that the parent guessed right and figured out what their child wanted. Children with autism are frequently unable to get their ideas or needs across to other people, either verbally or nonverbally.
Using a parent's hand to communicate
Sometimes a child will take their parent’s hand and pull them toward the kitchen to let them know they are hungry, often while glancing back at the parent. They may pat a parent’s arm or try to turn their parent’s face toward them if they want attention, such as when the parent is using their cell phone. This is not unusual. However, pay attention if your child tries to use your hand as a tool without looking at you. For instance, if they can’t open something, do they pick up your hand and place it on the object without looking at your face? This is seen more often in children with autism than in typically developing children. It is as if they understand that this hand is able to open this thing, so they go directly to the source, the hand, to get the job done.
Avoiding social interaction
When you go to a park, playground or other place where you see other children your child’s age, how does your child respond to seeing other kids? Typically, babies, toddlers and preschool children show a lot of interest in other children. They may want to run over and play with them. They may be shy and watch them from behind their parents or between their fingers. In either case, they definitely notice them or show interest.
On the other hand, many children with autism seem oblivious to other children. They may run over to them, but it is to play near them on the same playground equipment without actually interacting. Many children who are later diagnosed with autism may show appropriate interest in other children at a young age, but as they grow older, this seems to plateau, and they are left behind socially. They continue to interact with others the way preschoolers might and may prefer playing with younger children or adults or much older children, while being unable to respond appropriately to children their own age.
Lack of language
Parents can also pay close attention to their child's language skills to pick up on early signs of autism, licensed psychologist Dr. Crystal I. Lee tells SheKnows. If your child doesn't babble by 12 months, says no clear words by 16 months or says no meaningful, spontaneous two-word phrases by 24 months (not including repeating or imitating phrases), you should consider an assessment.
However, Lee adds that just because your child exhibits these signs, it doesn't necessarily mean they have autism. "These are just behaviors that should prompt you to get testing," she says.
If your child ticks a number of these boxes, Marsh recommends contacting your local county office of education to find out what assessment and early intervention services may be provided for children your child’s age. Your child may be eligible for early intervention as a child at risk for autism before they have a proper diagnosis, and you should take advantage of whatever opportunities are available. Be aware that your child’s doctor may not be able to recognize autism at the well-baby checkup unless the autism is extremely obvious, as they usually don’t have specific training in autism assessment.
Whatever the outcome, try not to view a diagnosis of autism as a tragedy. "Your child is the same adorable, charming, curious, funny, precious little treasure the day after you hear a diagnosis as they were the day before," says Marsh. "You know who your child is, and that has not changed. The purpose of a diagnosis is not to put a ceiling or close a door on what your child may accomplish. Don’t let anyone tell you otherwise or warn you against letting your child be 'labeled.'"
A diagnosis of autism might be scary, but it's the first step toward getting your child the support they need to live a fulfilling life on their terms — and the support you need to help them live that life. If your child does have autism, a diagnosis is the best thing that can happen to them.