Early warning signs of autism every parent should know

Jan 19, 2016 at 2:32 p.m. ET
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With autism on the rise, and hundreds of studies exploring the possible causes, there are a few questions every parent has asked themselves at least once: Could my child have autism? And would I know what to look for if they did?

Thanks to global and national autism awareness campaigns, we’re a lot more comfortable talking about autism than we were just a few decades ago. And it certainly helps that autism research abounds — teams of scientists have dedicated their careers to figuring out the possible causes or triggers of this neurodevelopmental disorder that can present on a spectrum in children as young as 12 months old.

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Many parents are dying to know the why of autism, but until that day comes, moms and dads are left with the more immediate question: Is my kid on the spectrum? Experts agree that the earlier autism is detected and diagnosed, the better the chance of finding an effective treatment for each unique child.

When do the signs of autism first appear?

Knowing what to look for is key. According to Dr. Mayra Mendez, PhD, LMFT, a program coordinator for intellectual and developmental disabilities and mental health services at Providence Saint John's Child and Family Development Center in Santa Monica, California, “Autism is a neurodevelopmental disorder with genetic, behavioral and environmental implications. The disorder consists of a variation of behaviors that atypically affect the development of abilities such as communication of experiences, communication of emotions, use of appropriate imagination and engagement of interpersonal social relationships with others.”

For most kids on the spectrum, the most common signs of autism start during the critical periods of early development, normally between 12 to 18 months of age. To the untrained eye, it’s easy to overlook those times when a child may not hit all of the “typical” milestones along with his or her friends. This may be part of the reason many kids are not officially diagnosed with autism until age 4, on average, though healthcare providers may see some red flags at annual checkups.

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What are the early signs of autism?

Testing for autism may seem intimidating to an outsider, but Dr. Oksana Hagerty simplifies the screening process for any parents with questions on their minds. Dr. Hagerty, an educational and development psychologist who serves as a learning specialist at Beacon College in Leesburg, Florida, the first accredited higher education institution to award bachelor’s degrees exclusively to students with learning disability, ADHD and autism spectrum disorders, says the signs of autism can be divided into three basic categories:

Autism warning signs
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1. Communication and social interaction

  • The child does not babble, point or smile by 1 year of age.
  • The child does not speak one word by 16 months.
  • The child does not combine two words into a meaningful phrase by 2 years.
  • The child does not respond to his or her name (at times he or she may seem to be hearing impaired).
  • Poor eye contact.

2. Physical movement and activities

  • Stereotyped movements.
  • Repetitive non-functional activities (hand flapping; rocking back and forth; jumping and twirling; arranging, rearranging and moving objects, like opening and closing doors; repeating sounds, words or phrases, etc.).
  • The child does not seem to know how to play with toys (toys are no different from other objects; no “role plays”).
  • The child tends to line up toys and other objects in a certain way; gets frustrated if they are moved.
  • The child is attached to one particular toy or object.

3. Environment and daily routines

  • The child gets frustrated if his/her daily routine is disrupted (due to visitors, travel, etc.).
  • The child negatively responds even to the slightest changes in the physical environment: higher/lower room temperature, a new bright object in the bedroom (like a yellow pillow, for example), a new arrangement of furniture, a softer/harder mattress, an air-freshener, etc. – no matter how “positive” these changes are (more comfortable room temperature, cute pillow, new mattress, pleasant aroma), your child will be uncomfortable for quite some time because his/her senses are just too delicate.

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When should you call the doctor?

Most parents who take the time to read through a list like this will still have one question on their mind: Where’s the line between a sign of autism and a unique personality? For an experienced psychologist like Dr. Hagerty, this question is nothing new and is even welcomed. Seeing a few of the signs above could mean a shy or quirky kid, though Dr. Hagerty points out that it’s important to consult a doctor when three or more of the signs of autism have been exhibited regularly by a child.

Dr. Hagerty explains, “These signs are usually pretty evident before the age of 3. The good news is that this is the time when the child is seen by the doctor most regularly. The bad news is that there are no medical tests for diagnosing autism. Furthermore, brief observation in a single setting is usually not enough to see all the behaviors. That is why the parents’ feedback is very important. The earlier you talk to your child’s pediatrician about the presence of the signs mentioned above (at least three!), the more chances you have to develop an appropriate and effective educational and treatment program.”

It never hurts to get a second opinion — especially when making a diagnosis as serious as autism. Dr. Mendez shares many of Dr. Hagerty’s baseline criteria for autism diagnosis, explaining that key characteristics can include difficulties in relationships, communication and social-emotional reciprocity, as well as repetitive behavior and sensory reactivity. Like Dr. Hagerty, Dr. Mendez also believes it’s important to look at the bigger picture when making a first-time diagnosis. She says, “No one behavioral concern alone determines an autistic spectrum profile.”

For the many concerned parents out there, this comes as welcome news. One symptom does not an autism diagnosis make, but three or more symptoms could warrant a visit to the doctor. And remember, as the parent, you know best — talk with your child’s pediatrician about any developmental issues that come up.

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Updated on 1.19.16