Autism: The Early Signs
The earliest signs of autism involve the absence of normal behaviors— not the presence of abnormal ones—so they can be tough to spot. In some cases, the earliest symptoms of autism are even misinterpreted as signs of a “good baby,” since the infant may seem quiet, independent, and undemanding. Some autistic infants don’t respond to cuddling, reach out to be picked up, or look at their mothers when being fed. If autism is caught in infancy, treatment can take full advantage of the young brain’s remarkable plasticity.
Although autism is hard to diagnose before 24 months, symptoms often surface between 12 and 18 months. If signs are detected by 18 months of age, intensive treatment may help to rewire the brain and reverse the symptoms. However, you can catch warning signs early if you know what to look for.
Early signs
Your baby or toddler doesn’t:
- Make eye contact, such as looking at you when being fed or smiling when being smiled at
- Respond to his or her name, or to the sound of a familiar voice
- Follow objects visually or follow your gesture when you point things out
- Point or wave goodbye, or use other gestures to communicate
- Make noises to get your attention
- Initiate or respond to cuddling or reach out to be picked up
- Imitate your movements and facial expressions
- Play with other people or share interest and enjoyment
- Notice or care if you hurt yourself or experience discomfort
Developmental red flags
The following delays warrant an immediate evaluation by your child’s pediatrician:
- By 6 months: No big smiles or other warm, joyful expressions
- By 9 months: No back-and-forth sharing of sounds, smiles, or other facial expressions
- By 12 months: Lack of response to name
- By 12 months: No babbling or “baby talk”
- By 12 months: No back-and-forth gestures, such as pointing, showing, reaching, or waving
- By 16 months: No spoken words
- By 24 months: No meaningful two-word phrases that don’t involve imitating or repeating
Signs and symptoms in older children
As children get older, the red flags for autism become more diverse. There are many warning signs and symptoms, but they typically revolve around impaired social skills, speech and language difficulties, non-verbal communication difficulties, and inflexible behavior.
- Signs of social difficulties
- Appears disinterested or unaware of other people or what’s going on around them
- Doesn’t know how to connect with others, play, or make friends
- Prefers not to be touched, held, or cuddled, OR seems to crave sensory input more than other children to the point of invading personal space and boundaries
- Doesn’t play “pretend” games, engage in group games, imitate others, or use toys in creative ways
- Has trouble understanding feelings or talking about them
- Doesn’t seem to hear when others talk to him or her
- Doesn’t share interests or achievements with others (drawings, toys)
- Basic social interaction can be difficult for children with autism spectrum disorder. Many kids on the autism spectrum seem to prefer to live in their own world, aloof and detached from others.
Signs of speech and language difficulties
- Speaks in an abnormal tone of voice, or with an odd rhythm, pitch or cadence (e.g. ends every sentence as if asking a question)
- Repeats the same words or phrases over and over often known as parroting, usually without communicative intent
- Responds to a question by repeating it, rather than answering it, or offers and an unrelated answer
- Uses language incorrectly (grammatical errors, wrong words) or refers to him or herself in the third person
- Has difficulty communicating needs or desires
- Doesn’t understand simple directions, statements, or questions
- Takes what is said too literally (misses undertones of humor, irony, and sarcasm)
- Children with autism spectrum disorder have difficulty with speech and language. Often, they start talking late.
Signs of nonverbal communication difficulties
- Avoids eye contact
- Uses facial expressions that don’t match what he or she is saying
- Doesn’t pick up on other people’s facial expressions, tone of voice, and gestures
- Makes very few gestures (such as pointing). May come across as cold or “robot-like.”
- Reacts unusually to sights, smells, textures, and sounds. For example, may be especially sensitive to loud noises, is an extremely picky eater and/or dislikes most foods, can appear unresponsive to people entering/leaving as well as efforts by others to attract the child’s attention.
- Abnormal posture, clumsiness, or eccentric ways of moving (e.g., walking exclusively on tiptoe)
- Children with autism spectrum disorder have trouble picking up on subtle nonverbal cues and using body language, making the “give-and-take” of social interaction difficult.
Signs of inflexibility
Children with autism spectrum disorder are often restricted, inflexible, and even obsessive in their behaviors, activities, and interests:
- Follows a rigid routine (e.g., insists on taking a specific route to school)
- Has difficulty adapting to any changes in schedule or environment (e.g., throws a tantrum if the furniture is rearranged or bedtime is at a different time than usual)
- Unusual attachments to toys or strange objects such as keys, light switches, or rubber bands.
- Obsessively lines things up or arranges them in a certain order.
- Preoccupation or hyperfocus towards a narrow topic of interest. Many are often thought of as gifted due to their exceptional ability in a specific area (such the ability to memorize information, solve math or read at a very early age)
- Spends long periods watching moving objects such as a ceiling fan, or focusing on one specific part of an object such as the wheels of a toy car
- Repeats the same actions or movements over and over again, such as flapping hands, rocking, or twirling (known as self-stimulatory behavior, or “stimming”). Some researchers and clinicians believe that these behaviors may soothe children with autism more than stimulate them.
Common restricted and repetitive behaviors:
Hand flapping
Rocking back and forth
Spinning in a circle
Finger flicking
Head banging
Staring at lights
Moving fingers in front of the eyes
Snapping fingers
Tapping ears
Scratching
Lining up toys
Spinning objects
Wheel Spinning
Watching moving objects
Flicking light switches on and off
Repeating words or noises
If you a unsure of your child’s behavior but sense it is different from other children, call us (813) 468-6528 for a consultation. Early interventions affords the best outcomes!
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