Autism is much more prevalent than it was 20 years ago. When I was growing up, I didn’t know a single person with autism. Now as an adult with my own children, I was highly concerned during the first few years of my children’s lives that they would show symptoms of autism.
I knew the signs of autism but there are also some overlooked symptoms of which all parents should be aware. Knowing these signs can help a parent seek earlier intervention, which leads to better treatment outcome for the child long term.
How common is autism in children?
Autism is a concern for every parent now, as the rates of children being diagnosed with autism has increased steadily since the year 2000.
In the year 2000, the CDC (Centers for Disease Control and Prevention) reported that autism was prevalent in 1 out every 150 children.[1] In most recent reporting by the CDC (which was recorded in 2014), the rate of autism is now 1 out of 59 children.
Boys are far more likely to have autism–four times greater, to be exact. These are alarming statistics that have parents baffled by the increased numbers of children with this disorder.
The exact cause of autism is unknown. Researchers are hard at work trying to find the cure, caus and physical blood test that would make it easier to diagnose.
For now, parents must rely on clinicians to diagnose their child with autism based on their observations of the child’s behavior along with information relayed from the parent to the clinician regarding their child’s behavior and development.
Catching autism earlier
Parents must be the advocate for their child. It is imperative that all parents know the signs of autism, so they can seek intervention as soon as possible. Research, as cited by the American Psychological Association has found that early intervention and treatment of autism provides greater results in the long run.[2] This is not a disorder where a parent should wait and see if the symptoms get worse over months and years.
Early intervention is the key to helping a child with autism. If you see early signs of autism in your child, immediate help should be sought in order to get your child the best chances for overcoming their symptoms long term.
If you are concerned, then seek professional advice and medical support to have your child assessed. Even if they do not qualify for an autism spectrum diagnosis, you may be recognizing learning disabilities or behavioral abnormalities that can be addressed and treated.
It is remarkable how physical therapy, play therapy, occupational therapy and other modalities of therapy can provide a dramatic difference in improving abnormal or delayed behaviors when these treatments are provided over a dedicated period of time such as 6 months, a year or more.
Parents are responsible for recognizing the help that their child may need. Once recognized, the next step is finding reputable avenues for assessing and then treating the child.
Below are tips on how to recognize potential autism in your child, along with tips on what to do next if you do feel your child exhibits autistic symptoms.
Diagnosing autism
The DSM-5 (The Diagnostic and Statistical Manual of Mental Disorders Version 5) is the diagnostic tool that clinicians rely upon for diagnosing a child with autism. Their observation of the child, interactions and communications with the parent are all utilized for assessing a child for a potential autism diagnosis.
Parents should be aware of the diagnosing criterion because this can help parents to recognize the symptoms and behavior associated with autism early on. For many parents with autistic children, they notice that their child had motor skill difficulties as an infant and even difficulties with social interactions before 1 year of age.
The key is, parents noticed these behaviors. It is helpful to know what kind of behaviors to look for in a child that may indicate autistic tendencies.
A. Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history (examples are illustrative, not exhaustive, see text):
- eficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.
- Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication.
- Deficits in developing, maintaining and understanding relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.
Specify current severity: Severity is based on social communication impairments and restricted repetitive patterns of behavior.
B. Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history (examples are illustrative, not exhaustive; see text):
B. Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history (examples are illustrative, not exhaustive; see text):
- Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypies, lining up toys or flipping objects, echolalia, idiosyncratic phrases).
- Insistence on sameness, inflexible adherence to routines, or ritualized patterns or verbal nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat food every day).
- Highly restricted, fixated interests that are abnormal in intensity or focus (e.g, strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interest).
- Hyper- or hyporeactivity to sensory input or unusual interests in sensory aspects of the environment (e.g., apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).
C. Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies in later life).
D. Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.
E. These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay. Intellectual disability and autism spectrum disorder frequently co-occur; to make comorbid diagnoses of autism spectrum disorder and intellectual disability, social communication should be below that expected for general developmental level.
Note: Individuals with a well-established DSM-IV diagnosis of autistic disorder, Asperger’s disorder, or pervasive developmental disorder not otherwise specified should be given the diagnosis of autism spectrum disorder. Individuals who have marked deficits in social communication, but whose symptoms do not otherwise meet criteria for autism spectrum disorder, should be evaluated for social (pragmatic) communication disorder.
Specify if:
- With or without accompanying intellectual impairment
- With or without accompanying language impairment
- Associated with a known medical or genetic condition or environmental factor(Coding note: Use additional code to identify the associated medical or genetic condition.)
- Associated with another neurodevelopmental, mental, or behavioral disorder(Coding note: Use additional code[s] to identify the associated neurodevelopmental, mental, or behavioral disorder[s].)
- With catatonia (refer to the criteria for catatonia associated with another mental disorder, pp. 119-120, for definition) (Coding note: Use additional code 293.89 [F06.1] catatonia associated with autism spectrum disorder to indicate the presence of the comorbid catatonia.)
Red flags
The diagnosing criterion is helpful but it can also be cumbersome. It is a great deal of information and clinical wording, thus some basic red flags are also helpful for parents who are concerned that their child may be autistic.
Possible signs of autism in babies and toddlers:
- At 6 months of age: Lack of smiling while socially interacting with people, lack of happy expressions when interacting with people, and/or lack of eye contact.
- At 9 months of age: Still a lack of smiling, failure to begin non verbal communications such as noises meant to get their care giver’s attention when wanting something, and/or failure to begin making vocal sounds for the purposes of interacting with other people.
- At 12 months of age: No babbling or attempts to form baby-talk and words for communicating with other, failure to begin use of non verbal motions to communicate their wants such as pointing or gesturing what they want or need, and/or does not respond when their name is said or called out.
- At 16 months of age: Failure to say any words. No attempts to begin verbal communication with actual words. There may be seen a disinterest in the child to learn or try to form words through babbling or making verbal noises that sound like the start of words. Caregivers will notice the lack of interest in verbalization by this age.
- At 24 months of age: Still lacking age appropriate verbal communications. They may have achieved the ability to say one word at a time such as ball, mom, or drink. However, they lack the ability to form phrases or put two words together.
There are also red flags to look for at any age:
- Loss of previously acquired skill. For example, a child who was once using phrases and almost forming sentences now only uses one word at a time to communicate their wants and needs.
- As early as toddler age, they appear to prefer being alone. They lack a general desire to interact with their peers. For example, when at a play setting with children their own age a caregiver will notice lots of children playing together while their child choses to play on their own and seems content to do so. If a child is playing on their own and expresses sadness by saying “nobody is playing with them” or “nobody likes them”, thus they play on their own, this child does not fit the category, as they are interested in playing with others. It is the lack of interest in playing with others that is a red flag at any age.
- The child not only prefers but requires a stringent routine. Any deviation by the caregiver of this routine will cause the child to become anxious, stressed, or even distressed. They don’t just “go with the flow” when changes arise. They show an emotional dependence on their routine, and when it is changed they are visibly upset.
- They exhibit echolalia. This is the repeating of words and phrases that they hear from others. What they are repeating does not seem to have significant meaning. For example, they may hear someone say “red ball” during a conversation. The child will repeat “red ball” over and over again, like a broken record. They can also imitate and repeat motions of others. Some autistic parents also report that their child fails to initiate their own words, instead their child only repeats words that they hear.
- Exhibiting repetitive behaviors. Some of the most common are flapping, rocking or spinning. Some of these behaviors are age appropriate, such as spinning. However, it is the continual repetition of the behavior that should be of concern to parents.
- Has difficulty understanding the feelings of others. To others it may seem that they are disconnected to people and their feelings in general.
- Has sensitivity with any of their senses. They will show a more intense than normal reaction to certain sounds, smells, textures, tastes, or lighting. Their reaction can range from very intense to unusual. The key for caregivers to note is the consistency of this reaction when the same sense is affected.
- Language delays of any kind combined with any of the other warning flags.
- Remaining nonverbal.
- The child has highly restricted interests. This can be shown by their fixation on only playing with one kind of toy to the exclusion of interest in any other toys.
Keep in mind that a child with autism can have just a few of these signs and difficulties. Other children who may have some of these difficulties, may not qualify for a clinical diagnosis of autism.
