The flowers are starting to pop up from beneath the mulch, birds are singing, and the days grow warmer each week. Nature is once again blossoming, bringing the promise of new life along with it. lately I have been leaving the screen door open and peering out to watch daffodils spout in my front yard. It seems as if overnight, they will grow 3 inches and look completely different the next day. Soon I expect them to blossom into beautiful, yellow trumpeted flowers. It is a predictable but beautiful process to watch.
The same thing happens for children. They learn new things each and every day. Sometimes, the skills acquired seem to appear overnight and surprise everyone! And sometimes, it is a slow but beautiful process to watch. If you are a first or third time parent, the process never ceases to bring joy. Some parents know what to expect as a child develops speech and language, and some do not. What happens when some skills appear late, or don’t appear at all? When should I be concerned about Autism?
Let’s get right to it – Autism Spectrum Disorder, or ASD, can be an overwhelming thing to think about. The initial fear may come with the idea that children with ASD present in many many ways, and have differing abilities because Autism is a spectrum. Autism spectrum disorder (ASD) is a developmental disability caused by differences in the brain (1). Research has not yet provided a direct cause of ASD. There are many factors that contribute to a diagnosis of ASD. Some of it may be genetic, and some of it may have to do with environmental factors. Because ASD is a broad spectrum, people with ASD can have a varying level of difficulty in a variety of areas. Learning, communicating, social skills, and behavior can all be affected by ASD. According to Autism Speaks, the age when symptoms first appear can be as early as 6 months old, or as late as 3 years old (2). In fact, some studies demonstrated that nearly 80%–90% of parents who had children diagnosed with ASD observed problems by 24 months of age (3). While the age and signs of ASD can vary, I want to provide you with commonly observed “red flags” in children with ASD. It is important to note that children not on the Autism Spectrum can have difficulty with one or more of the following areas.
At 6 months of age:
- Lack of emotion
- Limited or no smiling
- Lack of eye contact when spoken to
At 12 months of age:
- Little or no babbling or vocalizations
- Lack of response to name
- Does not use gestures to communicate (uch as pointing, showing, reaching or waving)
By 24 months of age:
- Few to no words, delay of speech skills
- Not using 2 word phrases
- Regression in number of words or attempts to verbalize
- Avoids eye contact
- Does not engage in back and forth conversation
- Does not engage in pretend play (feeding a doll)
- Prefers to play alone, does not play with peers
Red Flags observed at any age:
- Difficulty understanding other people’s feelings
- Delayed language development, regression in speech and langage
- Repeating the same words or phrases
- Restricted interests
- Playing with same toys in a repetitive manner; may obsessively line up objects or sort items by color
- Repetitive behaviors (flapping, rocking, spinning, etc.)
- High sensitivity to textures, foods, lights, or sounds.
- Does not understand jokes
If you are concerned that your child may have ASD, please reach out to your pediatrician. See the resources below for more information.
- Johnson, C.P. Early Clinical Characteristics of Children with Autism. In: Gupta, V.B. ed: Autistic Spectrum Disorders in Children. New York: Marcel Dekker, Inc., 2004:85-123.