How To Know When It Might Be Autism

As a pediatric occupational therapist, one of the questions that new parents often ask when I’m working with them is, “What are the early signs of autism?” It’s an excellent question and requires a comprehensive answer. The most important thing I always tell parents is to educate themselves on neurotypical early childhood development. When parents know what important milestones to expect at each age, they can immediately identify a developmental delay and seek early intervention. Early intervention makes a tremendous difference in a child’s outcome. Recent studies have found that autism can now be identified as early as 18 months.¹ And the earlier you can identify it, the earlier you can seek support and resources for your child.^1,2

I’m always conscientious of saying early “indicators” of autism versus “warning signs” of autism, as the latter carries such a negative connotation. It’s important to remember that as devastating as this developmental disability might feel for parents, all children are unique, amazing, and individual. With the proper support network in place, children and their families can still thrive and live happy, productive lives. That said, let’s collectively do all we can to give every child the best start possible!

What Does It Mean To Be on the Autism Spectrum?

According to the Centers for Disease Control and Prevention (CDC), autism spectrum disorders (ASD) are a group of developmental disabilities that affect a child’s brain development.³ They’re “spectrum disorders” because they affect each child differently, ranging from very mild to severe levels of care.⁵ The primary types of ASDs are autistic disorder, often referred to as “classic” autism, Rett syndrome, childhood disintegrative disorder, and pervasive developmental disorder (PDD).² Most ASDs are characterized by difficulties with social interaction, verbal and nonspeaking communication, intellectual abilities, gross and fine motor skills, and attention.^2,3,4

Please remember that every child develops a little differently and at their own pace, so don’t panic if your baby is a little bit late to hit a milestone, and try not to compare your child to other children. Early development is very highly variable. Remember that ASDs involve various developmental delays, so consider your baby’s social, emotional, motor, and cognitive milestones.⁶ Also, developmental delays don’t always mean autism.⁷ In some cases, they carry a heightened risk, but not always. Trust your instincts!

Helpful Resources on ASDs

I cannot stress enough how important it is for parents to understand neurotypical development. You identify ASDs by the absence of neurotypical behaviors, not the presence of abnormal ones.^2,8 Parents can educate themselves in so many ways with countless videos, apps, blogs, books, websites, and magazines on early childhood development. For instance, the American Academy of Pediatrics is an excellent website with information about ASD. The CDC also has a great page on the signs and characteristics of ASDs.

In addition, some wonderful books to read are:

• “Your Child’s Growing Mind” by Dr. Jane Healy
• “Your Baby’s First Year” by the American Academy of Pediatrics
• “Baby Development: Everything You Need to Know” by Dr. Claire Halsey

When parents understand what neurotypical development looks like, they can better spot delays or early indicators of ASDs. Observe your children closely in different situations, and don’t rely on your pediatrician to point out delays. The delays might not present themselves during your 10-minute doctor appointment. Your pediatrician is a valuable partner, but your observations are most important.

The Don’ts of Autism

Characteristics of autism usually start to surface between 12 and 18 months.^2,3,5 Again, the earliest signs of autism are marked by the absence of developmentally typical behaviors, so they can be hard to spot.⁸ Autism can sometimes present itself by what babies “don’t” do as opposed to what babies “do.” Babies demonstrate early signs of autism when they:^2,4,5,6,9,10

• Don’t respond to cuddling
• Don’t reach to be picked up
• Don’t make eye contact
• Don’t smile when you smile at them
• Don’t make noises or imitate facial expressions
• Don’t point or wave goodbye
• Don’t respond to their name or familiar voices
• Don’t follow objects visually

There’s also an excellent assessment that parents can do on their own called the Modified Checklist for Autism in Toddlers (M-CHAT). You can find it here. It’s a simple yes/no checklist, and you can print the results and review them with your pediatrician.

ASDs are a hot topic right now, with 1 in 54 children being diagnosed and the medical community scratching their heads about this staggering increase in cases.⁴ However, it’s also a sensitive topic, as so many families are dealing with it on a day-to-day basis.⁴ This article isn’t just for families with children who may be on the spectrum but also for the community at large. People with autism are all around us, and families need support and understanding. Everyone should understand autism and how to best support people of any age on the spectrum and their families.