How to Know When it Might be Autism
How to Know When it Might be Autism | Baby Chick

By Aimee Ketchum

Pediatric Occupational Therapist

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Ketchum is a pediatric occupational therapist practicing in the neonatal intensive care unit and pediatric out-patient at Central Pennsylvania Rehab Services (CPRS) at the Heart of Lancaster Hospital. Also certified in newborn massage and instructing yoga to children with special needs, Ketchum is the owner/operator of Aimee’s Babies LLC, a child development company. Through Aimee’s Babies, Ketchum has published 3 DVDs and 9 apps which have been featured on the Rachael Ray Show and Iphone Essentials Magazine. Ketchum is one of the five finalists in the National Word Gap Challenge through the U.S. Department of Health and Human Services. She will compete against 4 other large organizations and Universities in March 2017 in the finals of the Word Gap Challenge.

Ketchum has been working in pediatrics for 18 years and is currently pursuing her doctorate at Philadelphia University. Ketchum lives in Lititz, PA with her husband and two daughters and enjoys running marathons and half-marathons and directing elementary school musicals in her spare time.


As a pediatric occupational therapist, one of the questions I get asked most often when working with new parents is “what are the early signs of autism?” It is a very good question and requires a comprehensive answer.

The most important thing that I always tell parents is to educate themselves on typical early childhood development. When parents know what important milestones to expect at each age, if a developmental delay presents itself parents can identify it immediately and seek early intervention. Even though there is no cure for autism, 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 and in some rare cases, intensive early therapy has actually reversed the effects of autism because the still-developing brain can be re-wired.


I am always conscientious of saying early “indicators” of autism verses “warning signs” of autism as the latter carries with it such a negative connotation. It is important to remember that as devastating as this developmental disability can be, 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 being 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 CDC, autism spectrum disorders (ASD) are a group of developmental disabilities that affect a child’s brain development. They are called “spectrum disorders” because they affect each child differently, ranging from very mild to severe. The primary types of ASDs are autistic disorder, often referred to as “classic” autism, asperger syndrome, Rett syndrome, childhood disintegrative disorder, and pervasive developmental disorder (PDD). Most of the ASDs are characterized by difficulties with social interaction, verbal and non-verbal communication, intellectual abilities, gross and fine motor skills, and attention.

I cannot stress enough how important it is for parents to understand typical development. ASDs are identified by the absence of typical behaviors, not the presence of abnormal ones. Parents can educate themselves in so many ways. There are countless DVDs, apps, blogs, books, websites, and magazines on early childhood development. American Academy of Pediatrics has a great website. Some wonderful books are Your Child’s Growing Mind by Jane Healy, Your Baby’s First Year by the American Academy of Pediatrics, and Baby Development Everything You Need to Know by Dr. Claire Halsey.


When parents have a good understanding of what typical development looks like, they are better equipped to spot delays or early indicators of ASDs. The Centers for Disease Control and Prevention has a great page on Signs and Symptoms of ASDs. Autism Speaks also has a good page on early signs of autism.

Observe your children closely in different situations and do not rely on your pediatrician to point out delays. The delays might not present themselves during your ten minute doctor appointment. Your pediatrician is a valuable partner, but your own observations are most important.

Please remember that every child develops a little differently, and at their own pace, so do not 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 a variety of developmental delays, so consider your baby’s social, emotional, motor, and cognitive milestones. Also developmental delays don’t always mean autism. In some cases they carry a heightened risk, but not always. Trust your instincts!

Symptoms of autism usually start to surface between 12 and 18 months. The earliest signs of autism are marked by the absence of normal behaviors, not the presence of abnormal behaviors, so they can be hard to spot. Autism can sometimes present itself by what babies “don’t” do as opposed to what babies “do”.

The Don’ts of Autism

Babies demonstrate early signs of autism when they:

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

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There is a great assessment that parents can do on their own. It is called the Modified Checklist for Autism in Toddlers (M-CHAT) and it can be found online. It is a very simple yes/no checklist and results can be printed and reviewed with your pediatrician.

ASDs are not only a hot topic right now with 1 in 88 children being diagnosed and the medical community scratching their heads about this staggering increase in cases, but it is also a very sensitive topic, as so many families are dealing with it on a day-to-day basis. This article is actually not just geared toward families with children who may be on the spectrum, but it is geared toward the community at large. Autism is all around us. Families need support and understanding. Everyone should have an understanding of autism and how to best support people of any age who are on the spectrum and their families.

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