The earlier ASD is diagnosed, the better the outcome for children. Early diagnosis leads to earlier interventions that can improve social communication and cognitive and academic development. Diagnosis before age 3 allows a child to start receiving specialized therapies and education during critical early development periods. Early intervention can reduce difficulties that will otherwise persist and worsen over time.
This guide will provide parents with information on recognizing potential early signs and symptoms of ASD. Catching signs of autism early is crucial, as the average age of diagnosis is around 4 years old. We will cover developmental red flags from ages 1-5 that may indicate risk for ASD. Understanding these early indicators can help parents seek evaluation and get their child’s needed support as soon as possible.
What is Autism Spectrum Disorder?
Autism Spectrum Disorder (ASD) is a developmental disorder that affects communication and behavior. The “spectrum” in its name refers to the wide variation in the type and severity of symptoms that people with ASD can have.
Some key characteristics of ASD include:
-
Difficulties with social communication and interaction. This can include problems with social cues, facial expressions, establishing friendships, and conversational skills.
-
Repetitive patterns of behavior and interests. People with ASD may adhere to specific routines, repeat motions or words, or have intensely focused interests.
-
Sensory processing issues. Individuals may be oversensitive or undersensitive to sounds, lights, textures, and other sensory inputs. This can affect behavior.
-
Delayed language and communication skills. Many children with ASD start talking later than their peers and have challenges using and understanding language.
ASD is called a “spectrum” disorder because the types and severities of symptoms can vary widely. Some people with ASD have mild challenges and can live independently, while others require very substantial support. However, all individuals on the spectrum share the same core characteristics.
Importance of Early Diagnosis
Early diagnosis is critical for children with autism spectrum disorder (ASD). The earlier ASD is diagnosed, the sooner the child can begin receiving specialized interventions and treatments. This leads to significantly improved outcomes overall.
There are several key reasons why early diagnosis leads to a better prognosis for children with ASD:
-
Early intervention – Beginning behavioral, communication, and social skills therapies as early as possible allows crucial development and learning to occur during ages 2-5 when the brain is still rapidly developing. Early intensive therapy capitalizes on neuroplasticity.
-
Building skills – Early diagnosis gives more time for the child to learn critical skills like communication, social interaction, self-care, and cognitive function. Starting therapies during the preschool years helps prepare them for school.
-
Supporting development – Early intervention prevents delays in key developmental milestones. It also minimizes difficulties from compounding over time, which often occurs when ASD goes undiagnosed.
-
Improved behavior and functioning – Diagnosing ASD early and providing appropriate therapy helps minimize problematic behaviors that can emerge as the child gets older while unsupported. Early intervention leads to better emotional regulation, social skills, and independence.
-
Access to services – A formal ASD diagnosis opens doors to specialized services in health care, education, therapy, and community support programs. The earlier the diagnosis, the sooner the child can benefit from these vital resources.
12-24 Months: Early Red Flags
Some early signs of autism may emerge around 12-24 months. While every child develops at their own pace, some red flags to look out for during this period include:
-
Lack of eye contact or reduced eye contact. Babies typically look into their parents’ eyes, but autistic babies may avoid this visual connection.
-
Not responding to their name. Most babies will turn their heads or eyes towards a parent when hearing their name called. An autistic baby may seem not to notice.
-
Lack of babbling or pointing. Babbling and pointing to objects are early communication skills. Their absence could suggest a problem.
-
Lack of typical social interaction. Babies are hardwired for social connection and engagement. An autistic baby may seem content in their world with limited interactions.
-
Lack of joint attention. Making eye contact while pointing at an object to ‘show’ it to a parent is joint attention. Its absence can be an early red flag.
-
Unusual or repetitive motions like rocking, arm flapping, or spinning. These are known as stimming behaviors in autism.
-
No interest in pretend play. Babies may start to mimic parental actions or play with toys appropriately around 12 months. Autistic babies likely won’t engage in pretend play.
-
Extreme reactions. Some autistic babies may not react at all, while others have big emotional reactions to sensory inputs like noise, lights, and textures.
-
Delayed speech development. Most babies will say their first words around their first birthday. An autistic baby likely won’t have any words by this age.
Paying attention to these potential red flags can help parents recognize the early signs of autism and seek professional screening. Early intervention is hugely beneficial.
2-3 Years: Communication Delays
During this age range, children with autism often show noticeable delays in communication skills compared to peers their age. Some of the key communication delays to look out for include:
-
Lack of speech – Children with autism may not begin speaking at the same time as other toddlers. They may have very limited speech, or be completely non-verbal at this age.
-
Repetitive speech – Children with autism frequently engage in repetitive babbling, repeating the same words or phrases over and over. Echolalia, or repeating what someone else says, is also common.
-
Poor nonverbal communication – Children with autism tend to avoid eye contact or have trouble understanding facial expressions and body language. They often don’t point things out or use gestures to communicate.
-
Difficulty understanding others – A child with autism may appear uninterested when people talk directly to them or have trouble following simple instructions.
-
Unusual tone and rhythm – Some children speak in an abnormal tone of voice or rhythm that doesn’t sound conversational. Their speech may sound robotic or monotone.
During this age range, if a child isn’t beginning to put words together into short phrases or sentences, it warrants an evaluation. Lack of communication milestones is one of the most obvious red flags for autism spectrum disorder at this age.
3-5 Years: Social Challenges
By ages 3-5, children with autism often show difficulties interacting and playing with other children. Some common social challenges that may emerge during this time include:
-
Lack of interest in peers. Children with autism may seem disinterested in other children and prefer playing alone. They may not respond to other kids’ requests to play or join activities.
-
Poor empathy and understanding of others’ feelings. Children with autism tend to have difficulty understanding emotions and putting themselves in someone else’s shoes. They may seem unaware or unconcerned about others’ distress.
-
Preferring solitary play. Children with autism usually prefer playing alone rather than engaging in interactive or cooperative play with peers. They may seem content playing by themselves.
-
Poor eye contact. Maintaining eye contact and using it to regulate social interaction can be challenging for children with autism. They may avoid looking others in the eye.
-
Difficulty with pretend play. Pretend play involves social interaction and imagination, which can be hard for autistic children. They may not pretend along with other kids.
-
Trouble making friends. Due to their social difficulties, children with autism often struggle to make and keep friends their age. They may isolate themselves from their peers.
-
Aversion to physical contact. Hugs, cuddling, and other forms of affection may bother or upset autistic children. They may shy away from physical touch.
-
Minimal facial expressions. Children with autism tend to have flat or unusual facial expressions. Their expressions may not match what they are feeling inside.
-
Unusual body language. Autistic children may avoid gestures like pointing, waving, or nodding. Their body language and nonverbal communication can seem unusual.
-
Repetitive behaviors. Repetitive motions like hand flapping, spinning, or rocking are common in children with autism, especially when excited or distressed.
Noticing social delays or unusual social behavior between ages 3 and 5 can be an important red flag for autism. Discussing these concerns with your child’s doctor is recommended.
Other Signs to Look Out For
Some additional signs of autism may emerge in early childhood or the elementary years, including:
-
Sensory issues – Children with autism may have unusual reactions to sensory input, like hypersensitivity to light, sound, touch, or texture. For example, they may refuse to wear certain fabrics, cover their ears to block sounds, or have an aversion to being held or cuddled.
-
Rigid routines – Children with autism often adhere to rigid schedules or rituals that they insist must be followed precisely. Disrupting these routines can provoke extreme distress. For example, a child may lose control if their morning routine is not done in the same order daily.
-
Intense focus – Children with autism commonly develop intense, obsessive interests. They may amass huge amounts of knowledge about topics like transportation, dinosaurs, or maps, often to the exclusion of learning other information.
-
Self-harm – Some children with autism engage in behaviors like hand biting, head banging, or excessive scratching and picking of the skin as a way to self-soothe or regulate emotions.
-
Gastrointestinal issues – Around 50% of children with autism also experience gastrointestinal problems like chronic diarrhea, constipation, abdominal pain, acid reflux, and vomiting. The underlying causes of these issues in autism are still unclear.
Paying attention to these additional signs, on top of social and communication delays, can help parents notice early patterns and seek an evaluation for autism if warranted. The earlier autism is diagnosed, the sooner interventions and support services can be put in place.
Screening and Diagnosis Process
The road to an autism diagnosis often starts with regular well-child checkups. Around 18 months, your pediatrician will likely give your child a general developmental screening, involving questions about your child’s speech and behavior. If there are any concerns, they may refer you for autism-specific screening.
There are two main autism screening tools used for toddlers – the M-CHAT (Modified Checklist for Autism in Toddlers) and the STAT (Screening Tool for Autism in Toddlers). These involve yes/no questions about your child’s social communication, language, play skills, and repetitive behaviors. The questionnaires take about 5-10 minutes to complete.
If your child screens positive, the next step is a more thorough diagnostic evaluation involving specialists like a psychologist, psychiatrist, developmental pediatrician, speech-language pathologist, and occupational therapist. This comprehensive assessment takes into account:
- Your child’s behavior during structured activities and free play
- Developmental history based on parent interview
- Speech, language, and communication skills
- Cognitive skills like problem-solving abilities
- Motor skills and sensory issues
- Medical and family history
The clinical team looks for delays and difficulties across areas of development to determine if your child meets the criteria for an autism diagnosis. This involves testing social interaction, communication, behavior patterns, interests, and activities.
Going through the autism diagnostic process takes time, often spanning multiple appointments over weeks or months. But an accurate, thorough assessment is crucial to get your child the support they need as early as possible. Don’t hesitate to ask your pediatrician about developmental screening during routine visits. Early intervention can make a lifelong difference.
Coping with a Diagnosis
Receiving an autism diagnosis for your child can be an emotional time. As a parent, you may feel overwhelmed, worried, confused, or relieved to finally have an explanation. Know that these feelings are normal. Focus on taking it one step at a time. Here are some tips for coping with your child’s diagnosis:
-
Seek support. Talk to your doctor about support groups, therapists, and resources in your area. Connecting with other parents going through similar experiences can help you feel less alone. Support groups allow you to share your feelings and learn from others.
-
Learn about autism. Educate yourself on the spectrum, your child’s specific symptoms, and evidence-based treatments. Understanding autism will empower you to make informed decisions for your child’s care.
-
Get early intervention services. Research shows behavioral therapy and interventions have the greatest impact when started early, ideally before age 3. Work with your doctor to get referrals and start therapy as soon as possible.
-
Take care of yourself. This is a marathon, not a sprint. Make sure to take breaks, get sleep, eat well, and lean on your support system. Taking care of yourself will give you the strength and energy to take care of your child.
-
Connect with your child. Focus on their unique strengths, gifts, and personality. Bond through play, reading, and quality time together. Your child is so much more than their diagnosis.
-
Stay positive. With the right support and interventions, many children with autism go on to lead happy, fulfilled lives. Maintain hope for your child’s future. Take it one day at a time.
An autism diagnosis marks the start of a journey. While there will be challenges ahead, you and your child have so much to look forward to. With the proper care and support, children with autism can thrive and reach their full potential.
Conclusion
The journey to an autism diagnosis begins with paying close attention to your child’s development and looking for early red flags in their behavior. Though the signs can vary widely, key indicators in the first years of life often include lack of eye contact, reduced babbling and gestures, poor response to their name being called, and delays in speech and social skills. If you have any concerns, don’t hesitate to raise them with your pediatrician and request further screening.
While an autism diagnosis can be difficult to accept at first, it opens the door to essential support services and therapies that can make a tremendous difference in your child’s life. There are many resources available ranging from speech therapy to behavioral interventions to help your child communicate, learn, and thrive. With the right treatment plan in place, many children with autism go on to lead happy, fulfilled lives. Focus on taking it one step at a time, celebrating small victories, and finding a community of other parents on this journey with you. Though there will be challenges ahead, you and your child have a bright future.
