It is of utmost importance for parents and caregivers to be familiar with the signs of Autism Spectrum Disorder (ASD) so that early identification, diagnosis, and treatment can occur. The earlier in a child’s life ASD can be identified, the more likely it may be to lessen the severity of the disorder by introducing early intensive intervention.
Early signs of autism can be detected in infancy but are most identifiable by 2 to 3 years of age. It is also possible for children who are not autistic to demonstrate some signs associated with autism, so professional evaluation and diagnosis are crucial.
What are the three main symptoms of autism?
Symptoms of autism are varied and can overlap with those related to other disorders. However, several core symptoms have been identified, such as in learning or delayed language. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), core symptoms include:
1. Difficulty communicating and interacting with others
- Delayed language skills, may not start speaking at typical developmental milestones, if vocal speech is demonstrated it may be limited to a few words or babble may be repetitive in nature
- Difficulty orienting toward people in a social environment, such as avoiding eye contact or problems with responding to interaction initiated by others
- Limited attempts to direct others’ attention to share things that are of interest to the child
- Difficulty with recognizing or fixing a breakdown in communication
- Difficulty demonstrating emotional states such as happy, sad, or mad
- Difficulty recognizing the emotional states of others
- Absence of back-and-forth gestures such as pointing, reaching, or waving, or no reciprocation of back-and-forth social engagement, such as making silly sounds or faces
- Any sudden loss of babble, vocal speech, or social skills that otherwise appeared to be developing as expected
2. Restricted or repetitive behavior and/or interest
- When playing, will typically line toys or objects up and may become upset if the order is changed
- Vocal speech during play, or otherwise, is repetitive such as saying the same phrases or words or making the same sounds
- Engagement with toys is the same every time or focus is placed on parts of the item such as wheels, doors, specific buttons, etc.
- In the home environment, may get upset by minor changes or movements of items
- Insists on sameness with common routines, such as getting dressed, and may become upset if sameness cannot be maintained
- May demonstrate strong aversions to specific or unusual sounds, smells, tastes, the way things feel, or how things look
- Engages in repetitive motor behaviors such as rocking, jumping, pacing, flapping hands, etc.
3. Symptoms affecting the ability to function as expected in school, work, and other areas of daily living
- Demonstrates hyperactivity, inattentiveness, or impulsive behaviors
- Exhibits excessive worry or anxiety over minor issues
- Demonstrates intense meltdowns over minor issues
- Demonstrates self-injurious or aggressive behaviors
- Prefers to be alone or prefers the company of adults over peers
- Has a significant lack of fear or more fear than expected
- Unusual sleeping habits or difficulty with sleep
- Unusual eating habits or limited diet due to food aversions and sensitivities
- Frequent gastrointestinal issues such as constipation
- Delayed gross and/or fine motor skills development
- Delayed cognitive and intellectual skills development
How can you tell if your child is mildly autistic?
While the symptoms above may be demonstrated by all autistic individuals, they may present differently in milder cases. Mild forms of autism often lead to late diagnosis, usually well into young adulthood or later rather than .
These can look like:
- Difficulty engaging in a prolonged conversation with others due to struggles with sharing own interests, maintaining engagement in the interests of others, or seeming blunt or rude even without meaning to do so
- Difficulty understanding what others are thinking or feeling due to struggles with reading social cues, body language, or a lack of understanding of social communication rules
- Difficulty making and maintaining friends, not for lack of trying – may be labeled the “socially awkward” or “odd” child
- Taking things too literally due to difficulties with understanding implications, sarcasm, or phrases like “it’s raining cats and dogs” or “break a leg”
- Noticing very specific patterns, sounds, or smells that others do not
- An intense need to plan ahead, often excessively so, and seeking constant reassurance that things will go according to the plan
- Limited range of interests but has a deep knowledge of those interests
- Engages in self-stimming behaviors that may seem unusual to others, such as humming, specific gross motor movements, or flapping or clapping hands
- Becoming very anxious about social situations
- Becoming very anxious about things that are coming up, such as events, holidays, visitors, etc.
At what age does autism appear?
Depending on the severity of autism, symptoms can appear as early as infancy or six months. In milder cases, autism may often be diagnosed much later, even in adulthood. The majority of cases, however, are typically identified by ages 3-5. For this reason, knowing what the symptoms of autism are and how they present at different developmental stages can help with early diagnosis. Early diagnosis leads to early intervention, which is critical in managing and reducing the overall severity of the developmental disorder throughout a child’s life.
In any case, it is important to be aware of typical developmental milestones, as many, but not all, can be delayed or entirely skipped in an autistic child. Here are some important milestones to monitor in the first 2 years of a child’s development:
By 2-4 months:
- Calms down when spoken to or picked up
- Looks/attends to the caregiver’s face and seems happy to see the caregiver
- Smiles back when caregivers talk to or smile at a child
- Makes sounds other than crying and begins reacting to loud noises
- Watches caregivers as they walk by or maintains focus on a toy for a few seconds
- Smiles as a way to get attention from caregivers
- Turns to locate caregiver after hearing their voice
- Makes noises in response to caregiver talking to them
By 6-9 months:
- Takes turns making sounds with caregiver
- Knows and recognizes familiar people
- Laughs and becomes aware of the self in a mirror
- Reaches toward items they want
- Closes lips or turns head to indicate they don’t want something
By 1-year:
- Engages in reciprocal games such as “pat-a-cake”
- Understands being told no
- Waves “bye-bye”
- Places items in containers and searches for things they see being hidden
- Starts to develop a pincer grasp (uses thumb and pointer to pick small items up)
- Pulls up to stand and walks
By 2-years:
- Imitates or copies what others do
- Shares interests by showing others a preferred toy
- Shows affection on their own such as giving a hug
- Points to things or looks toward familiar items when named
- Follows one-step directions, such as “give that to me”
- Attempts to feed self with utensils or drink from a cup without a lid
- Notices when others are hurt or upset
- Looks to caregiver to know how to react in an unfamiliar situation
- Uses more communication gestures than pointing or waving, such as blowing kisses or nodding
Always refers to the child’s pediatrician for guidance on the next steps if there is a concern that an autism spectrum disorder might be presenting.
Ivy Rehab for Kids ABA Therapy Can Help
Following a professional diagnosis of Autism Spectrum Disorder, a number of options are available to the child and family. Many local school districts have early head-start programs that can help, although an appropriate level of intervention and intensity can be difficult to obtain. Applied Behavior Analysis (ABA) is one of the few effective, evidence-based interventions available for addressing symptoms associated with autism. Occupational, speech, and physical therapy are also key supports to address symptoms of autism.
At Ivy Rehab for Kids, the child can access all four therapies under one roof! This allows the treatment team to collaborate closely on treatment objectives and goals to create a highly-individualized plan for the child, addressing their specific and unique needs. ABA also has the added benefit of parent training, which allows the therapist to provide ongoing education and coaching to parents and caregivers on how to carry over treatment objectives into the home environment.
Contact your local Ivy Rehab for Kids location today to see how we can assist! Click here to find a location near you.
Article By: Elisa Murray MA, BCBA, LBA
Elisa began her ABA career nine ago. Elisa loves working with the autistic population and believes in the importance of providing individualized and effective ABA therapy with a focus on agency and independence in all areas of life. She currently specializes in working with autistic children who also struggle with trauma, anxiety, and Attention Deficit and Hyperactivity Disorder. Elisa enjoys working with children, ages 0-21, to reach their full potential, while closely collaborating with their caregivers on how to continue to support their success and growth without the need for programmed intervention. She currently treats patients at Ivy Rehab for Kids ABA in Canton, MI.
