Autism is disorder of the brain that affects about 1 in 88 children in the United States. There is no specific test to diagnose autism. Instead it has to be identified by the signs and symptoms as observed by the parents of a child along with the assessment of relevant health care practitioners. Autism is evident from early childhood but the signs and symptoms can be difficult to spot. The problem is that most parents are not aware of the features of autism. It is only when parents realize that something is “wrong” that they seek medical advice and research autism further.
Unlike in Down syndrome, children with autism do not typically have physical traits that can serve as an indicator of the condition. No short neck, flat nasal bridge nor a protruding tongue as in Down syndrome. Diagnosis is often delayed and understandably so. Autism and autism spectrum disorders (ASD) affects a child’s intellectual development, ability to communicate and social interaction. The symptoms would understandably only be evident after 1 to 2 years or life.
High Risk Children
Although all parents should be aware of the signs of autism, it is even more important for parents with kids who may be in the high risk group. Firstly, autism can occur in a child even without any known risk factors being present. However, kids with one or more risk factors obviously have a higher chance of being autistic and should be monitored closely in early life. Autism is five times more common among boys than girls. Secondly, the first signs of autism only become apparent around 18 months of age. Here are some of the risk factors that you should be aware of which may increase the likelihood of your child being autistic:
- Parents older than 35 years of age at conception.
- If one or more children in the family is autistic.
- Cigarette smoking, alcohol consumption or use of illicit drugs by the mother during pregnancy.
- Exposure to environmental toxins like phenols and certain pesticides.
There may be a host of other factors that may also play a role and increase the risk of autism. Not all of these risk factors have been identified as yet. As previously stated, a child may not be considered to be high risk but can still be autistic. It is important to note that autism is not linked to any contagious factors and there is no evidence to confirm the belief that immunizations may be a causative factor.
This is one of the key features of autism and a common motor symptom that can be a bit confusing in children. Here there is repetitive motions like rocking, spinning and hand flapping. However, children do exhibit repetitive motions in the course of play. On its own and when occasional, it may not be a cause for concern. If it is pronounced and regular especially when the child is alone then it should raise the cause for concern especially when other signs that possibly point to autism are also present. Remember that a healthcare professional should be contacted for a proper assessment before a diagnosis is made.
There are several features in the speech development of autistic children that can serve as a sign of the condition. Firstly, there may be a tendency to repeated certain words or phrases constantly. This is known as echolalia. There are a range of other speech symptoms that may also be present such as:
- Delay in developing the ability to speak and sometimes may not speak at all.
- Unable to say words or phrases that were previously learned and able to vocalize.
- Rate and rhythm of speech is abnormal in that it may be monotonous, sound like it does not flow or inappropriate for the context. Often it is said that the child sounds like a robot or computer-generated voice, or has a singsong voice.
- Cannot start or maintain a conversation with others but this must not be mistaken for shyness.
- Difficulty or inability in comprehending instructions or questions.
Social Skills and Behavior
While children may have different personalities, even from very early in life, the social and behavioral features of autistic children cannot just be attributed to personality differences and individual traits. These children appear to be aloof and tend to be attached from others. They would rather play alone that in a group, and not even one-on-one with another child. There is an over-possessiveness towards objects like certain toys. Autistic children tend not to pay attention to verbal communication and will usually not partake in a conversation. There is poor eye contact and at times other may feel “invisible” to the child. Even hugging and cuddling may be met with resistance.
Year 1 Signs of Autism
While many of the signs and symptoms mentioned above may be more obvious after 18 months of age, there are also some signs that can be spotted by as early as 1 year. From 6 months the symptoms could be apparent but it is too early at this point to say if it is related to autism. Not responding to smiles by 6 months or not attempting to mimic facial expressions by 9 months could indicate a problem.
Normally by 12 months of a age, a baby is able to turn their head or body to sound of the mother’s voice, smile in response to certain actions or sounds, babble (baby talk), attempt to point or grab at nearby objects of interest, make eye contact for at least short periods of time and respond to their own name. Sometimes one of more of these behaviors are absent in autistic children by 12 months of age.
Year 2 Signs of Autism
By the middle of the second year of life (between 16 to 18 months), other key features become evident. The child often seems to be detached from their surroundings. They are unable to form single words by 16 months and two word phrases by age 2 years. Any advancement in speech abilities seems to be lost quickly. The continuous linguistic development that should occur in these years seems to be delayed or stalled.
Autistic children do not interact with parents and other children as would be expected by at least 18 months of age. They do not respond to others pointing out objects. Instead they appear to be overtly sensitive to stimuli that does not pose a problem to most children. The reclusiveness is evident from this point in life in that they would rather play alone and may not want to be hugged or cuddled.
What to do?
If you suspect that your child may be autistic, you should see a health care professional as soon as possible. The child’s pediatrician should be informed immediately. Certain diagnostic investigations like blood tests may be necessary. The results of these tests will not confirm autism but rather exclude other medical conditions that may cause similar signs and symptoms. Questionnaires developed for autism screening need to be completed by the practitioner in consultation with the parents and by observing the child. It is only once a practitioner confirms that it is or may very likely be autism that the parents can accept the diagnosis.