Early Signs and Symptoms of Autism Spectrum Disorder

During the first few years of life, it is an exciting time to watch your child grow and learn. As you are observing some of these milestones for the very first time you may be wondering if some of these milestones are on track with your child’s same-age peers. Being aware of the early signs of autism spectrum disorder can help in knowing what to look out for and validate what your instincts may be already telling you. Remember you know your child best! Here at Behavioral Innovations, we aim to raise your awareness of this process by providing clarity on some of the early signs of autism spectrum disorder so you can easily communicate any concerns you may have with your child’s pediatrician.

Developmental milestones matter and most children reach certain milestones at a particular age range. However, for some children, they may take longer to reach certain milestones, below we outline some of the red flags and subtle indicators of autism spectrum disorder so that you can more easily discuss these concerns with your pediatrician. The American Academy of Pediatrics (AAP) recommends that children receive developmental screening during routine checkups at nine months, 18 months, and 30 months. Screening for autism can be done whenever a parent or provider has a concern. You can also ask your pediatrician at any time to either screen your child or share results with you from the most recent screen. You can find more information about developmental screening and routine checkups at https://www.aap.org

Red flags and subtle indicators

While the list below is not an exhaustive list of the signs and symptoms of autism spectrum disorder, there are some red flags and subtle indicators that may be helpful for you to know when reviewing your child’s developmental progress.

Signs to look for during your child’s first year of life:

  • Avoiding or not holding eye contact with others
  • Not responding to their name when called by others
  • Not yet babbling or mimicking others’ vocalizations
  • Not showing facial expressions such as happy, sad, angry, and surprised.
  • Not reciprocally playing back-and-forth simple interactive games such as pat-a-cake and peek-a-boo.
  • Not demonstrating affection or having a dislike for being held or cuddled

Signs to look for during your child’s toddler years or older:

  • Not using gestures to communicate with others (e.g., waving goodbye, pointing, clapping, or reaching for objects).
  • For example, they may point to an object of interest and look back at you to see if you’re looking where they’re pointing.
  • Not responding to your gestures or copying your actions (e.g., when you smile your child smiles back).
  • Not noticing when others get hurt or upset.
  • Not noticing their peers or approaching them to play and/or responding to their approaches to play.
  • Not engaging in pretend play or pretending to be something else (e.g., pretending to be their favorite cartoon character).
  • Engaging in behaviors or interests that appear unusual in nature (e.g., unusual reactions to the way things sound, smell, taste, look, or feel).
  • Repeatedly engaging in the same movement (e.g., flapping hands, rocking body, or spinning self in circles).
  • Walking on their tip toes most of the time.
  • Engaging in repetitive behaviors such as lining up toys or other objects and becoming upset if the order is changed.
  • Engaging in repetitive vocalizations.
  • Playing with objects in the same way every time or being focused on parts of objects (e.g., wheels, doors, buttons).
  • Have obsessive interests and become upset if unable to engage in these interests.
  • Having a high need to follow certain routines and becomes upset with minor changes.

What to do if you have some concerns with your child’s development

Your concerns are important, and you know your child best. If you have concerns with your child’s development, it is important to review those concerns with your child’s pediatrician. Early detection of autism spectrum-related symptoms can assist with giving your child the help they need early on through supportive services like early intervention services. Screening for autism spectrum disorder can assist you in taking the next steps for a formal evaluation if warranted. Obtaining a proper diagnosis can sometimes be difficult because there are no medical tests, like a blood test, to diagnose autism spectrum disorder but rather there are diagnostic measures that can assist in identifying symptoms of autism spectrum disorder. Typically, a formal diagnosis can be made for a child at 18 months or older by an experienced professional.

The Centers for Disease Control and Prevention (CDC) states that from birth to five years, your child should reach certain milestones in how he plays, learns, speaks, acts, and moves. You can learn more at cdc.gov/MilestoneTracker.

About the Author: Dr. Kearie Newman

Dr. Kearie Ann Newman earned her Doctoral Degree in Clinical Psychology in 2020 with honors. She has over 15 years of clinical experience across a variety of milieus including outpatient settings, private practice, and psychiatric facilities.

Dr. Kearie Ann Newman’s expertise includes diagnostic assessment for children and adults with intellectual disabilities, mental & behavioral disorders, personality disorders, and neurodevelopmental disorders.

Her diagnostic approach emphasizes a scientist-practitioner model that utilizes the application of relevant assessment technologies and empirically supported clinical interventions.

Using those empirically supported technologies and clinical interventions she makes a clinically comprehensive analysis to assist in diagnostic clarification and treatment planning.

Through her professional insight, she enjoys analyzing why people behave the way they do. Her specific fields of interest include diagnostic assessment and treatment planning.

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