Signs of Autism Spectrum Disorder

It’s a challenge to spot early signs of Autism Spectrum disorder. Parents/guardians are in the best position to do so in their children. They are the first responders to all of their child’s needs, be it behavioural, psychological, emotional or physical. 

Parents/guardians spend most of their time observing the child, their behaviour and other activities. These things can not be observed or diagnosed in a 15-minute appointment with the paediatrician. A paediatrician can be of great help, but do not undermine the importance of your own experience and observation. It is important to educate yourself to know all the important aspects to consider.

Take notice of the following:

Monitor a child’s development

This is one of the most important aspects to observe. An Autistic child will have various developmental delays. As a parent/guardian, you must look closely to see if the child is achieving their cognitive, emotional and social milestones. It is one of the ways to spot a  problem at an early stage. However, developmental delays do not necessarily indicate that the child is autistic, it may indicate another disability as well.

Take actions

Every child is different and so is their pace of development. It is normal if your child starts talking or walking a little late. These are two of the typical problems that most parents face. However, if a child is facing these issues, then immediately share it with your child’s paediatrician.

Do not wait-and-watch

It is usually advised to parents/guardians not to worry and  ‘wait and watch' as the child will eventually catch up on his/her milestones. However, adopting this approach can be harmful as you may lose valuable time of your child’s age where they can improve drastically if the problem is treated earlier. There are low chances of your child to ‘grow out of’ problems if they are developmentally delayed. The child would require targeted treatment and additional help in the area of delay.

Trust your gut

Sometimes, doctors underestimate the problem or miss the red flags in their diagnosis. Usually, doctors perform a thorough evaluation for developmental problems and autism but there is always a chance of missing out on an important aspect. Referral to a child development specialist or a second option may prove to be helpful in some cases.

Regression is a prominent red flag

Do not underestimate any sign of ‘Regression’ as it is a major sign of Autism Spectrum Disorder

Children with Autism Spectrum Disorder (ASD) develop skills and later regress. This happens between the age of 1-2 years. For instance, if the child starts using words such as ‘Dada’ or ‘mommy’, he may stop communicating entirely. The child may stop responding to social activities such as peek-a-boo or waving ‘bye’. If the child loses social skills, speech, gestures or babbling, it must be taken very seriously.

Signs and symptoms of ASD in toddlers

Diagnosis of autism in infancy can result in effective treatment because of the brain’s incredible plasticity. However, ASD symptoms are usually diagnosed between 1-2 years of age. If symptoms are caught at an early age, thorough treatment can reverse the symptoms and rewire the brain completely.

The absence of typical behaviour is the earliest symptom and signs of Autism Spectrum Disorder. Atypical behaviour is comparatively easier to spot than typical behaviour. However, if a child is independent, quiet or undemanding, these are signs that can be misinterpreted as a ‘good baby’. You can identify the early symptoms only if you are looking for them 

Infants with ASD usually don’t reach out when they are picked, respond to hugs or maintain eye contact with the mother while being fed.

Early signs

The baby doesn’t:

1. Make eye contact
2. Respond to their own name or recognise a familiar voice
3. Follow gestures or objects visually
4. Point, wavy or use gestures of communication
5. Make noise for attention
6. Play with other kids/people
7. Imitate expressions or movement
8. Respond to cuddle
9. Care or notice when you hurt yourself or express discomfort

Red Flags (Developmental) 

Contact the paediatrician if your child does the following:

Up to 6 months: Lack of joyful and warm expressions or big smiles

By 9 months: Not sharing or producing  sounds, expressions and smiles with others

By 1 year: Doesn’t respond to own name, no babbling or lack of sharing gestures (pointing, waving, reaching).

Up to 16 months: No speech/spoken words

By 2 years: Lack of constructing two-word meaningful phrases. It does not include imitating others.

Signs and symptoms in older children

As a child grows older, the signs and symptoms of autism spectrum disorder diversify. A few common symptoms can be inflexible behaviour, difficulty in verbal and non-verbal communication, impaired speech or communication and lack of social skill.

Signs of lacking social skills

• No interest in people or activities around
• Doesn’t know how to make friends
• Prefers no physical contact (touch, cuddle or being held)
• Trouble understanding own feelings and talking about them
• Doesn’t hear what others talk to them
• Doesn’t share own achievements with others
• Doesn’t play social games
• Doesn’t play “pretend” games, engage in group games, imitate others, or use toys in creative ways.

Social interactions can be challenging for children that suffer from ASD. Autistic individuals prefer staying aloof, in their own world, away from others.

Signs of impaired speech and communication

• Speak in a tone that has an odd pitch or rhythm to it (e.g. ending a sentence as if they’re asking a question)
• Repeating the same sentence over and over again without the intent of communication
• Not answering a question, rather repeating the question over again.
• Make grammatical errors or use wrong words.
• Refer to oneself as a third person
• Faces issues in communicating own needs and wants
• Doesn’t understand directions, questions or statements
• Doesn’t understand humour or sarcasm, rather take things the way they are said literally

Children with ASD usually have difficulty with speech and communication. They usually start talking very late.

Signs of difficulties in non-verbal communication

• Try to avoid eye contact
• Facial expression doesn't match with what they say
• Don’t understand facial expressions, gestures and tone of others.
• Lack using gestures
• Sensitive to loud noises
• May seem unresponsive when people refer to them
• Different posture (walk on tiptoes) (not common) 

Autistic children can’t pick up non-verbal cues or gestures. This very point makes social interaction nearly impossible for them.

Signs of inflexible behaviour

• Don’t prefer/fear change in routine
• Don’t prefer the rearranged setting of the room or change in environment (this includes a change in bedtime than usual)
• Attachment with objects including toys, switches and rubber bands.
• Arranging things in a certain order
• Preoccupied with topics of own interest
• Focusing on one part of an object, for instance, a wing of a fan, steering of a toy car
• Repeat a certain action or movement over again (spinning, rocking, hand movements)

Autistic children have inflexible, obsessive and restricted behaviour, interest, actions and activities.

Few restricted or repetitive behaviours

• Repeat sounds
• Repeat words
• Flick light switches
• Tap objects
• Scratch
• Tap ears
• Bang head
• Flick fingers
• Staring
• Lining up objects
• Rocking
• Flap hands