With the world-wide epidemic of autism, one of the most common questions I’m asked during an initial speech-language evaluation with a child is, “Could my child be autistic?” Many people assume, incorrectly of course, that because a child isn’t talking by age 2 or 3, he or she must be autistic. There are many reasons for speech-language delays in toddlers, and autism is one of them. Late talking in and of itself usually does not mean autism.
Autism spectrum disorder is a complex disorder that lasts throughout a person’s life. Autism is called a developmental disorder because issues start before age 3, during the critical period of development, and it causes problems in the way a child develops, learns, and grows. Areas affected by autism include delayed or disordered skills in:
1. Social Interaction - the way a child relates to others.
2. Language - the way a child understands and uses words, gestures, and symbols.
3. Cognitive - the way a child thinks and learns.
4. Motor - the way a child moves his body.
5. Sensory - the way a child takes in and processes information through his senses of sight, touch, hearing, smell, taste, and movement.
Autism is a spectrum disorder which means that all children with autism do not share exactly the same difficulties. Severity can range from mild to severe.
Below is list of the other concerns noted during daily routines in young children with autism spectrum disorder. This is not an official diagnostic list, but rather a list of concerns that parents might note. This list was gathered from several sources.
- Does not consistently respond to his/her name.
- Cannot tell you what he/she wants with words or gestures.
- Doesn’t follow directions.
- Seems to be deaf at times.
- Seems to hear sometimes, but not others.
- Doesn’t point or wave bye-bye (past 15 months) or use other gestures such as shaking his head “yes” or “no” appropriately and back and forth in conversation.
- Used to say a few words or babble, but now he/she doesn’t.
- Throws intense or violent tantrums.
- Has odd movement patterns such as flapping arms or shaking body, especially when excited.
- Shows other odd visual behaviors such as staring repeatedly at spinning wheels on a toy or shifting his eyes to the side as he runs.
- Seems hyperactive much of the time; is always “on the go.”
- Is often uncooperative or oppositional during daily routines.
- Doesn’t know how to play with toys. Might spin or line them up excessively.
- Doesn’t smile when smiled at.
- Doesn’t make eye contact. He/she seems to look right through/past you.
- Gets “stuck” on things over and over and can’t move on to other things.
- Seems to prefer to play alone.
- Gets things for him/herself only without asking for help.
- Is very independent for his/her age.
- Seems to be in his/her “own world.”
- Seems to tune people out.
- Shows very little interest in other children.
- Or may interact inappropriately with other children.
- Walks on his/her toes.
- Shows unusual attachments to toys, objects, or schedules (i.e., always holding a string or having to put socks on before pants).
- Spends a lot of time lining things up or putting things in a certain order and gets upset if this is disrupted.
- Has delayed speech-language skills when compared to other children of the same age.
- Memorizes and quotes long scripts of favorite TV shows, sing entire songs, or label lots of objects, but he/she uses very few “real” or meaningful words to ask for things or participate in conversation.
- Repeats what he/she hears rather than using words on his own.
- Learns to read at age 2 or 3 (or has a very strong interest in visual symbols such as letters and numbers), but has difficulty communicating with others in a meaningful way.
- Is a very picky eater. May eat only 3 or 4 different foods.
Let me reiterate that the presence of a few, or even several, of these concerns does not mean that your child could be autistic. Please discuss these signs/symptoms with your pediatrician, and then decide whether a comprehensive developmental assessment is needed for your child.
Research tells us that early identification and treatment for children with these difficulties is essential before these symptoms become severe and chronic patterns are established. Waiting until a child is in preschool or kindergarten before seeking professional and educational assistance NEVER leads to the best outcome for a child with any developmental delay. The earlier a child is diagnosed, the better chance he has of correcting his problems.
Research also tells us that children with autism, regardless of the severity, can make progress with specialized intervention that focuses on facilitating developmentally appropriate skills. The current recommended “best practices guideline” for a child with autism is that he or she be involved in AT LEAST 25 HOURS PER WEEK of engaged time with caring, nurturing adults. This can be a combination of time in therapy, structured and developmentally appropriate preschool (Not mother’s day out), and quality, focused 1:1 play at home with mom and dad or other trained assistants.
Parents with children with autism play a crucial role in determining the ultimate outcome of their child. Success comes when parents make a huge commitment to learning their child’s unique strengths and weakness, become their child’s biggest advocates, and wholeheartedly embrace a comprehensive approach to improving their child’s developmental skills. This means getting a child professionally evaluated as soon as your gut tells you there’s a problem, selecting and following through with appropriate treatments, and pursuing additional education about your child’s needs until you become the best “expert” you can be. It’s not easy, but it will be worth it.
Link to another article of mine about autism here on this site -