We parents want the best for our little ones, and that includes tracking developmental milestones. Since most kids develop at their own pace, this can pose questions for parents who may feel that their child is not developing appropriately. As parents, we have become more aware of Autism through news, social media, and our child’s pediatrician. The CDC has updated its findings in recent years to the current statistics of 1:68 children nationwide as having an Autism diagnosis. These findings come as a result of more social awareness of Autism, along with higher quality diagnostic tools, such as the GARS-3 (Gilliam, 2014).
Awareness of Autism has become widespread in television and movies over the last decade, with TV personalities like Sheldon Cooper and Abby from NCIS as probably living with Autism; to Julia, who is the newest edition on Sesame Street as having Autism. Movies have also displayed characters with Autism (decades before television jumped on board) and include the notable Raymond “Ray” Babbett in Rain Man. The newest edition of a television character living with Autism is Sam, the protagonist at the center of Netflix’ new series, Atypical.
Children living with Autism often grow up to lead productive, healthy and happy lives, however early intervention is necessary in helping kids increase their social communication, in learning new adaptive skills, and in learning when and where “stimming” behaviors are appropriate. Since it is purported of Autism running in families, knowing the early warning signs of Autism can help empower parents and shed a light on when (or if) diagnosis and assessment are necessary.
Children are unique and develop at their own pace. This guide should be considered informational and not to replace formal diagnosis or assessment. If your child does not fit into the prescribed guidelines for development from his/her pediatrician, then you may consider speaking with a neurologist, or licensed clinical psychologist who specializes in Autism.
Infants 0 – 12 months: At this stage of development, most children will not display many (if any) signs of Autism. Most infants will be on track developmentally, which includes: rolling over, gazing at parents when they speak to them, holding their head up, learning to crawl, making guttural noises (mmm, ba, da, ma, etc), glancing at their reflection or the television, pulling themselves up to stand, and exploring their environment with their mouths, hands and feet.
Toddlers 12 months – 18 months: At this stage, developmental appropriateness often includes: walking, run/walk, throwing balls, vocalizing about 10 simple words, exploring their environment independently of caregiver, and beginning self-help (simple dressing, brushing teeth, potty training). This is the stage of development that is often most concerning for parents. Many parents report regression in their child, or a lack of new skills being learned during this stage. Formal diagnosis can occur at 18 months of age in order to ensure that diagnostic criteria remains reliable. Read below for 8 early warning signs to look out for:
- Irregularities or oddities in playing with toys. This is a red-flag for parents, as many parents have reported that their child will:
- No longer play with their favorite toys
- Uses the toys inappropriately such as to mouthing or chewing
- Lining toys up in a row
- No longer seeks affection. Most toddlers have a significant bond with their parents which includes seeking out their attention when they are sad, angry, or hurt. Often times, a significant warning sign when a child no longer seeks out parental comfort or affection but engages in self-soothing (rocking). Children may also become averse to touch and recoil when mom or dad attempts to console them.
- Limited or No Imitation. Modeling and imitation are powerful tools for teaching children. Kids love pat-a-cake, singing and dancing to songs such as “Head, Shoulders, Knees and Toes”, playing Monkey See, Monkey Do, and the list goes on…However, children at risk of Autism may stop imitating mom or dad, or may not progress in learning this skill.
- No Interest in Socialization. One of the biggest warning signs for Autism are children who have no interest in playing with other children. Kids often use parallel play at first, in which kids sit next to each other, but play independently. This skill typically comes before collective play, where children begin engaging together. The toddler who sits alone in the sandbox with his back turned away from other kids may just prefer playing alone, or it may be something worthy of speaking to a professional.
- Significantly Reduced Communication. A once babbling, cooing and talkative toddler may become quiet, and uncommunicative. Many parents report vocal regressions in their child, including toddlers who used to say words such as “mama” “dada” “baba” and “baby”, now do not speak. Nonverbal communication such as pointing to favorite toys or the family dog may also lessen.
- Limited Affect. Most infants and toddlers show an array of emotions, especially when happy or sad. Games like Peek-A-Boo usually get a belly laugh out of little kids, and falling down when trying to walk may result in crying. However, children at risk for Autism may show limited emotion when playing a favorite game, or when injured, or a child who was once animated may become withdrawn and quiet.
- Limited Responding to Interaction. Children love playtime. And most kiddos can’t wait for mom or dad to play tickle games with them, or chase them, or sit down with them and play make believe games with their favorite toys. However, children at risk of Autism may seem to ignore others’ interactions, or may be more interested in an unrelated item such as the carpet, or a piece of clothing. Noticing that your little one is not attending to you during playtime may be no cause for worry – they may simply be tired or more interested in whatever they are doing. However, repeated lack of interaction may be a sign to call a specialist.
- No Longer Responding to Their Name. Most toddlers know mom and dad’s voice and giggle while running to their parent when they hear their name called. Common developmental age for responding to their name is about 12 months old. However, the toddler who used to respond to their name and no longer does, or has not responded to their name by 14 months old may be worthy of speaking to a professional.
- Limited or No Eye Contact. This is often cited as the hallmark of Autism. Infants and toddlers typically make eye contact and seek it out. They often look at themselves in mirrors and in reflective items such as glass, a mobile, or the television, and will turn their heads towards familiar voices to make eye contact. Not all children will make eye contact every single time, so there should be no cause for concern if your little one found his chicken nuggets more interesting than looking at mom at dinner. However, a toddler who once made eye contact and no longer does, or who seems to “ignore” people attempting to engage with them may indicate a cause for concern and for reaching out to a professional.
Center for Disease and Prevention. [CDC]. (2017). Data and statistics. Retrieved from https://www.cdc.gov/ncbddd/autism/data.html
Gilliam J. E. (2014). Gilliam Autism Rating Scale (3rd ed.). Austin, TX.