Autism Signs in Toddlers: What To Look For
Trained and experienced professionals can often diagnose Autism between 18 and 24 months, and sometimes even earlier, yet the average age that a child in the U.S. receives an Autism diagnosis is four-and-a-half years old. This is often because many parents and professionals miss the early signs of Autism. Although it’s never too late to begin treatment and see some progress, a child’s best opportunity to learn critical developmental skills, including language, socialization, and problem solving is during the infant and toddler years. This relates to brain plasticity, or the brain’s ability to strengthen certain pathways, reorganize itself, or develop ways to compensate for weaknesses. Neuroscience and developmental research clearly show that our brains are more plastic or changeable the younger we are. Please visit this website for a short video on brain development by The Center on the Developing Child at Harvard University: https://www.youtube.com/watch?v=VNNsN9IJkws. This is why is it’s much easier for a child to learn a foreign language or to learn to play a musical instrument, than for an adult. The same logic applies to early intervention for children with Autism Spectrum Disorder. Research shows that children with Autism who have better long term outcomes are those who begin effective behavioral treatment before the age of five, with the best outcomes noted in those beginning intervention before age three (Koegel, Koegel, Ashbaugh, & Bradshaw, 2014). In other words, the sooner the better! The common “let’s wait and see” approach leads to valuable time lost when your child has the best opportunity to learn. Interventions focused on teaching language skills seem to be especially beneficial when started before age three (Koegel, Koegel, Ashbaugh, & Bradshaw, 2014).
If you’re reading this, perhaps you’re concerned that your young child may have Autism or other type of developmental delay. You’ve probably seen lists of symptoms and red flags for autism on the CDC or American Academy of Pediatrics websites. Perhaps you’ve noticed that some symptoms do in fact sound like your child, but others perhaps don’t. What trained and experienced diagnosticians now know is that Autism can present somewhat differently for each child. While some children may show clear delays in their developmental milestones, such as delayed babbling, speaking, crawling, walking, and toilet training, others may not show such obvious delays. Another group of children seem to “lose their skills.” In other words, children who met their milestones early on seem to regress or almost go backwards in development. Did your child often babble, or even say some first words, but now no longer seems to babble or speak? Or perhaps your child previously often appeared socially engaged with others, smiling, laughing, and interested in what you and other familiar caregivers were doing, but now seems to prefer “do his own thing”? This regression or loss of skills can appear gradually or all of a sudden, and is the clearest indicator of a likely diagnosis of Autism. Although this pattern doesn’t occur in all children, in those for whom it is apparent, regression usually occurs between 18 and 24 months. This is why the CDC and American Academy of Pediatrics recommend screening for an Autism at 18 months and again at 24 months, even if no concerns were identified at 18 months.
Other potential early signs of Autism include limited sharing of items of interest and excitement with parents and caregivers. Does your toddler bring you toys that he or she thinks are exciting (not simply to get something, like opening a juice box), or point to things (e.g. the moon, a dog, an unusual truck driving by) and look at you, as if to comment, “Hey, look at that!” The reverse can also be true. Parents of young children with Autism often have a very difficult time getting and keeping their child’s attention. Social games and routines that many young children find engaging, like playing peek-a-boo or pat-a-cake may not amuse your child. Toddlers and young children with Autism may not respond to hearing their name called. In children without a hearing impairment, this should certainly raise concern about a possible Autism.
Additional early signs of Autism include repetitive body movements, such as hand-flapping, finger flicking or twirling (or other unusual hand movements), tip-toe walking, rocking back and forth, jumping, spinning, and falling or bumping into things as if on purpose. Over time, some children, particularly those with limited communication skills, may show repetitive self-injurious behaviors, such as head banging or biting their own hands during times of frustration or anxiety. Other children may do less of the repetitive body movements, but seem to play with toys and objects in unusual and repetitive ways. They may drop toys over and over, perhaps watching to see how something wobbles, line toys up in a particular order, open the door to a toy house or car over and over, or perhaps seem to fixate on printed numbers or other unusual details of toys or objects.
Considering whether your child may have autism can be overwhelming and scary. By acting early and seeking help, you are giving your child access to effective early intervention and the opportunity to develop critical skills he or she will need to succeed. Above all, trust your instincts. You are an expert on your child, and parents are often the first to suspect that something isn’t quite right. If you notice any of these early indicators of Autism, or have other concerns about your child’s development, contact our licensed clinical psychologists at 954-465-1633 or firstname.lastname@example.org or visit your child’s pediatrician to discuss your concerns and determine if your child will benefit from a comprehensive developmental evaluation. We are also available to provide effective early intervention and help you navigate community resources and benefits related to Autism and other special needs.
-Dr. Jennifer Sanderson
Centers for Disease Control and Prevention. (2016). Autism Spectrum Disorder (ASD). Retrieved from http://www.cdc.gov/ncbddd/autism/index.html.
Koegel, L.K. Koegel, R.L., Ashbaugh, K., & Bradshaw, J. (2014). The importance of early identification and intervention for children with or at risk for autism spectrum disorders, International Journal of Speech-Language Pathology, 16:1, 50-56, DOI: 10.3109/17549507.2013.861511
*This content is intended for informational purposes only, and is not intended as a substitute for health care services from a psychologist, physician, or other qualified professional. Your responses to posts are welcome, but please note that this does not constitute a professional relationship, and confidentiality cannot be maintained in this format. Please refer to the Contact Us page or contact Dr. Valdes at (954)465-1633 for an individual, confidential consultation.