Early Signs of Autism Spectrum Disorders
Social Differences
- Resists snuggling when picked up; arches back instead
- May have temperament differences during infancy, such as being described as a very quiet or very fussy baby
- Makes little or no eye contact
- Shows no or less expression in response to parent’s smile or other facial expressions
- May avoid following a parent’s gaze or finger to see what parent is looking at or pointing to
- No or less pointing to objects or events to get parents to look at them
- Less likely to bring objects to show to parents just to share his interest
- Less likely to show appropriate facial expressions
- Difficulty in recognizing what others might be thinking or feeling by looking at their
facial expressions - Less likely to show concern (empathy) for others
- Has difficulty in establishing and keeping friendships
Communication Differences
- Says no single words by 15 months or 2-word phrases by 24 months
- May repeat exactly what others say without understanding its meaning (parroting or echolalia)
- Responds to sounds (like a car horn or a cat’s meow) but less likely to respond to name being called
- May refer to self as “you” and others as “I” (pronoun reversal)
- Shows no or less interest in communicating
- Less likely to start or continue a conversation
- Less likely to use toys or other objects to represent people or real life in pretend play
- May have a good rote memory, especially for numbers, songs, TV jingles, or a specific topic
- May lose language milestones, usually between the ages of 15 and 24 months in some children (regression)
Behavioral Differences (Stereotypic, Repetitive, and Restricted Patterns)
- May rock, spin, sway, twirl fingers, or flap hands (stereotypic behavior)
- Likes routines, order, and rituals
- May be obsessed with a few activities, doing them repeatedly during the day
- More likely to play with parts of toys instead of the whole toy (for example, spinning wheels of a toy truck)
- May have splinter skills, such as the ability to read at an early age but often without understanding what it means
- May not cry if in pain or seem to have any fear
- May be very sensitive or not sensitive at all to smells, sounds, lights, textures, and touch (sensory processing differences)
- May have unusual use of vision or gaze (for example, looks at objects from unusual angles)
- May have unusual or intense but narrow interests
What an Autism Spectrum Disorder Might Look Like
It isn’t always easy for parents to know if a child has an autism spectrum disorder (ASD). Some of the symptoms of ASDs may be seen in children with other types of developmental or behavioral problems or, to a lesser extent, in children with typical development. Also, not all of the symptoms are seen in all children. Some children may only display a few of the symptoms. This is what makes the process of diagnosing ASDs difficult. But here are some examples that may help distinguish a child with an ASD from other children.
At 12 Months
- A child with typical development will turn his head when he hears his name.
- A child with an ASD might not turn to look, even after his name is repeated several times, but will respond to other sounds.
At 18 Months
- A child with delayed speech skills will point, gesture, or use facial expressions to make up for her lack of talking.
- A child with an ASD might make no attempt to compensate for delayed speech or might limit speech to parroting what is heard on TV or what she just heard.
At 24 Months
- A child without an ASD brings a picture to show his mother and shares his joy from it with her.
- A child with an ASD might bring her a bottle of bubbles to open but doesn’t look at his mom’s face when he does or share in the pleasure of playing together.