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Understanding Autism (page 3)

By — Helpguide
Updated on Feb 18, 2011

Developmental delays as a sign of autism

As children grow, they go through a process where fundamental skills, or developmental milestones, are learned and mastered. These milestones include: physical skills (such as sitting up, crawling, and walking), social skills (such as smiling, playing, and imitating others), and communication skills (such as gesturing and talking). Since the pace of growth varies from child to child, there are flexible windows of time where certain developmental milestones should be reached. However, if your child has not reached milestones at the expected age, this indicates a developmental delay.

Autism involves a multitude of developmental delays, so keeping a close eye on when—or if—your child is hitting all the key social, emotional, and cognitive milestones is an effective way to spot the problem early on. While developmental delays don’t automatically point to autism, they do indicate a heightened risk. Furthermore, whether the delay is caused by autism or some other factor, developmentally delayed kids are unlikely to simply “grow out” of the problem. In order to develop skills in an area of delay, your child needs extra help and targeted treatment.

The following delays warrant an immediate evaluation by your child’s pediatrician:

  • By 6 months: No big smiles or other warm, joyful expressions.

  • By 9 months: No back-and-forth sharing of sounds, smiles, or other facial expressions.

  • By 12 months: No babbling or “baby talk.”

  • By 12 months: No back-and-forth gestures, such as pointing, showing, reaching, or waving.

  • By 16 months: No spoken words.

  • By 24 months: No meaningful two-word phrases that don’t involve imitating or repeating.

  • At any age: Any loss of speech, babbling, or social skills.

Source: First Signs

Regression of any kind should be taken seriously. According to Catherine Lord, the director of the University of Michigan Autism and Communication Disorders Center, about 25% of autistic kids appear normal as babies and then regress at some point between 12 and 24 months. For example, a child who was communicating with words such as “mommy” or “up” may stop using language entirely, or a child may stop playing social games he or she used to enjoy such as peek-a-boo, patty cake, or waving “bye-bye.”

Detecting autism in babies

Most children are diagnosed with autism around the age of three. However, when autism is detected even earlier, treatment can take full advantage of the young brain’s remarkable plasticity. If detected by 12 months of age or even earlier, intensive treatment may even be able to rewire the brain and reverse the symptoms.

However, the earliest signs of autism are easy to miss because they involve the absence of normal behaviors—not the presence of abnormal ones. For example, autistic babies typically don’t follow moving objects with their eyes, reach out to grasp toys, or make gestures to attract attention. In some cases, the earliest symptoms of autism are even misinterpreted as signs of a “good baby,” since the infant is quiet and doesn’t make demands. But while such a baby may be easy to deal with, these are red flags of a very serious problem, not positive qualities.

Babies—like all humans—are social creatures. By the time they are 2 to 3 months old, babies who are developing normally will make sounds to get their parents attention, smile at the sound of a familiar voice, play with other people, and imitate certain movements and facial expressions. If your baby isn’t responding to you, despite your attempts to interact and show affection, it is cause for concern.

Other early signs of autism:

  • The baby doesn’t make eye contact.
  • The baby doesn't respond to his or her name.
  • The baby doesn’t follow objects visually.
  • The baby doesn't smile when smiled at.
  • The baby doesn’t imitate other people.
  • The baby doesn't point or wave goodbye.
  • The baby doesn’t babble or make noises.

According to Harvard Medical School, babies who are passive and inactive at 6 months, then extremely irritable or joyless at 12 months, are also at a higher risk of developing autism.

The First Sign of Autism

A study published in the April 2007 issue of Archives of Pediatrics and Adolescent Medicine found that the failure to turn or look in response to hearing one’s name may be one of the earliest signs of autism.

Autism red flags in children of all ages

As children get older, the red flags for autism increase and become more diverse. There are many warning signs and symptoms, but they typically revolve around verbal and non-verbal communication difficulties, impaired social skills, and repetitive behaviors.

Verbal warning signs and symptoms of autism:

  • Slow to develop language skills.
  • Repeats or echoes certain words or phrases.
  • Has trouble expressing needs.
  • Used to say a few words or babble, but doesn't anymore.

Non-verbal warning signs and symptoms of autism:

  • Avoids eye contact.
  • Doesn’t play "pretend" games.
  • Reacts unusually to sights, smells, textures, and sounds.
  • Doesn’t seem to hear when others talk to him or her.

Social warning signs and symptoms of autism:

  • Appears uninterested in other people.
  • Has trouble understanding or talking about feelings.
  • Doesn’t know how to talk to or play with others.
  • Prefers not to be held or cuddled.

Repetitive behavior warning signs and symptoms of autism:

  • Has difficulty adapting to changes in routine.
  • Shows unusual attachments to toys or other objects.
  • Obsessively lines things up or arranges them in a certain order
  • Repeats the same actions or movements over and over again.

What to do if you 're worried

If your young child or baby is delayed in any area or if you’ve observed red flags or other warning signs for autism, schedule an immediate appointment with your pediatrician. In fact, it’s a good idea to have your child screened by a doctor even if he or she is hitting the developmental milestones on schedule. The American Academy of Pediatrics recommends that all children receive routine developmental screenings, as well as specific screenings for autism at 9, 18, and 30 months of age.

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