Could my child have autism?
Jack was 16 months old when his mom noticed something was different about her son. While other children happily threw their arms around their parents, Jack seemed to recoil at cuddles and seemed completely disinterested in human contact.
Jack is one of the estimated 1-1.5 million Americans with autism – it’s our nations fastest-growing disability, increasing at a rate of 10-17% a year. The disorder can, in some cases, be diagnosed from as early as 18 months – and early diagnosis is associated with a dramatically better outcome. However, because the autistic spectrum is so complex it can be easy to miss clues.
What are the symptoms?
Symptoms range from difficulty with social interaction and a lack of empathy with others, to delayed speech development.
Impairment of social interaction
Children with autism often have difficulties engaging with others. They may find it hard to make friends and appear aloof or indifferent to peers and family members. If they do seek interaction, it may be one-sided or inappropriate – for example, they may speak to their mom in the formal manner they’d use with their school principal.
Impairment of communication
Children with autism may have impairments in their verbal and non-verbal communication. As well as delayed speech development, they might not understand the purpose or pleasure of speech. For example, a child with autism might be thirsty but will not realize he needs to ask for a drink. Conversely, children with high functioning autism, such as Aspergers syndrome, may have excellent vocabulary but may use it in a formal or inappropriate manner, such as reciting irrelevant facts or talking over other people.
Other problems may include an inability to recognize non-verbal cues, such as posture, facial expressions and tone of voice. They may also avoid eye contact and use limited hand gestures, such as pointing.
Impairment of imagination
Children with autism may have difficulty playing with other children, objects and toys. They often focus on a small part of an object, for example the wheel of a toy car, and play with it in a repetitive manner. When it comes to reading, they may find it difficult to comprehend fiction and tend to prefer factual books – this can cause difficulty in school subjects such as literacy, where there’s a need to use abstract thought.
Kids with autism can also have difficulty empathizing with others or seeing things from another point of view. Change can be hard to cope with, and they may become distressed if their usual routine is disrupted.
Other traits they may display include repetitive movements, such as flicking fingers; poor control of their fine and gross motor skills and sensory differences – for example, unusual sensitivity to heat or noise.
How is it diagnosed?
You may notice symptoms in a baby as young as 18 months but symptoms tend to become more apparent between 2 and 4 years.
First signs
Your pediatrician will carry out developmental screenings as part of your child’s well-baby/well-child checks, and he’ll be alerted to the possibility of autism if your baby doesn’t babble, coo, point, wave or grasp by 12 months; doesn’t say single words by 16 months and doesn’t use two-word phrases by the time he’s 2. He would also be concerned if your child appeared to lose any language or social skills he had previously exhibited. None of these signs prove your child is autistic but your pediatrician would probably suggest further evaluation by a psychologist, developmental pediatrician, speech/language therapist or learning consultant.
Screening tests
There is no one test that can detect autism, so your child’s doctors will use a range of screening tools to reach a diagnosis…
- CARS (Childhood Autism Rating Scale) This looks at your child’s relationship to people, body use, adaptation to change, listening response and verbal communication.
- CHAT (Checklist for Autism in Toddlers) This method is used at around 18 months of age and uses a short questionnaire with two sections, one prepared by you and the other by your child’s pediatrician.
- STAT (Screening Tool for Autism in Two-Year Olds) uses direct observation to study behavioral features in children under 2, focusing on play, motor imitation and joint attention.\
- Autism Screening Questionnaire This screening scale is used with children aged 4 and over, and evaluates communication skills and social functioning.
Living with autism
A diagnosis of autism in your child is likely to bring a mixture of feelings – shock, despair, denial – and even, perhaps, relief at being able to finally understand your child’s needs. For most parents, it is a starting point for getting the right support for their children and helping them live the most rewarding life they can.