Did you know autism spectrum disorder (ASD) can be detected in babies, infants and toddlers, yet many children on the spectrum do not receive a diagnosis until the ages of two or three?
This article overviews the main symptoms and characteristics of autism in babies and toddlers in an effort to help more parents and caregivers get an early diagnosis for their children.
Diagnosing children with autism spectrum disorder
The National Institute of Neurological Disorders and Stroke (NINDS) cites four major “classic” symptoms which are often used by pediatricians to diagnose children with autism:
- Poor communication skills
- Restricted interests
- Stimming and repetitive behaviors
- Limited to no verbal skills
However, many of the above are almost impossible to see in a small baby who is not yet in the age range of talking or developing interests. This means many parents do not seek diagnosis until a later stage, and their child might miss out on the benefits of early intervention.
So, let’s break down some of the early signs of autism parents can look out for.
What are the early signs of autism in babies?
Every infant and adult with autism spectrum disorder will display unique symptoms, but there are several key traits that may point to autism.
1. Lack of physical engagement with parent
Autistic babies might not engage with their caretaker the same way neurotypical infants do. For example, a baby with autism might not respond to cooing or will ignore movements such as waving and clapping.
2. Limited eye contact
A mother might notice her baby does not make eye contact while nursing. Autistic babies might have difficulty smiling or giggling. Additionally, autistic babies may be fussier and harder to console than their neurotypical peers.
3. Sensory processing challenges
Textures, bedding, and clothing (especially new fabrics) can cause distress to babies on the spectrum. They also get overwhelmed by toys that make noise or have flashing lights.
Early signs of impaired social interaction may appear at six to nine months when neurotypical babies will start to imitate and respond to the people around them. Babies with autism spectrum disorder will often not smile back or laugh when playing a silly game, and some may stare blankly and appear oblivious to the game. Others might even show distress at the sound of laughing. However, an upset or loud voice might not startle nor mean anything to them.
Other developmental milestones they might not meet include responding to their name. They might also not babble at six months, which is usually when neurotypical babies start doing so. By 18 months, most babies engage in imaginative play. Infants with autism, however, will likely show no interest or become flustered.
Download our FREE Checklist on the Signs Of Autism
What are the signs of autism in toddlers?
Toddlers with autism generally exhibit a progression of the symptoms expressed during infancy. Autistic toddlers may express frustration via tantrums or outbursts.
Diagnosing autism in toddler boys is markedly more common than in girls. Boys (and some girls) aged two to four often begin to show symptoms associated with autism such as:
Symptoms of autism are likely to become more obvious as the toddler begins to meet other kids in school or daycare and struggles with social skills.
2. Restricted interests
The child might have a fascination with one or two types of toy or topic and little interest in other play.
3. Sensory issues
Sensory dysregulation is often harder for a toddler to manage as they receive intense stimuli that neurotypical children enjoy. Distressing events might include birthday parties or group outings.
Pronounced difficulty connecting with their caretakers. Issues spotted when the child was a baby will continue.
4. Challenging behaviors
Aggressive or apathetic relationships with caregivers might develop. Aggression might be a sign of frustration, fear, or pain that the toddler is attempting to communicate.
How signs of autism in girls differ to boys
Early signs of autism are sometimes clearer in boys than in girls. According to child behavior specialists at the Cleveland Clinic located in Ohio, only one in three children diagnosed with autism is female. Only one girl to every nine boys is diagnosed with high functioning autism or Asperger’s syndrome. Young children might be misdiagnosed as having social communication disorders or developmental disorders.
A study of 300 girls by the Cleveland Clinic suggests autistic females are less likely to exhibit “classically male” symptoms. These include restricted interests, difficulties in social situations, episodes of intense aggravation, and self-harm.
These girls are often labeled as having developmental delays, but without the diagnosis of autism, their access to resources and care become limited. The Cleveland Clinic recommends being proactive and seeing your pediatrician if you notice any signs your daughter might be autistic, especially if she is in between regular medical check-ups.
When can my child be diagnosed with autism?
According to the Center for Disease Control (CDC), an autism diagnosis can be appropriately given at 18 months of age or sooner. Doctors screen for autism spectrum disorders at the nine-month, 18 month, 2-year, and 3-year wellness checkups. Many children with autism do not receive an official diagnosis until they reach the age of two or three. It is often after the child has started school. This is when the child’s challenges in social skills become obvious. It is never too late to get a diagnosis and begin identifying resources to help make life with autism easier.
The earlier a child gets a diagnosis (especially in his/her formative years of development), the sooner the child can start therapy or treatment.
When to see your pediatrician
During checkups, your child’s pediatrician will assess developmental progress. In between appointments, however, you may notice signs of autism or suggestions your child is not developing similarly to his/her peers. He/She may not engage with you the same way other babies engage with their parents, or he/she may exhibit some of the other symptoms listed above.
If you feel something is amiss, consult your child’s pediatrician to run a series of diagnostic exams. These exams are non-invasive and will often include a behavioral and developmental assessment. You might also be given a questionnaire for you and other caregivers in your child’s life.
What to bring to your appointment
Some parents find it helpful to keep a list of symptoms they suspect are likely to be autism. You can keep track of the frequency of instances each behavior occurs for reference. This kind of documentation will give your child’s pediatrician a better idea of how long and how often your child’s symptoms appear.
Most infants with autism will develop skills late—or might even regress in their social skills and sensory processing.
Getting a second opinion
If your doctor is unsure if a diagnosis of autism is appropriate for your infant, the CDC recommends seeking a second opinion. The earliest interventions can serve as building blocks for your child’s future therapies.
Download our FREE Checklist on the Signs Of Autism
They also suggest acting early as interventions can change your child’s developmental path and improve outcomes in school and relationships. The CDC cites that, in the first three years of a child’s life, his/her behaviors are most malleable and that children are more likely to change undesirable habits and adopt positive ones most willingly during these years. They suggest trying several interventions until you find one (and a therapist) your child responds to best.
What are the early interventions for ASD?
Once you’ve spotted the signs of autism and received an early diagnosis, you can think about the next steps. Psychiatrists, psychologists, and occupational therapists can all help support autistic children. The following are popular interventions and therapies:
Early Start Denver Model
ESDM is a relationship-based program that encourages positive feedback, shared activities, and parental involvement.
Applied Behavioral Analysis
Many families opt to use ABA which also encourages a positive reward system and parental engagement with the program.
Picture Exchange Communication System
PECS teaches nonverbal and semiverbal children to communicate via pictures and symbols.
Verbal Behavioral Intervention
VBI is also used with children who struggle with speech, but instead of communicating with pictures, it focuses on teaching verbal communication.
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Discrete Trial Training and Pivotal Response Training
DTT and PRT focus on behavioral and motivational challenges a toddler with autism may experience.
DIR/Floortime aims to help children with ASD connect while using their interests and passions to develop engagement skills, symbolic thinking, increase logical thinking, and improve interaction.
While autism is most often diagnosed when a young child hasn’t met popular milestones during the formative years and/or when a child’s development has suddenly regressed, some experts believe there are signs of autism that point toward a diagnosis earlier in a child’s life.
While not every person who is autistic can be diagnosed as an infant, there are many benefits to receiving a diagnosis before reaching preschool age.
If your child is exhibiting signs of autism, even minor ones, be sure to document them and share your concerns with your child’s physician. The earlier a child with autism is diagnosed, the sooner families and specialists can work with the child using popular interventions and selected therapies.