How Is Autism Diagnosed
Doctors diagnose children as autistic by observing them at play and interacting with others.
There are specific developmental milestones that most children reach by the time theyre 4 years old, such as having a conversation or telling a story.
If your 4-year-old has signs of autism, your doctor may refer you to a specialist for a more thorough examination. A specialist will observe your child while they play, learn, and communicate. Theyll also interview you about behaviors youve noticed at home and may request input from your childs teachers or other adults who interact with your child.
While the ideal age to diagnose and treat the symptoms of autism is 3 years old or younger, the sooner your child receives treatment, the better.
Under the Individuals with Disabilities Education Act , all states and Washington, D. C., are required to provide an adequate education to school-age children with developmental issues. Contact your local school district to find out what resources are available for preschool-age children in your area.
Signs Of Social Difficulties
- Appears disinterested or unaware of other people or whats going on around them.
- Doesnt know how to connect with others, play, or make friends.
- Prefers not to be touched, held, or cuddled.
- Doesnt play pretend games, engage in group games, imitate others, or use toys in creative ways.
- Has trouble understanding feelings or talking about them.
- Doesnt seem to hear when others talk to them.
- Doesnt share interests or achievements with others .
Basic social interaction can be difficult for children with autism spectrum disorder. Many kids on the autism spectrum seem to prefer to live in their own world, aloof and detached from others.
Diagnosis Of Autism: What We Do Know
Autistic children benefit from early diagnosis, preferably in the first two years of life. Early diagnosis allows behavioral therapy or other treatments to begin early when it seems to be most effective. If you are concerned about your child, talk to your doctor about a referral to see a specialist who can help determine if follow-up is needed. Signs of autism may include symptoms such as:
- no babbling or pointing by age 1
- no single words by 16 months or two-word phrases by age 2
- no response to name
- loss of language or social skills
- poor eye contact
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How To Begin A Diagnosis Process
Adults who suspect they or a loved one might be autistic can do a self-assessment test for adults. A person can find these tests online. While they cannot give a diagnosis, the tests are a good starting point.
A person seeking a diagnosis can take the results of such a test to a primary care doctor who will try to determine whether ASD may be present by:
- enquiring about the symptoms, both current and during childhood
- observing and interacting with the person
- speaking to a loved one
- checking for other physical or mental health conditions that may be causing symptoms
If no underlying physical condition can explain the symptoms, the doctor may refer the person to a psychiatrist or a psychologist to make an ASD diagnosis.
If symptoms are not present in childhood but begin in adolescence or adulthood, this may indicate a cognitive or mental health condition other than ASD.
It may be difficult to find a specialist who can diagnose ASD in adults. Individuals who would like a diagnosis for themselves or a loved one may need to do research to find a provider with experience diagnosing autistic adults.
Another option is to speak to a developmental pediatrician or child psychiatrist who is willing to see adult clients.
Early Signs In Infants And Toddlers
Early signs of autism can often be detected in infants as young as 6-18 months. For example, if a baby fixates on objects or does not respond to people, he or she may be exhibiting early signs of an autism spectrum disorder.
Older babies and toddlers may fail to respond to their names, avoid eye contact, lack joint attention , or engage in repetitive movements such as rocking or arm flapping. They may play with toys in unusual ways, like lining them up or focusing on parts of toys rather than the whole. Parents who notice these signs, or are concerned their children are not meeting developmental milestones, should contact their pediatricians and request a developmental screening. The American Academy of Pediatrics recommends routine screening of all infants for autism as part of 18-month and 24-month well-baby examinations.
Early diagnosis and early intervention are critical. Studies show that about half of children with autism who are in an evidence-based early intervention program from age 3-5 can gain enough skills to be mainstreamed for kindergarten. There are now evidence based interventions for babies as young as 12 months old, and studies are underway to design treatments for 9 month old babies at risk for autism.
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Attention Autism Stage 2 The Attention Builder
This needs to be an activity that is great to watch and will hold the childs attention. This can be used to build on sequencing and vocabulary. You need to have all the items prepared before you do it with the child and in some cases may want to practice in advance. There are so many great attention builder ideas one of our favourites is the Flower Pot Rocket.
Behaviour: Early Signs Of Autism
Repetitive and restricted interests If young children are autistic, they might:
- have an intense interest in certain objects and get stuck on particular toys or objects for example, theyll flick the light switch off and on repeatedly, or play only with cars or dolls
- interact with toys and objects in limited ways for example, they might mainly spin the wheels of a toy car rather than pretending to drive the car along the floor, or take the clothes on and off a doll repeatedly
- be very interested in certain objects or activities and get upset if they cant do that activity for example, watching the same TV show over and over
- focus narrowly on objects and activities, like lining up objects or putting toys into a pile.
RoutinesIf young children are autistic, they might be easily upset by change and need to follow routines. For example, they might need to follow the same route to child care or a grandparents house every time.
Repetitive movementsIf young children are autistic, they might repeat body movements or have unusual body movements, like back-arching, hand-flapping, arm-stiffening and walking on the tips of their toes.
Sensory sensitivitiesIf young children are autistic, they might:
If youd like to check your childs behaviour and development for early signs of autism, you can download ASDetect a free, evidence-based, app developed by La Trobe University and suitable for use with children aged 11-30 months.
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Autism Signs By 12 Months
She doesn’t say single words.
She doesn’t use gestures such as waving or shaking her head.
She doesn’t point to objects or pictures.
She can’t stand when supported.
It’s important to note that these criteria aren’t conclusive evidence of autism. “Theyre simply things we look for to determine if we need to further assess the baby, says Mandi Silverman, PsyD, MBA, senior director of the Autism Center at the Child Mind Institute. Another social or developmental factor may be to blame.
Carry On The Conversation
What has been your experience of the impact of autism over time? Let me know in the comments below. And, if you would like to learn about the many different types of autism then check out this article titled:What are the Different Types of Autism? The MANY Autism Types Explained
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Thank you for reading and I will see you next week for more thoughts from across the spectrum.
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Communication: Early Signs Of Autism
In the first year of life, childrens social and communication development is an important area to watch for early signs of autism. Social and communication development includes things like learning to smile, make eye contact, and use gestures.
Social interaction and communicationIf young children are autistic, they might:
- not consistently use eye contact to get someones attention for example, they might not always look at you and then at a snack to show you they want it, or not look back towards you when they see something that excites them
- rarely point to or hold up objects to show you things for example, they might not point to a dog and look back at you to make sure youve seen it too, or they might drop a toy in your lap and walk away instead of holding it up and looking at you
- not consistently respond to their name being called
- not consistently use gestures on their own for example, they might not wave bye-bye or clap without being told to, or without copying someone else whos waving or clapping
- not consistently smile at you or other familiar people without you smiling at them first
- rarely copy other peoples actions, like combing their hair when you do it
- not sound like theyre having a conversation with you when they babble
- not understand simple, one-step instructions for example, Give me the block or Show me the dog.
Relationships and playIf young children are autistic, they might:
Diagnosing Autism In Girls
The phenomenon of masking autism symptoms is more pronounced in girls than in boys. Traditionally, girls are more likely to act in very passive ways, to avoid being thought of as troublemakers. What might appear to be quiet and submissive behavior could actually be undiagnosed autism that the girl was born with and did not develop.
Because the symptoms of autism can be as subtle as they are, this means that people who are high-functioning on the autism spectrum can go for years without an appropriate diagnosis, leading to the belief that they developed their autism as they aged.
For example, adults with high-functioning autism can have relatively mild social and communication challenges when compared to people with more recognizable symptoms of autism. This has led many such adults to be mistakenly diagnosed with attention deficit hyperactivity disorder.
Similarly, many girls with high-functioning autism are also misdiagnosed because their autism does not fit the stereotypes of the disability. No two presentations of autism spectrum disorder are exactly the same, and some presentations are outside the norm.
High-functioning individuals can also be better at hiding the signs of their condition, to better fit in with others or to avoid being bullied or abused.
Autistic Children And Developmental Milestones
Steven Gans, MD, is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.
A developmental milestone is a sign of typical child development. Children reach dozens of developmental milestones between birth and adulthood. Early milestones include social smiles, rolling over, and sitting up. Later milestones involve the acquisition of language, social, physical, and emotional skills, and intellectual abilities.
Children with autism tend not to reach all of their developmental milestones at the appropriate times. But that statement is a huge oversimplification of the reality because:
- Many autistic children reach early developmental milestones on time or early, but then lose ground.
- Most autistic children reach some of their developmental milestones on time or early, but reach others late or not at all.
- Some autistic children reach some of their developmental milestones extraordinarily early but reach others extraordinarily late.
- Children with autism can appear to gain important skillsbut in fact, be unable to use those skills in real-world situations.
- Many children with autism have so-called “splinter” skills, which can be very advanced but which are not useful in daily life.
- Autistic children, particularly girls who are high-functioning, are sometimes able to hide or overcome some developmental delays.
Restricted Or Repetitive Behaviors Or Interests
People with ASD have behaviors or interests that can seem unusual. These behaviors or interests set ASD apart from conditions defined by only problems with social communication and interaction.
Examples of restricted or repetitive interests and behaviors related to ASD can include:
- Lines up toys or other objects and gets upset when order is changed
- Repeats words or phrases over and over
- Plays with toys the same way every time
- Is focused on parts of objects
- Gets upset by minor changes
- Has obsessive interests
- Flaps hands, rocks body, or spins self in circles
- Has unusual reactions to the way things sound, smell, taste, look, or feel
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The Early Signs Of Autism Unfold From 9 To 16 Months
The early signs of autism are easy to miss. Autism can be diagnosed by 18-24 months but its not usually diagnosed until 4-5 years.
This article illustrates 16 early signs of autism that unfold from 9-16 months to help you detect autism before it’s usually diagnosed.
Diagnosing autism can be difficult because there are no medical or blood tests. The diagnosis is based on behavioral symptoms or features.
The American Academy of Pediatrics recommends that all children be screened for autism at 18 and 24 months. Autism can be diagnosed by 18-24 months, but its not usually diagnosed until 4-5 years.
The early signs of autism can have a cascading effect on brain development and lead to significant social, language, and cognitive deficits, as well as challenging behaviors, if theyre not caught early.
Early Signs Of Autism In A 2 Year Old
If you feel like your 2-year-old doesnt seem to be catching up with their development milestones, you may start looking for certain signs of autism spectrum disorder for any delays.Mild symptoms can be mistaken for being shy or the terrible twos.
Here are some red flags that may indicate ASD:
- Doesnt speak more than 15 words,
- Cant walk ,
- Doesnt know functions of household items like fork,
- Doesnt imitate parents actions or words,
- Doesnt use items for their own purposes,
- Doesnt follow simple instructions
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Learn The Signs Act Early
Families: During COVID-19 you can still schedule appointments for well-child visits, developmental screening, and immunizations. Continue to monitor your child’s development between visits.
From birth to 5 years, your child should reach milestones in how he plays, learns, speaks, acts and moves. Track your childs development and act early if you have a concern.
This new poster from CDC and Vroom shares the importance of tracking your childs development and using brain building tips to add learning to everyday moments. Click here to download and print English pdf iconSpanish pdf icon!
Links with this icon indicate that you are leaving the CDC website.
- The Centers for Disease Control and Prevention cannot attest to the accuracy of a non-federal website.
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How Is Autism Spectrum Disorder Treated
The earlier treatment for kids with ASD starts, the better. Depending on a child’s needs, treatment may include behavior therapy, speech therapy, occupational therapy, medicine, and extra help with learning. The goal is to help kids:
- communicate better
- be safe and take care of their bodies
Before Age 3
Before age 3, kids might be eligible for services through their state’s early intervention program. Families work with a team of experts on an Individualized Family Service Plan . This plan outlines goals and comes up with a treatment plan.
A team of therapists provides therapy at home or in daycare to eligible families.
Services may also be available in hospital-based clinics or in community centers. Insurance companies may reimburse for many services.
After Age 3
Kids ages 3 to 5 years old with ASD who qualify are entitled to free preschool services under the Individuals with Disabilities Education Act . Therapy and/or extra learning help is offered through local school districts or other learning centers either at home or in a classroom.
When kids reach kindergarten age, parents can ask to switch to an individualized education program through the local school district. An IEP can include learning goals along with behavioral, social, and self-care goals. Special education services are available until a child’s 21st birthday.
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Early Signs Of Autism
Signs of autism in babies
Autism spectrum disorder is a developmental disorder, which means that signs become apparent as a child does not develop as expected, for example developing speech or learning to crawl later than expected.
As such, there are few signs of autism that are noticeable in newborns. However, if a baby fails to reach the developmental milestones expected at two months old, four months old, six months old, nine months old and a year old, this could be one of the first signs of autism or another developmental condition.
Good to know: Not all babies reach developmental milestones at the exact same time. It is normal to have some variation in development. If in doubt about a childÃ¢â¬â¢s development, check with a doctor.
Some of the early signs that a baby under one year old may have autism spectrum disorder include:
- Not babbling by four months old
- Not smiling by five months old
- Not laughing by six months old
- No interest in games like pat-a-cake or peek-a-boo by eight months old
- Not responding to their name by 12 months old
- Not looking at objects pointed out by other people by 12 months old
- Being upset by loud noises
- Not looking to a parent for comfort in new situations
- Being happy to play alone for long periods of time
- Not making eye contact
Signs of autism in toddlers
Some of the signs that a toddler, between one year old and two years old, may have autism spectrum disorder include: