Recognizing Early Signs of Autism in Babies: What Parents Need to Know

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder known to affect about 1 in 36 kids as of 2020. While some autistic people don't show symptoms clearly enough to get a diagnosis until they're about four years old, other kids have very apparent signs early on, like a lack of cooing, babbling, or eye contact as an infant. It's imperative that children who show symptoms as a baby are monitored by providers so that they can get an accurate diagnosis as soon as clinically possible.

Getting an Autism diagnosis early in life means that children can access services available for their symptoms, age, and developmental level, which can support their success and well-being as they age. Similarly, if the cause of a symptom like lack of eye contact is related to something else, like ocular problems, it's important to find out sooner rather than later.

So, what do parents need to know? This article will review common signs of Autism in babies, what to do if you notice them in your child, and resources for parents of children who have or may have Autism.

Common early signs of Autism in babies

Autism affects brain development, including possible differences in the amygdala, white matter, and cerebral cortex. Some of what we know about brain development and Autism can differ based on sex, which is part of why it's so essential to ensure that Autism research is inclusive. Not all children with Autism have developmental delays, but some do. Similarly, in kids around age 2 years of age lower, ASD symptoms are not always apparent yet. If your child experiences developmental differences or signs of a neurodevelopmental disorder like Autism at any point in their development, talking with a medical professional is essential.

Lack of eye contact or reduced eye contact, limited speech development, and developmental differences are often some of the most common early signs of ASD in those who do have a more clear-cut case as a baby. Here are some common early warning signs of Autism Spectrum Disorder in babies and a little bit about what you might notice as a young child with ASD starts to enter toddler or preschool years.

Lack of eye contact

Poor eye contact might be the most well-known early sign of Autism. Your baby may have limited eye contact, or they might stop making eye contact. Although not all autistic children lack eye contact, poor eye contact is an early red flag for many children diagnosed at a young age. Healthcare professionals can look into a child's lack of eye contact and rule out other possible causes, like vision issues. Lack of social smiling and limited facial expressions are two other common signs of Autism in babies that parents might notice. Your baby with Autism may also struggle with joint attention (e.g., their eyes don't follow your finger when you point).

Delayed or limited speech development

Speech delays, like eye contact and problems with joint attention, are not something everyone with Autism experiences. However, they are some of the first differences in social interaction and communication skills a parent might notice in a baby with ASD who hasn't been in diverse social situations like an older child will have yet. Infants with ASD:

• May not babble, or babbling is limited.
• May not coo (this usually occurs at 6-8 weeks).
• May not respond or react to their name by ten months old.
• May not follow simple instructions (this usually occurs at about age one).
• May not say as many words as other children their age as they get older.

It is important to note that even children without ASD may exhibit one or more of these delays or difficulties so any of these alone does not mean that your child definitely has ASD. Parents of older kids might start to notice that their child experiences other differences in social communication and interaction. For example, difficulties with social cues, taking things literally, use of abnormally formal speech, little interest in other kids, and other signs may show up later, regardless of language development.

Repetitive behaviors

As early as infancy and early toddler years, autistic children may display notable repetitive behaviors. Examples of repetitive behaviors in Autism Spectrum Disorder can include but aren't limited to:

• An intense fixation on specific objects or stimuli (other interests could be limited).
• Repetitive body movements, such as rocking, swaying, or flapping hands.
• Lining up toys or engaging in other atypical modes of play.

Children of speaking age may repeat words or phrases. Language skills vary in people with Autism. Some kids may have excellent or above-average vocabulary, whereas others will be non-speaking or minimally speaking.

Sensory sensitivities

Young children with ASD may show intense distress when met with specific sensory stimuli, or they may under-react to stimuli that would usually lead to a reaction. Kids with Autism may:

• Be sensitive to certain textures, such as food textures and fabrics or clothing items. In infancy, difficulties during breastfeeding or resistance to solid foods can be present in some children.
• Be sensitive to certain sounds, whether that is loud noises, a specific noise (like a vacuum cleaner), or something else.
• Have trouble identifying physical needs like hunger or thirst.
• Have reduced reactions to pain, hot, cold, or touch.

About 90% of autistic people have sensory processing differences of some kind. Some of these traits, like low reaction to pain, can be concerning to parents and may be one of the first things that makes them consider Autism as a possibility.

Difficulty with transitions or change

As your child gets older, you might notice that they have difficulty with changes in routine or transitions, even if these changes are minimal and would not be disruptive for most. This may not be a symptom parents and providers can see in infancy, but it is something to look out for as a child reaches their toddler or preschool years.

Importance of parental observation and communication with healthcare providers

The American Academy of Pediatrics (AAP) recommends that all young children aged 18-24 months get screened for ASD, which can take place in a regular pediatrician's office and may be the first step toward an official diagnosis. Although the general population and medical field are starting to understand Autism better, there are still many providers who don't fully understand Autism. As a parent, you play an integral role in helping your child get an adequate assessment and potential diagnosis. Here's a little bit about what you can do for your baby.

Role of parents in early detection

Parents can help their children get an early diagnosis by staying proactive. Often, this means learning about Autism, talking with your child's healthcare providers, and advocating for the child if necessary. By learning about the possible signs of Autism and the diverse ways they can manifest, you'll be more able to detect signs others may not know to look out for. You know your child best and are with them the most, so you can compile a list of the symptoms you notice, take note of how they fit the criteria, and present them to providers.

Once your child is 16-30 months old, consider discussing with your child's provider the appropriateness of completing the M-CHAT (Modified Checklist for Autism in Toddlers). This is a free screener you can print out and complete at home. Taking an online screener can help you detect red flags, and bringing the results to a medical provider may help your child get a referral for an official Autism assessment.

Seeking professional support and evaluation

Once you talk with your child's pediatrician and they agree that your child's symptoms indicate possible ASD, they can refer your child for an evaluation. Your infant or young child may see a child neurologist, developmental pediatrician, or child psychologist for their Autism diagnosis. Sometimes, the diagnostic process involves other professionals, too. Since Autism is complex, the professionals involved in your child's diagnostic process may differ based on symptom presentation and other considerations.

Resources and support available for parents of children with Autism

Research shows that kids who get adequate support for Autism symptoms sooner are more likely to experience long-term positive effects on symptoms and skill development. This is largely because of a child's brain's neuroplasticity (changeability) at or before preschool age. Your child may be able to get some types of professional support for their symptoms as soon as Autism is either diagnosed or highly suspected based on symptoms like delayed language skills that often benefit from treatment.

Early intervention programs

The Centers for Disease Control (CDC) has a list of early intervention services by state or territory. If you're concerned about your child's development, you can contact the early intervention program in your area, found here, and express the need for an evaluation for your child. Some examples of the services young children with ASD or suspected ASD may benefit from include but aren't limited to occupational therapy, social skills training, speech therapy, applied behavior analysis (ABA), and physical therapy.

Support groups for parents

The Autism Society website can help you find various online and in-person support groups. These include support groups for parents, friendship groups for children with ASD, and support groups for people with ASD. To find your local affiliate, go to https://Autismsociety.org/contact-us/ and scroll down to where it says "Our Affiliates." There, you'll find the website for the affiliate closest to you, which will give you access to support groups and other resources in your area. For example, Idaho's affiliate is Autism Society Idaho.

Psychology Today is another website that can help parents of children with ASD find support groups. 

Educational resources

In addition to a directory of support groups, The Autism Society is an excellent educational resource. Not only do they offer resources for those seeking evaluations, therapy, housing services, and other supports, but their website is a great place to learn more about Autism. Additional Autism educational resources for parents include but aren't limited to the following:

The Child Mind Institute: A Complete Guide to Autism

CDC - Autism Spectrum Disorder

NIMH - Autism Spectrum Disorder

Conclusion

Autism Spectrum Disorder is a common condition said to affect about 1 in 36 kids. Falling under the category of neurological and developmental disorders, symptoms of Autism can differ from one person to another. Delayed speech, poor eye contact, difficulty with changes in routine or transitions, limited facial expression or gestures, lack of response to name, and sensory issues are all common early signs of Autism that parents and healthcare professionals might notice.

If you notice possible signs of Autism, developmental differences, or other symptoms of another condition in your baby or child, it is important to seek help. Early intervention can help kids get help for their specific symptoms sooner rather than later. Examples of early intervention services that can be helpful for young kids with an Autism diagnosis include but aren't limited to speech therapy, applied behavior analysis, and physical therapy.