Recognizing the Early Signs: Common Symptoms of Autism

Attention deficit hyperactivity disorder (ADHD) and Autism Spectrum Disorder (ASD) are both common neurological and developmental disorders. While the diagnoses differ significantly, they share some similarities and can co-occur, meaning that it is possible to have both ADHD and ASD. Autism is more common than once suspected. According to the Centers for Disease Control, about 1 in 36 (or 2.8%) of 8-year-olds in the United States were estimated to have Autism as of 2020.

The American Psychiatric Association correctly calls ASD a complex condition. One of the things that can make ASD hard to detect is how much it differs from person to person. For example, social and communication differences in autistic people can vary dramatically. One autistic person might make exaggerated facial expressions; another might make few facial expressions or have a flat affect. One autistic person may talk about a special interest excessively or have excellent language skills, even if they have other challenges in social situations; another might experience language delays or not talk at all.

Early detection can be important for autistic people for multiple reasons. First, getting a proper Autism diagnosis can mean that young children can access treatment options early in life, supporting their long-term success and helping them with things like communication skills, which can be vital. Older children may be able to get accommodations at school, such as an individualized education plan (IEP). So, what should you know? This article will discuss common symptoms of Autism that parents can look out for at an early age or as their child grows and the benefits of early diagnosis.

Common Symptoms of Autism 

ASD is diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria. The most recently updated version of the DSM states that people must experience symptoms in all three areas of social-communication differences listed and at least two out of four areas of restricted interests and repetitive behaviors, alongside other criteria. Kids can be reasonably diagnosed by two years old in some cases, but other kids get diagnosed at around age five. In this case, it is usually because Autism symptoms become more clear when a child is around preschool age. Some people also receive a diagnosis as teenagers or adults. However, it is ideal that children are assessed sooner rather than later when possible.

Social communication difficulties

Difficulties with social interaction and communication can vary extensively. For an ASD diagnosis to occur, someone must have deficits in social-emotional reciprocity, nonverbal communication, and developing or maintaining interpersonal relationships. What social and communication difficulties look like in Autism can range dramatically, so it is important to keep an open mind.

Lack of eye contact

Not all autistic people lack eye contact, but it is a well-known and common symptom of Autism. If your child, toddler, or infant lacks eye contact, it is essential to see a medical provider right away. This can be an Autism symptom, but it is also essential that providers check for other causes, such as vision problems. Other common early signs include but aren't limited to:

• Difficulty with reciprocity in social interactions, including lack of responsive social smiling (this is a common early sign for some infants and toddlers).
• Difficulty with joint attention (e.g., following someone's gaze or finger when pointing).
• Not answering or reacting to one's name.

Note that some people with Autism will meet typical developmental milestones or could be close to them. Like with lack of eye contact, you do not have to have delayed milestones to receive an Autism diagnosis.

Difficulty with verbal and nonverbal communication

Some children with Autism will have delayed language skills. While other autistic people may meet all typical speech-related developmental milestones or could even talk excessively at times, about 25-35% of autistic people are minimally verbal. People who are minimally verbal may benefit from language supports like augmentative and alternative communication (AAC). Other challenges with verbal and non-verbal communication can include but aren't limited to:

• Difficulty identifying and understanding social cues (e.g., noticing when the other person is upset or that it's time to let the other person speak).
• Trouble understanding other people's facial expressions, body language, and gestures.
• Making exaggerated facial expressions or making fewer facial expressions than others.
• Repeating words or phrases (echolalia).
• Use of abnormally formal language.
• Delayed speech or lack of speech.

If babies, toddlers, and young children aren't meeting language and speech-related developmental milestones (like babbling and cooing for babies), it is important to speak with a healthcare professional.

Repetitive behaviors

In addition to social and communication differences, children must experience repetitive or restricted patterns of behavior, activities, or interests in at least two out of four of the following areas: Repetitive speech, movements, or use of objects, excessive adherence to routines or resistance to change (insistence on sameness) fixed or obsessive interests, called special interests, and being over-reactive to sensory stimuli, under-reactive to sensory stimuli, or both.

Obsessive interests

A special interest can refer to an intense interest in any topic. For example, a TV show, video game, or book series, animals, science topics, cars, historical periods, or something else. Many autistic people go on to become experts in their special interest, and some may even have a career related to it.

Repetitive movements or phrases

Autistic children may have intense difficulty with change. For example, changes in routine can be tough, even if they are small. Parents may notice this early on, even in young children. Kids may also show the following Autism symptoms related to repetitive behavior:

• Repetitive body movements, such as swaying, rocking, pacing, or stepping back and forth from one foot to another
• Repetitive hand movements, like flapping hands or flicking fingers
• Repeating words or phrases (echolalia)

Repetitive body movements, hand movements, repeating words, phrases, or parts of a song, and other related symptoms can be ways that young children, as well as older kids and adults, stim.

Sensory sensitivities

Sensory sensitivities are extremely common in autistic people with about 90% of autistic people demonstrating this system, as detected by research. Like other Autism symptoms, sensory sensitivities can differ dramatically and may include either or both of the following.

Overreacting to sensory stimuli

Certain sounds, tastes, and textures could lead to emotional reactions and distress in autistic children. For example, they may have extreme emotional reactions to certain fabrics, food textures, specific noises, including those that may not bother others (e.g., vacuum cleaners), or another form of sensory stimuli.

Seeking sensory stimulation

Autistic people can be hyper-sensitive (overly sensitive) to sensory stimuli, hypo-sensitive to sensory stimuli, or both. Some autistic people are sensory seekers and may experience:

• Unusual fascination with specific visual or other sensory stimuli (e.g., watching lights, watching water flow, or watching a toy or object spin).
• An abnormally high pain tolerance or under-reacting to physical sensations that would usually cause distress.
• Seeking certain sounds repetitively or making sounds repetitively.

Unusual fascination with visual stimuli can be called "visual stimming," and making sounds or repeating words and phrases can be called "vocal stimming." Stimming is not necessarily problematic unless it includes behaviors that could harm the child.

Importance of Early Intervention

One of the most common diagnostic tools used to identify Autism Spectrum Disorder is the Autism Diagnostic Observation Schedule (ADOS). For younger children, the Autism Diagnostic Observation Schedule will include a play session. For older kids and adults, it may include an interview, if possible. The ADOS test might be used alongside other diagnostic and screening tools, like assessments from speech-language pathologists. Sometimes, diagnosing Autism is more complex and requires more screenings to rule out other symptom causes.

The first step toward diagnosis is often talking with a child's pediatrician and asking about an Autism assessment. In some cases, pediatricians may notice signs during a developmental screening. The American Academy of Pediatrics (AAP) suggests that all children are screened for Autism at 18 months and two years old (24 months).

Benefits of early diagnosis

When autistic children have an official diagnosis, they're able to access proper treatment earlier in life and as needed. Treatment for ASD may depend on a person's unique Autism symptoms. Benefits of early diagnosis and intervention can include but aren't limited to:

• Help with social challenges, including better communication, friendship, and other social skills.
• Support and accommodations at school, such as an IEP for 504 plan.
• A better understanding of oneself and coping skills for symptoms.

Getting an Autism diagnosis sooner may also protect a child's mental health in some ways. Awareness of social cues can help children better understand potentially dangerous situations, and undiagnosed Autism can lead to negative mental health implications.

Available resources and support for children with Autism

While Autism is a lifelong neurological and developmental disability, there are treatments that can help and empower children to increase communication skills and learn other essential tools. Treatments like social skills training can take place at school, an office, or even at home. Occupational therapy can help kids with daily life activities, sensory differences, communication, and more.

Treatment options for Autism may include but aren't limited to the following:

• Applied behavior analysis (ABA).
• Speech and language therapy.
• Sensory integration therapy.
• Occupational therapy.
• Social skills training.

Kids with ASD can also sometimes qualify for social security benefits, which could be important for families who have a hard time paying for basic needs and services for their children or who cannot work while caring for a child with ASD.

Conclusion

Autism is a common neurological and developmental disability or neurodevelopmental disorder affecting about 1 in 36 kids in the United States. Symptoms of Autism show up early in life but can vary dramatically, and the condition is lifelong. Some children will display fewer symptoms early on than others. One child might be able to get an accurate diagnosis at two years old if it is clear that their symptoms are attributed to Autism. These kids may get detected during developmental assessments. For others, Autism may be a more clear cause of symptoms at around age four or five. High-functioning Autism may become more clear as a child ages.

Parents can look out for signs like repetitive body movements, differences in social communication and interaction, sensory sensitivities, and sensory-seeking behaviors. If you suspect that your child may have Autism Spectrum Disorder, it is important that they get assessed by a qualified health professional. An Autism diagnosis can mean that a child is able to access treatment options, develop a better understanding of themselves, or benefit from a more individualized approach to education at school.