What are the Early Signs of Autism in Children?

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder. At this time, it's estimated that about 1 in 36 eight-year-olds have ASD. While ASD awareness is increasing, it's still largely misunderstood. Knowing the possible signs of ASD can empower parents and help them identify symptoms in their children. 

Early identification matters for kids with neurological and developmental disorders like ASD because it opens the door to support and understanding. So, what should you know if you're the parent of a young child with suspected or confirmed ASD?

Let's go over common autism symptoms in children first. Then, we'll talk about some of the earliest indicators of ASD in infancy-early childhood. Finally, we'll discuss the importance of early intervention, including benefits and treatment options, and tips for parents to recognize signs of ASD.

Common Signs of Autism in Children

ASD is marked by differences in social communication and interaction, repetitive behaviors, and restricted interests. Sometimes, a child's symptoms will be noticeable by the time they're 2-3 years old. In other cases, a child's symptoms may not be visible or distinctive enough for a diagnosis to occur until they're slightly older. By going over some of the most common signs of ASD, you'll know what to look for now and as your child gets older.

Social communication difficulties

Social and communication symptoms in ASD can present in diverse ways. Common examples of social communication challenges in ASD include but aren't limited to the following.

• Trouble understanding non-verbal cues, like facial expressions and gestures, from others.
• Trouble with social awareness (e.g., social cues) or personal space.
• Difficulty identifying their own or other people's emotions.
• Unusual ways of initiating social interactions.
• Limited or excessive facial expressions.
• Rarely initiating social interactions.
• Little interest in other kids.
• Taking things literally.
• Scripted speech.

Part of why some kids, especially those with strong verbal skills, might not get diagnosed right away is that social communication and interaction differences and other ASD symptoms might not be as noticeable until they're around other kids more often. For example, around the time they enter preschool. 

Repetitive behaviors

Repetitive behaviors and restricted interests can take many different forms in autistic children. Some kids may have routines they are adamant about following. Other prevalent examples of repetitive behaviors may include but aren't limited to the following.

• Rocking, swaying, twirling in circles, jumping, pacing, or stepping back and forth from foot to foot.
• Resistance to change, including minor changes to routines that may not upset others.
• Flicking fingers, shaking or flapping hands, spinning or tapping objects, or snapping.
• Special interests, referring to abnormally intense interests in a specific topic.
• Repeating words, phrases, or sounds (e.g., humming).
• Difficulty with transitions.
• Atypical posture.

Unusual body movements, hand movements, or sounds can all be ways of stimming. As long as the child does not engage in possibly harmful behaviors (e.g., headbanging, pressing or poking eyes), there is nothing wrong with stimming. In fact, it can be very regulating for an autistic person.

Sensory sensitivities

Sensory sensitivities fall under the category of restricted, repetitive patterns of behavior, interests, or activities. While anyone can have sensory sensitivities, about 90% of people with ASD have atypical sensory experiences, so they are worth talking about. What sensory sensitivities look like can differ, ranging from hypo to hyper-sensitivity. Examples of sensory sensitivities in autistic children may include:

• Intense reactions to sensory stimuli, including but not limited to unusual reactions to sounds, scents, tastes, or textures. For example, clothing tags, fabrics, bright lights, movie theaters, loud stores, certain sounds that don't bother others (e.g., a light buzzing, a vacuum), or foods.
• Reduced reactions to hot, cold, or bodily discomfort (e.g., reduced reactions to an injury or lack of awareness regarding bodily signals).
• An abnormally high pain tolerance.

Accommodating sensory sensitivities can be helpful for children with ASD. Some kids are hyper-sensitive to some forms of sensory stimuli and under-reactive to others. For example, a child with a high pain tolerance may face extreme discomfort due to certain clothing items.

Early Warning Signs of Autism

Now that we've gone over common signs of ASD overall, let's talk about some of the early warning signs you might notice in an infant or toddler. Even very young kids around their second year may experience symptoms like unusual body movements and sensory processing differences, so keep these in mind as well.

Lack of eye contact

Lack of eye contact is potentially the most well-known early sign of ASD. If a baby or toddler displays limited eye contact that is not considered developmentally appropriate for their age, it could be a sign of ASD. There are various possible causes of limited or poor eye contact. Talking with a provider is necessary for ruling out other causes, like vision issues, which can be integral to address early on as well.

Delayed speech development

Language skills can vary dramatically in children with ASD. It is said that around 25-30% of autistic children are minimally verbal. Look out for developmental differences related to communication, such as not saying their name when asked or not asking questions like "Why?" or "How?" by 2-3 years. Other children with ASD may have strong language skills and a rich vocabulary. Some kids with ASD speak in an overly formal way, like a "little professor."

If a child does have delayed speech, seek help right away. They may benefit from early intervention services like speech therapy, which can be accessed with or without an official ASD diagnosis. It's also vital that providers rule out other possible causes of limited verbal communication in children.

Difficulty with social interactions

Like verbal communication development, other communication and social interaction symptoms can vary dramatically in ASD. In young children, signs may include but aren't limited to:

• Hiding from visitors or being easily distressed when guests come over.
• Difficulty following or using joint attention skills (e.g., pointing).
• Lower interest in social play/playing with other kids.
• Not reacting to their name.
• Lack of social smiling.

At a young age, autistic children might play differently than other kids. This could include atypical use of objects or being interested in other things.

Importance of Early Intervention

Parents do not cause autism. Although there are various known risk factors, like fragile X syndrome and family history (whether or not the family member has an official diagnosis), anyone can have ASD. Parents are often their children's best advocates. With that in mind, let's talk about why early intervention is so vital and possible treatment options.

Benefits of early diagnosis

An accurate diagnosis can be life-changing. With ASD, early detection and intervention are associated with positive outcomes such as improved social skills, motor skills, work and education outcomes, and a better quality of life overall. It can help parents understand their children and children understand themselves. Getting an autism diagnosis requires a formal evaluation from a qualified provider. Often, this will be a developmental pediatrician, neurologist, psychologist, or psychiatrist with specialized training.

Available treatment options

The treatments or support options your child benefits from could vary extensively based on their unique symptom presentation. Note that support options like school accommodations can be for kids with any level of support needs. Kids with ASD may benefit from any combination of the following:

• Changes to their environment or tools (e.g., weighted blankets) that support sensory needs.
• School accommodations (in older children of school age).
• Applied behavioral analysis (ABA).
• Sensory integration therapy.
• Social skills training.
• Occupational therapy.
• Speech therapy.

Structured routines can be crucial for autistic people. If a child has a co-occurring condition, such as an intellectual disability, attention deficit hyperactivity disorder (ADHD), or a mental health condition, additional forms of support or treatment specific to the co-occurring condition could be critical additions to their treatment plan.

Tips for Parents to Recognize Signs of Autism

Parents are often the first to notice potential autism symptoms. Since not all providers are equipped to detect or diagnose ASD and only have basic or general information about the condition, it's vital that parents and caregivers are proactive. Here are some tips for parents who suspect that their child has ASD.

Regular developmental screenings

The American Academy of Pediatrics (AAP) recommends screening for ASD alongside developmental differences at 18 and 24 months. Not all children will have clear enough symptoms to get an autism diagnosis at this time. If that's the case, you may continue to monitor your child for possible signs of ASD. Some children with ASD have developmental delays, but many do not. Developmental delays should be brought to a provider's attention, even if they aren't due to ASD. 

Observing behavior patterns

Observing and keeping a record of behavior patterns can be vital for helping your child get an official evaluation. Whether this is at age 2-3 or 4-5, writing your child's symptoms down can help providers get a clearer picture of possible ASD. Become well-versed in the diagnostic criteria for ASD and the diverse ways it can present so that you can advocate for your child.

Seeking professional help

The Autism Society is a great resource for parents and individuals seeking an official ASD evaluation at any age. You can also ask your child's pediatrician about evaluation and treatment resources, contact your insurance company, speak with your local school district, or search for ASD services in your area online. The Psychology Today website has a search tool that allows you to explore resources and providers by condition (including ASD), age, and insurance. 

The Centers for Disease Control (CDC) website can be another valuable resource. For example, their directory of early intervention services by state or territory may be helpful for some parents.

Conclusion

Autism Spectrum Disorder, or ASD, is characterized by a group of symptoms. These include social and communication challenges, repetitive or restricted behaviors and interests, and sensory sensitivities. ASD symptoms can present in many different ways, so it’s integral that caregivers are educated and proactive in identifying possible signs of ASD. You know your child best. If you notice early indicators of ASD in your child, it is important to speak with their pediatrician or another trusted healthcare provider.