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Jefferson Health

Home of Sidney Kimmel Medical College

Recognizing the Early Signs of Autism

When should you begin to ask questions about your child's development?
Dr. Schaaf with patients in her autism lab

Dr. Schaaf with patients in her Autism Laboratory within Thomas Jefferson University’s Department of Occupational Therapy.

As a parent of a young child, you spend what seems like every waking hour meeting your little one’s needs and helping them progress to the next milestone in life. While the timing of those milestones will vary to some degree, your pediatrician will provide you with basic guidelines on what to expect – from babbling and crawling to taking first steps and speaking first words – and when.

“I urge parents to remember that early childhood development is generally a dynamic evolution of maturation, with milestones often reached at varied times,” says pediatrician Dr. Steven A. Shapiro. “Don’t compare your child’s development with that of others. Instead, let your pediatrician help you understand what kind of advocacy makes sense for all of your concerns.”

If your child doesn’t reach a milestone when they should, there’s no reason to panic — but it may be time to ask questions.

“You’re smart to be vigilant about your child’s development and to talk frequently with your pediatrician about any concerns,” says occupational therapy professor Dr. Roseann C. Schaaf. “Any parent who is concerned about their child’s development should see their pediatrician and ask for an early screening for autism spectrum disorder.”

two hands holding a heart that symbolizes autism awareness

What is Autism Spectrum Disorder?
Autism spectrum disorder (ASD) is the most common neurodevelopmental disorder of childhood. It’s present from early childhood and is characterized by difficulties with communication, social interaction, hyper- and/or hypo-reactivity to sensory stimuli (such as pulling away from touch) and a restricted or repetitive range of behaviors (such as lining up toy cars).

“Currently, one in 68 children have ASD,” notes Dr. Schaaf. “The prevalence of autism has increased over the last 10 years, mainly due to better diagnostic procedures to identify autism, and changing diagnostic criteria that more specifically identify those children with autism.”

Dr. Schaaf recommends being aware of some of the early signs of autism. These include lack of a social smile, limited or no eye contact, limited language and vocabulary, limited communicative gestures such as waving goodbye or pointing to a parent or a glass to request a drink, failure to respond to a name and a preference for being alone.

Autism advocacy organization, Autism Speaks, provides helpful guidelines for these potential signs of autism by age range:

By six to nine months:

  • No social smiles or other warm, joyful expressions directed at people
  • Limited or no eye contact
  • No sharing of vocal sounds, smiles or other nonverbal communication (9 months)

By 12 months:

  • No babbling
  • No use of gestures to communicate (e.g. pointing, reaching, waving, etc.)
  • No response to name when called

By 16 – 24 months:

  • No words (16 months)
  • No meaningful, two-word phrases and loss of any previously acquired speech, babbling or social skills (24 months)

“It is important to note that children may display these behaviors and not have autism,” stresses Dr. Schaaf. “A full diagnostic assessment by a trained psychologist or therapist is needed to confirm the diagnosis.”

Dr. Schaaf and one patient play with a ball in her autism lab

The Importance of Early Intervention
In every state, children with developmental delays related to health conditions such as ASD are eligible for early intervention services that will help provide the necessary support for your child’s development and learning.

“Early in life, children learn new skills more quickly, so getting help early is beneficial,” says Dr. Schaaf. “Early intervention for children with autism often consists of an educational program with support services such as occupational therapy, speech and language therapy, and behavioral therapy.”

Educate Yourself
Dr. Schaaf also reminds not to panic or despair if you suspect your child may have ASD. Great strides have been made in helping children with autism lead successful and meaningful lives.

“Educate yourself with reputable sources of information from universities or organizations such as Autism Speaks,” she concludes. “They will help you learn accurate facts about autism. Also, find a support group of parents experienced in raising autistic children. They can provide emotional support and help you find the services you need.”

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