One of the hardest things about the early years of parenting is that everything is brand new territory. New parents spend a lot of time worrying whether their children are meeting expected milestones on time.
Both parents and child specialists today are increasingly aware of developmental disorders in a way many prior generations were not. Autism, in particular, has increased in both societal awareness and prevalence. The CDC now reports that approximately 1 in 44 children will be diagnosed with an autism spectrum disorder.
It is possible to diagnose autism as early as 18 months, with diagnoses made at 2 years and beyond considered very reliable. However, per the CDC, the average age of diagnosis for autism is still 4 years and 4 months. Naturally, many parents want to know: what are the early signs of autism?
Early Signs of Autism
The AAP, on their Healthy Children website, breaks down the early signs of autism into three main categories: social, communication, and behavioral.
Social
Early social signs of autism involve differences in the way a child responds to others in their environment. For example, a typically developing child will likely seek eye contact, look at what others are looking at (called “joint attention”), and show an interest in varied facial expressions.
Young children with autism may do these things to a lesser degree or not at all.
Communication
Young children with autism may experience delayed speech (or possibly no speech at all). They may show less interest in what other people are doing or attempting to communicate with others (such as pointing, for younger children or conversation, for older children). They may also engage less in pretend play than peers their age.
Behavior
Early behavioral signs of autism may include the need for a rigid schedule and significant challenges with transitions.
The child may have unusual sensory needs. For example, bright lights or loud sounds may bother them or they may seek out sensory stimulation by grinding their teeth. They may engage in repetitive movements or sounds, such as flapping hands or walking on their toes.
One other possible early sign of autism: Regression
Regression is one particularly worrisome potential sign of autism for many parents. This is when a child loses skills they’ve previously mastered, such as speaking or other social communication.
This is a known phenomenon in some (not all) children diagnosed with autism. However, it can also be a symptom of many other disorders or medical conditions, so a professional’s assessment is key.
Challenges of interpreting the early signs of autism
So far, you’ve probably noticed that I’ve use words like some, may, might, and sometimes quite a lot. That’s because autism is a spectrum disorder. What this means is the experience for people with this diagnosis can vary greatly.
Plus, all children are individuals and develop at their own pace. While yes, there are certainly recognized first-year milestones, those are just guidelines. A child failing to speak “on time” does not automatically indicate they have autism or any other developmental disability. Some children just speak later than others.
The same variation and uncertainty apply to any other communication or social milestones. That’s what makes diagnosing autism in young children so challenging.
Why is it important to diagnose autism early?
Early diagnosis of autism is important because, according to the American Psychiatric Association, children diagnosed with autism spectrum disorder before the age of 4 are
“more likely to get effective, evidence-based treatment, such as behavioral therapy. When children are diagnosed after that threshold, they are less likely to receive such treatment, but they are more likely to be treated with medication.”
The average age at which parents first raised concerns about their child’s development to their doctor was a little over two years old. Given that the average age of diagnosis is 4.3 years (per the CDC), there’s clearly a disconnect.
With this discrepancy in mind, trust your instincts. No one is a greater expert on your child than you. Don’t be afraid to ask tough questions or seek out a second (or third) opinion if you don’t feel satisfied with the answers you receive.
Whether your child has autism, a different developmental disorder, or is neurologically typical but on their own timeline, you are your child’s greatest advocate.