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Early signs of autism spectrum disorder

By Raising Children Network
 
 

Children with autism spectrum disorder (ASD) are very different from each other. One child might have only a few characteristics, and another might have many. In very young children, it can be hard to detect the early signs. But infants with ASD do develop differently from other infants, and there are some ‘red flags’ to watch out for.

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  • Research shows that when parents have concerns about their child’s development, they’re usually right.
  • If you’re worried, don’t wait – speak to your GP or maternal child health nurse.
 

Children all develop at different rates. Development is monitored by checking whether children are achieving various important milestones, which can be physical, emotional, social, linguistic or behavioural.

During the first year, monitoring a child’s social development is especially important for spotting early signs of ASD. Watching for behaviour such as smiling, eye contact, and the use of gestures can help you gauge your child’s development.

When my son was 18 months old, a friend brought her nine-month-old baby to our house. I had so much fun with the baby – there was this constant interaction between us. I realised this was completely absent from my own little boy.

Anna, mother of Lachlan, aged four

Early signs of ASD

Some early signs of ASD – usually seen in the first two years – are listed below. Some children will have many of these early warning signs, whereas others might have only a few. Also, any loss of social or language skills during this period is cause for concern.

AreaRed flags
Social

The child:

  • doesn’t consistently respond to her name
  • doesn’t smile at caregivers
  • doesn’t use gestures independently – for example, she doesn’t wave bye-bye without being told to, or without copying someone else who is waving
  • doesn’t show interest in other children
  • doesn’t enjoy or engage in games such as peekaboo or patty cake.
Communication

The child:

  • doesn’t use gestures – for example, he doesn’t raise his arms when he wants to be picked up, or reach out to something he wants
  • doesn’t use eye contact to get someone’s attention or communicate – for example, he doesn’t look at a parent then look at a snack to indicate that he wants the snack
  • doesn’t point to show people things, to share an experience or to request or indicate that he wants something – for example, when he’s being read to, he doesn’t point to pictures in books and look back to show the reader
  • doesn’t engage in pretend play – for example, he doesn’t play with stuffed toys
  • doesn’t sound like he’s having a conversation with you when he babbles
  • doesn’t understand simple one-step instructions – for example, ‘Give the block to me’ or ‘Show me the dog’.   
Behaviour

The child:

  • has an intense interest in certain objects and becomes ‘stuck’ on particular toys or objects
  • focuses narrowly on objects and activities, such as turning the wheels of a toy car or lining up objects
  • is easily upset by change and must follow routines – for example, sleeping, feeding or leaving the house must be done in the same way every time
  • repeats body movements or has unusual body movements, such as back-arching, hand-flapping and walking on her toes.
Sensory

The child:

  • is extremely sensitive to sensory experiences – for example, he’s easily upset by certain sounds, or will only eat foods with a certain texture
  • seeks sensory stimulation – for example, he likes deep pressure, seeks vibrating objects like the washing machine, or flutters his fingers to the side of his eyes to watch the light flicker.
If your child is showing some or many of the behaviours from the social and communication areas above, talk to your health care provider about a developmental assessment as soon as possible. Finding out for sure is the first step towards helping your child and accessing services and support suited to her needs.

The number of signs in each category varies according to the age of the child and the specific ASD diagnosis. A child with autistic disorder will most likely have many of these early warning signs, whereas a child with PDD–NOS will probably have only a few.

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I thought that maybe he was just incredibly smart, as he would remember everyone’s name and the alphabet and numbers, and mimic newsreaders and kids’ characters. He spoke like an adult and was reading signs at shopping centres when he was only two. Perhaps he didn’t want to mix with the other children because they weren’t at his intellectual level? He loved to sit and talk to the mums rather than go and play.

Sonya, mother of Jack, aged seven
 
 
 
  • Last updated10-01-2009
  • Last reviewed03-11-2010
  • Acknowledgements

    Article developed in collaboration with Cheryl Dissanayake and Cherie Green, The Olga Tennison Autism Research Centre, La Trobe University.

References

  • American Academy of Pediatrics (2008). Autism – Caring for children with autism spectrum disorders: A resource toolkit for clinicians. Elk Grove Village, IL: Author.

    American Psychological Association (2004). DSM-IV-TR: Diagnostic and statistical manual of mental disorders (4th ed., Text revision). Washington: Author

    Autism Speaks (n.d.). First 100 days kit:A tool kit to assist families in getting the critical information they need in the first 100 days after an autism diagnosis. Retrieved November 2008, from http://www.autismspeaks.org/docs/family_services_docs/100_day_kit.pdf.

    Autism Victoria (2003). Assessment guidelines and protocol for the identification of autism spectrum disorders. Retrieved November 2008, from http://www.bsdgp.com.au/content/Document/Resources/Prac%20Support/MBS%20Item/assessment-protocol.pdf. 

    O’Reilly, B. & Smith, S. (2008). Australian autism handbook: The essential resource guide for autism spectrum disorders. Edgecliff, NSW: Jane Curry Publishing.

    Young, R., Brewer, N., & Pattison, C. (2003). Parental identification of early behavioural abnormalities in children with Autistic Disorder. Autism, 7, 125-143.