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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.
 

Autism spectrum disorder and early development

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 communication development is especially important for spotting early signs of autism spectrum disorder (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 autism spectrum disorder

Some early signs of autism spectrum disorder (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. Some behaviour signs can change over time, or become clearer as the child gets older. Also, any loss of social or language skills during this period is cause for concern.

The number of signs in each category varies according to the age of the child and how severely the child is affected.

Social communication red flags
The child:

  • doesn’t point to or hold up objects to show people things, share an experience or show that she wants something – for example, she doesn’t point to a dog and look back at you to make sure you’ve seen it too, or she’ll drop a toy in your lap and walk away instead of holding it up and looking at you
  • doesn’t use eye contact to get someone’s attention – for example, she doesn’t look at a parent then at a snack to show she wants it
  • doesn’t consistently respond to her name
  • doesn’t smile at caregivers without first being smiled at or tickled
  • doesn’t use gestures on her own – 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 start games such as peekaboo or patty cake
  • doesn’t engage in pretend play – for example, she doesn’t feed her teddy bear
  • doesn’t sound like she’s having a conversation with you when she babbles
  • doesn’t understand simple one-step instructions – for example, `Give the block to me’, or `Show me the dog’
  • copies what she hears from others or from the TV – for example, when you ask if she wants more drink, she echoes back `more drink’.

Behaviour red flags
The child:

  • has an intense interest in certain objects and becomes ‘stuck’ on particular toys or objects – for example, he will flick the light switch off and on repeatedly, or will play only with cars
  • interacts with toys and objects in one particular way, rather than more broadly or in the way they were intended to be played with – for example, turning the wheels of a toy car or lining up objects
  • is very interested in unusual objects or activities – for example, drains, metal objects, or watching a specific ad on TV
  • 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 his toes
  • is extremely sensitive to sensory experiences – for example, is easily upset by certain sounds, or will eat only foods with a certain texture
  • seeks sensory stimulation – for example, rubs objects on his mouth, or face, or seeks vibrating objects like washing machines, 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 communication and behaviour 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 getting services and support suited to her needs.
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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
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  • Last Updated 20-11-2013
  • Last Reviewed 20-11-2013
  • Acknowledgements

    This article was developed in collaboration with Cheryl Dissanayake and Cherie Green, Olga Tennison Autism Research Centre, La Trobe University.

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

    American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th edn) (DSM-5). Arlington, VA: American Psychiatric Publishing.

    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.