Early Signs Of Autism: The Importance Of Early Detection And Health Support
Autism spectrum disorder (ASD) is a complex neurodevelopmental condition and form of neurodiversity marked by social challenges and repetitive behaviors. Autism is lifelong and symptoms first appear in childhood. Early detection of symptoms can help children receive support and improve their quality of life.
Because autism is a spectrum, not everyone shows symptoms in the same way, and some people don’t get diagnosed until adulthood as a result. Knowing the unique symptoms of autism, especially in vulnerable groups like young girls and BIPOC (Black, Indigenous, and People of Color) individuals, can help providers, families, and community members in offering adequate support to these young people.
What is autism spectrum disorder (ASD)?
Autism spectrum disorder is classified as a neurodevelopmental condition in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), meaning it arises in early childhood, impacts a child’s development and developmental milestones, and does not have a cure.
Autism is also considered a spectrum, affecting people in different ways. For example, some children may struggle more with social symptoms of the condition, whereas others may have the greatest difficulties with functional or sensory-related symptoms. Thinking of autism as a broad and diverse spectrum can be helpful when looking at why diagnoses are sometimes missed in early life.
Autism is considered a form of neurodiversity. This term is used to describe developmental differences in neural functioning that diverge from the “norm,” or neurotypicality. Some Autistic people consider themselves Autistic as an identity, distancing themselves from the idea that the way their brain works is a condition. Others may struggle significantly with having autism, prefering to view themselves as separate from this condition and referring to it as a disability.
Regardless of how one may identify with having ASD, the neurodiversity model allows people with autism to have a choice. The primary premise of this model is that all people deserve accessibility and that many Autistic people, as research indicates, also have unique strengths that might not be seen in the neurotypical population.
Differences in adult vs. childhood autism spectrum disorder
Children with autism may struggle in different ways with specific symptoms compared to adults, as adults often have learned ways to cope with daily life more efficiently and may “mask” certain behaviors.
For example, children may be more likely to outwardly “stim,” a term meaning “self-stimulation.” Stimming behaviors can include things like flapping hands, jumping up and down, turning in circles, yelling out sounds, or other attempts at sensory self-soothing or sensory seeking.
How is autism diagnosed in children?
For a child to receive an autism diagnosis, they must display symptoms of social difficulty, rigid thought patterns, and repetitive behavior. These symptoms might show up in the following ways:
- Difficulty making friends
- A lack of speech, strange speech, or limited speech
- A lack of reaction to one’s environment or when spoken to
- Lining up toys or organizing books by color
- Obsessive interest in a certain topic (though interests may change over time)
- Repetitive self-soothing movements or sensory seeking, such as biting, hitting oneself, spinning in circles, fidgeting, etc.
- Not interacting with toys a parent tries to show them, like a toy car
- Difficulty understanding nuance, neutrality, or jokes
- Difficulty making eye contact with others
Other symptoms may be necessary for diagnosis. Speak to a childhood psychiatrist, neuropsychologist, or psychologist about an autism evaluation if you think you or your child might be living with this condition.
Early signs of autism in children: Lack of eye contact, mental health challenges, and developmental delays
Early warning signs of autism generally show up in a child’s toddler years. Below are a few signs to look out for in children up to three years of age:
- Not responding to their name by nine months
- Not playing simple interactive games by one year of age
- Not using gestures by one year (waving hello, etc.)
- Not sharing interests with others by 15 months
- Not pointing to show interest by 18 months
- Not inviting other children to play by three years
- Not showing facial expressions by nine months of age
- Avoiding eye contact at an early age
- Not responding to one’s environment (like saying hello when spoken to) by two years of age
Toddlers may also have delayed speech and a lack of language skills if they have autism. If your child isn’t walking by 18 months or talking by two years (24 months), speak to an autism specialist for evaluation.
Early signs of autism in girls and BIPOC children: Difficulty with eye contact and other mental health symptoms
Girls are often underdiagnosed with autism in early life because much of the research done on autism was initially performed on young white boys. Girls may present differently in some ways, especially if they have fewer support needs and can talk. Below are some symptoms to look for in young girls up to age 12:
- Frequently partaking in pretend play or fantasy play involving the belief that they are an animal or magical creature and not human
- Difficulty making eye contact with others
- Extreme shyness or selective mutism
- Unconventional special interests, such as a specific animal (cats, horses, dogs, etc.), fantasy, reading books, philosophy, psychology, justice
- An extreme sense of justice and desire for fairness
- Avoiding social interaction or not seeking friendships
- Or, extroversion that seems “over the top” and a lack of realization when other people are irritated or don’t want to talk to them
- Frequent daydreaming
- “Quirkiness” and being “different” than other kids
- A tendency to become obsessive or possessive in friendships
- Mimicking others’ actions to “mask” their symptoms
- More hidden emotional meltdowns, often occurring at home
- A limited number of close friendships
- Thinking others are their friends when they aren’t
- Being a highly selective eater
- Advanced language skills for their age (such as the ability to read lots of books at an early age or an interest in higher-level school material)
- One-sided play
- Controlling behaviors
- Hair-twirling, fidgeting, nail-biting, and skin-picking as forms of “socially acceptable” stims
- Difficulty reading body language
These symptoms can also be seen in children of other genders, but they may be more common in Autistic girls. Many symptoms of autism persist into adulthood, but women are more likely to mask them than men, which can make them seem neurotypical even if they aren’t. Women and others who do not identify as men may have more difficulty receiving a diagnosis, even in adulthood.
It’s also important to note that research suggests that white children are diagnosed with autism earlier and more frequently than BIPOC children. Being aware of these disparities can be the first step toward achieving healthcare equity for all children.
The importance of early detection in diagnosis and treatment
Early detection of autism can validate someone’s struggles and help them receive support sooner. A diagnosis often opens the door for resources for a child that they may not be able to receive otherwise, such as an individual education plan (IEP) at school, a 504 accommodation plan at school, occupational therapy, speech therapy, and certain medications.
These tools can help a child grow, manage symptoms, and learn more about themselves. Many Autistic adults who were diagnosed in adulthood report disappointment in not having been diagnosed as a child, leaving them without support, which may lead to trauma, distrust of others, anxiety, stress, and depression. When you support your child, love them for who they are, and show them there are resources available for them, they may have a better chance of growing up feeling loved, safe, and supported.
If you are experiencing trauma, support is available. Please see our Get Help Now page for more resources.
Looking back: Understanding your childhood after an adulthood autism diagnosis
If you were diagnosed with autism as an adult but your symptoms were not noticed or taken seriously as a child, you may experience disappointment, distress, or mistrust. When you look back at your childhood, you might think of areas where you showcased behaviors and symptoms congruent with autism symptoms and validate yourself. Even if others in your life were unable to get you support, you can support yourself now by being open to asking for help, reminding yourself of the harm of masking, and accommodating yourself in daily life.
Ways to accommodate yourself as an adult can include things like organizing your home in a way that makes you comfortable (even if it’s unconventional), putting time into your special interests, not making eye contact if you don’t want to, stimming when you feel the urge, and making friends with other people who respect you for who you are. If you wish to identify yourself as Autistic to others, doing so can show that you’re proud of who you are, though how you identify and what you share about yourself is up to you.
Support options
Many support options are available for children with autism as well as adults. Below are some options to look into after an early diagnosis.
Therapy
Therapy for children with autism may focus on supporting them through sensory challenges, improving their communication skills, and working through social anxiety. Autism therapy is not meant to change a child, “cure” their autism, or make them act neurotypical. Instead, therapy may work on helping them accept themselves, be more confident in daily life, and develop independence.
You might take care to research the impacts of certain therapeutic modalities on Autistic children before choosing the type of therapist you want to work with. Be wary of working with someone who claims they can “cure” autism, as autism is not a curable condition.
Occupational therapy for Autistic children
Occupational therapy can help Autistic children build motor skills, organizational abilities, and speech abilities. Using an autism diagnostic observation schedule and other tools, an occupational therapist might help a child learn to stim in ways that don’t harm themselves or others and build confidence. In addition, they might help the child become more independent in daily activities like hygiene practices, cleaning, and supporting themselves. They might also teach children to express themselves through art and music.
Medication for co-occurring conditions
Autism frequently co-occurs with other developmental disorders and mental health conditions, including attention-deficit/hyperactivity disorder (ADHD), learning disorders, anxiety disorders, depression, and post-traumatic stress disorder (PTSD). A doctor may prescribe medications for certain symptoms in some cases, such as anxiety, to help the child cope with daily life and sensory-related stressors. For example, if a child can take an anxiety medication during a sensory-related meltdown, they may be able to self-regulate better.
Children with ADHD may also benefit from stimulant medications, though some doctors might not recommend these for children with high support needs and autism, as they can worsen symptoms for some. Talk to your doctor before choosing a medication or stopping a medication you’ve been prescribed.
The BetterHelp platform is not intended to provide any information regarding which medication or medical treatment may be appropriate for you. The content provides generalized information that is not specific to one individual. Do not take any action without consulting a qualified medical professional.
Family support
Family therapy can connect Autistic children with their caregivers. They can learn new ways to communicate and understand each other by working together. Family therapy often focuses on helping the parents understand how their Autistic child communicates their needs and helping the child be more comfortable with different forms of social communication.
Family therapy is not an attempt to change the child or make them talk if they do not want to. Instead, in these cases, parents might try assistive technology devices, which can allow a child to speak to them through icon-to-voice software. Children could also use the icons on the screen of a smart tablet to have it read out their requests or feelings to their loved ones, potentially making communication more manageable for both sides.
Mental health support for Autistic adults and families of children with autism
If you’re an adult with autism or a loved one of an Autistic child, talking to a therapist may be helpful for you as well. Individual therapy can be a way to explore all the daily occurrences that can accompany autism and learn ways to cope with challenges. If you struggle to connect with in-person resources due to barriers like cost, local availability, or transportation, you might explore online therapy through a platform like BetterHelp instead.
Online therapy may also benefit those who struggle with social interactions, as it allows you to choose between phone, video, or live chat depending on what makes you most comfortable. In addition, you can send messages to your therapist any time throughout the week and receive a response as soon as they’re available. Studies also indicate the efficacy of online therapy in many cases, suggesting that this method may help reduce symptoms of anxiety and depression and improve quality of life, in addition to often being more cost-effective.
Takeaway
Frequently asked questions
Below are some of the most frequently asked questions about the early signs of autism.
What does autism look like in a one-year-old?
Autism spectrum disorder is a spectrum, so symptoms can be different from one child to the next. However, some basic symptoms in young children around one year old may include a lack of response to their environment, language delays in language milestones, not responding to games from parents, such as peek-a-boo, and early stimming behaviors, such as hand-flapping or rocking back and forth. The child may also not make eye contact with parents or seem to stare off into the distance frequently. These behaviors can also be signs of other developmental disabilities in young children and toddlers in early development. For this reason, meeting with an expert in developmental science, such as a child psychology provider, may help you pinpoint the cause of these symptoms. You can speak to your child’s doctor to potentially get a referral.
At what age is autism first noticed?
Autistic symptoms are generally first noticed in preschool children under age five. Typically developing toddlers excel in spoken and non-verbal communication and have the social skills to interact with family members efficiently. Children with developmental delays tend to show signs early on, such as only using two-word phrases, not speaking at all, or failing to interact with their environment. Some children may lose previously acquired speech around this time, which may confuse parents or caregivers.
If you notice early signs of autism in your child, seek early intervention by meeting with an expert in abnormal child psychology and developmental conditions. Note that diagnosing autism and finding early treatment might not be as accessible for everyone. In addition, symptoms of autism may look different in young girls. Check out multiple sources of information (such as the Centers for Disease Control and Prevention (CDC) and the Autistic Self-Advocacy Network), and consider speaking with a doctor who has experience doing autism diagnostic interviews with multiple groups of children, not only one demographic. Working with a professional with diverse experience may make the difference for your child between early and later diagnosis.
How do you tell if your child has autism?
Your child might be Autistic if they have several symptoms that fall under three categories: delay in social skills, repetitive behaviors, and intense/fixated interests. For example, they may struggle to talk to other children, frequently flap their hands when distressed, and have an intense interest in dogs that takes up most of their time and energy. Not all children have the same symptoms in each category, which is why autism is a spectrum. The best way to know if your child has autism is to get them evaluated by a professional.
What are the red flags for autism?
Below are a few potential warning signs that a child might be Autistic:
- A lack of social interaction
- A lack of eye contact
- Frequent stimming behaviors
- Sensory challenges that are not typical for a child
- Intense interest in a certain topic that takes up a significant amount of their time and energy
- Delayed motor skills (walking, crawling, etc.)
- Higher intelligence than expected for their age group
- Selective mutism or being completely non-verbal and unable to speak
- Lack of fear or anxiety in fearful situations
- Rigidness in one’s routines
- A lack of facial expressions, especially joyful ones
- Not responding to questions or attempts to communicate by others
What is the biggest indicator of autism?
No one indicator of autism is more common in children. Instead, children must meet symptoms from multiple categories, including social challenges, rigid behaviors, and intense interests. Many children with autism also struggle to verbalize words. However, being non-verbal is not a requirement for an autism diagnosis. Many children with autism speak complete sentences, communicate with others, and have rich dialogues. In these children, other symptoms might be more prominent, such as difficulty picking up on social cues, lack of eye contact, and intense interest in their hobbies.
What is the hardest age for autism?
The age at which someone struggles most with symptoms related to autism depends on the individual. Often, children struggle significantly because they are still learning to self-regulate, become independent, and make social connections. In school, Autistic children may be more likely to be bullied, which can be traumatic for them and their families. They may have difficulty making friends, which can cause loneliness. As children learn to be independent, they may rely heavily on their caregivers, which can be difficult for them and their family members, especially if there are communication barriers. Having many accommodations and support systems for both the child and the family can help mitigate this effect.
At what age does autism appear?
Autism is a childhood developmental disorder, meaning it is present from birth and lasts one’s entire life. This condition is not curable and does not develop from external factors like vaccines or physical sickness. Autism is lifelong, and symptoms may change throughout life.
Why is autism so common now?
The increase in autism now is due to better screening and diagnostic tools and increased awareness of what autism looks like in different groups, including young girls and adults, who were previously not diagnosed as frequently. The first autism diagnosis ever was made in the 1940s, so this condition is fairly new to diagnostic manuals and is still being studied.
Is autism curable?
Autism is not curable, as it is a lifelong developmental condition and a form of neurodiversity. Some Autistic people do not see autism as a disability at all, whereas others may not see it as their identity. Whether someone identifies as Autistic or a person with autism is up to them. Still, there is no cure for the condition either way, and attempting to change specific traits in an Autistic person to make them more “neurotypical” can be harmful and lead to trauma.
What is autism caused by?
There is no predetermined singular cause of autism. Some experts believe the condition may arise due to environmental factors or birth difficulties. However, most experts look at the condition as genetic, as many children with autism have other family members with autism. 80% of autism cases tend to be genetic, passed on to a child from their parents.
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