A diagnosis of autism, or Autism Spectrum Disorder (ASD) usually occurs before a child is age 3. Because an ASD diagnosis is based on observation of behavior, not on a medical test, it is important that parents and caregivers be aware of early signs of autism in order to secure an early diagnosis and treatment, if warranted.
One of the main impairments of people with ASDs is social impairment. This goes beyond just “shyness” and is often combined with other problems, like trouble with communication skills. By age 3, normally developing children should be able to verbalize a range of emotions, and to be largely understood by strangers. People with ASDs may not be interested in other people at all, or have trouble interacting with peers or imitating others. Although it is hard for all children to learn to take turns and to share, children with ASDs have a particularly difficult time with this concept.
By age 4, a normally developing child has experienced a lot of growth in social skills: cooperation and conflict resolution have developed, and language use has developed to the point that children can be easily understood by others. However, children with ASDs exhibit language delays. While some children with ASDs my have only slight delays, about 40% of children with ASDs do not speak at all. Others may have some words and then lose them, or not speak until later in childhood. Some people with ASDs may repeat the same words over and over, and have a hard time understanding body language or tone of voice. They may not be able to participate in a give-and-take conversation, instead talking a great deal about things that interest them.
While normally developing children at ages 3 to 4 can run, kick a ball, climb, and walk forward and backward, those with ASDs may exhibit repetitive motions, such as rocking side to side, flapping the arms, or repeatedly turning a light off and on. Some children with ASDs develop unusual routines, like having to look in every window of a building, and being unable to do these things will elicit frustration. A change in routine can be very upsetting to children with ASDs.
While patterns of development vary somewhat from child to child, children with ASDs develop at different rates; some have delays in language, others with social development. Some may be very good at solving problems, but have trouble making friends.
Some “red flags” for ASDs include not playing “pretend” games; not pointing at objects; having trouble relating to others and avoiding eye contact; appearing unaware when spoken to; repeating or echoing phrases or words; repeating actions over and over; having trouble accepting change in routine; and losing skills once obtained (for instance, ceasing to say words already learned).
If you are concerned that your child exhibits signs of an ASD, your first step should be to schedule an appointment with your pediatrician to address your concerns. He or she may refer you to a specialist who can make additional assessments. Autism is treatable, but, as with any disorder, the sooner you can get a diagnosis and treatment, the better.