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Recognize autism in 5 steps

By: Sarah Watts for Nemours Children’s Health System
There are five common behavioral symptoms that can help parents determine whether an autism evaluation may be appropriate for their child.

This story is produced and presented by our advertiser Nemours.

In the mid-1940s, doctors in the United States identified a disorder called autism, a term they used to classify children who had difficulty speaking or interacting with others. A relative rarity in the 1940s, today more than one in 68 individuals in the United States is diagnosed with what is now termed Autism Spectrum Disorder, or ASD.

ASD is a life-long, neurological condition characterized by social and communication deficits, restricted interests and repetitive behaviors. As the name suggests, individuals with ASD function on a wide spectrum: While some who have autism may be nonverbal or completely withdrawn, others can complete college and hold steady jobs with only a few noticeable symptoms.

Because the autism spectrum is so wide, and because autism looks different for each person, parents may have trouble identifying the signs of autism in their own children. Below are five common behavioral symptoms that can tell parents whether an autism evaluation is appropriate. If you notice signs of ASD in your child, Nemours Children’s Health System can help connect you with the right testing, too.

Pay attention to your child’s developmental milestones. Anything outside of the typical range may be a sign of autism

Your baby isn't meeting developmental milestones.

One classic symptom of ASD is when a child meets developmental milestones outside of the typical range – if at all.

“Development doesn't happen in lockstep,” said Dr. Diane Treadwell-Deering, Director of the Swank Autism Center at Nemours Alfred I. duPont Hospital for Children. “You don't immediately sit up at nine months or start walking at 15 months. There's this range that makes it difficult for parents to figure out what's normal and what's not normal.”

Parents should watch for cooing and babbling by six months and two-word phrases by 24 months. “If kids have normal hearing and don't start to talk by age two, that's a possible red flag for autism,” added Treadwell-Deering.

Your baby makes a lot of repetitive sounds or movements.

Not all repetitive movements are bad, explained Treadwell-Deering. But if your baby spends an inordinate amount of time flapping his or her hands, spinning in circles, or rocking back and forth, that could be cause for concern. “It's a sense of how much of the time your child is doing the same thing, versus whether he's doing other things as well,” Treadwell-Deering said. “Dropping food off the high chair and having mom pick it up is a normal repetitive thing. But if that activity takes up 90 percent of your kid’s time, that's not normal.”

What's also key, added Treadwell-Deering, is whether there's social interaction involved with repetitive movements. “You might see a baby doing peekaboo, and they're using eye contact, bursting into a smile – that's very social,” she described. “A kid on the spectrum might do the repetitive stuff, but not have the social piece to go with it.”

Most children on the spectrum tend to have difficulty engaging with other people.

Your child isn't engaging with other people.

Despite their level of function, most individuals on the spectrum have difficulty relating to and interacting with other people. A child on the spectrum can lack the interest – or ability – to connect to people outside him or herself.

“I always think of a baby in a stroller, and he sees an airplane in the sky and points to show his parents,” said Treadwell-Deering. “They may not be saying 'look at that,' but the intent of that communication is to show them something. That's a social engagement, and it's not often happening in a kid with autism.”

In small babies, signs of social engagement are trying to catch others' attention and responding to their own name.

Your older child doesn't understand language the way other children can.

Plenty of children with ASD are able to speak – but they might have more subtle difficulties where language is concerned. “People who don't have an intellectual delay and can use language often have difficulty with the part of language like irony, sarcasm, figures of speech and other social uses of language,” said Treadwell-Deering. “They may not be good with the 'give and take' of conversations, or may not be able to use the social niceties in a conversation, whereas the rest of us can develop that as we learn language.”

Treadwell-Deering likens language difficulty in people with ASD to colorblindness, as they are simply unable to see the same nuances in language that children not on the spectrum can. “A higher-functioning person on the spectrum might be able to tell you the rules of language, but can't apply them himself.” 

Your older child understands language, but is extremely logical or rigid.

“Oftentimes, kids on the spectrum are not very compliant kiddos,” explained Treadwell-Deering. “A lot of how we interact is around social connectedness, and that motivates us to change and control our behavior.” A child with ASD, however, may not be motivated to change his or her behavior by a kind smile or other social rewards.

“A higher functioning kid with autism has the ability to do school work, but might not want to, even if it makes the teacher or the parents happy,” Treadwell-Deering said. “They don't want to do the homework because they know how to do the math already, and there's a kind of logic to that. But they have a harder time looking at someone else's logic.”

Do you need help finding the right testing for your child? If you suspect symptoms of autism, contact Nemours Children’s Health System for more information.[

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