How to tell if a baby has autism

Signs of autism in children

Autism in young children

Signs of autism in young children include:

not responding to their name
avoiding eye contact
not smiling when you smile at them
getting very upset if they do not like a certain taste, smell or sound
repetitive movements, such as flapping their hands, flicking their fingers or rocking their body
not talking as much as other children
not doing as much pretend play
repeating the same phrases

Autism in older children

Signs of autism in older children include:

not seeming to understand what others are thinking or feeling
unusual speech, such as repeating phrases and talking ‘at’ others
liking a strict daily routine and getting very upset if it changes
having a very keen interest in certain subjects or activities
getting very upset if you ask them to do something
finding it hard to make friends or preferring to be on their own
taking things very literally – for example, they may not understand phrases like "break a leg"
finding it hard to say how they feel

Autism in girls and boys

Autism can sometimes be different in girls and boys.

Autistic girls may:

hide some signs of autism by copying how other children behave and play
withdraw in situations they find difficult
appear to cope better with social situations
show fewer signs of repetitive behaviours

This means autism can be harder to spot in girls.

The National Autistic Society has more information about autistic women and girls.

Non-urgent advice: Get advice if:

you think your child might be autistic

You could speak to:

a GP
a health visitor (for children under 5)
any other health professional your child sees, such as another doctor or therapist
special educational needs (SENCO) staff at your child's school

Getting diagnosed can help your child get any extra support they might need.

Find out how to get diagnosed

Page last reviewed: 11 November 2022
Next review due: 11 November 2025

What are the Early Signs of Autism?

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Many children with autism spectrum disorder (ASD) show developmental differences when they are babies—especially in their social and language skills. Because they usually sit, crawl, and walk on time, less obvious differences in the development of body gestures, pretend play, and social language often go unnoticed.

In addition to speech/language delays and behavioral differences, families may notice differences in the way their child interacts with peers and others.

Recognizing signs of autism

Here are some examples of social, communication, and behavioral differences in children with autism.

Keep in mind: one child with ASD will not have exactly the same symptoms as another child with ASD. The number and severity of symptoms can vary a lot!

Social differences in children with autism

May not keep eye contact or makes little or no eye contact
Shows no or less response to a parent's smile or other facial expressions
May not look at objects or events a parent is looking at or pointing to
May not point to objects or events to get a parent to look at them
Less likely to bring objects of personal interest to show to a parent
Many not have appropriate facial expressions
Has difficulty perceiving what others might be thinking or feeling by looking at their facial expressions
Less likely to show concern (empathy) for others
Has difficulty making and keeping friends

Communication differences in children with autism

Less likely to point at things to indicate needs or share things with others
Says no single words by 15 months or 2-word phrases by 24 months
Repeats exactly what others say without understanding the meaning (often called parroting or echoing)
May not respond to name being called but does respond to other sounds (like a car horn or a cat's meow)
May refers to self as "you" and others as "I" and may mix up pronouns
May show no or less interest in communicating
Less likely to start or continue a conversation
Less likely to use toys or other objects to represent people or real life in pretend play
May have a good rote memory, especially for numbers, letters, songs, TV jingles, or a specific topic
May lose language or other social milestones, usually between the ages of 15 and 24 months (often called regression)

Behavioral differences (repetitive & obsessive behaviors) in children with autism

Rocks, spins, sways, twirls fingers, walks on toes for a long time, or flaps hands (called "stereotypic behavior" or stereotypies)
Likes routines, order, and rituals; has difficulty with change or transition from one activity to another
May be obsessed with a few or unusual activities, doing them repeatedly during the day
Plays with parts of toys instead of the whole toy (e. g., spinning the wheels of a toy truck)
May not cry if in pain or seem to have any fear
May be very sensitive or not sensitive at all to smells, sounds, lights, textures, and touch
May have unusual use of vision or gaze—looks at objects from unusual angles

How to distinguish a child with autism from other typically developing children

Here are some examples that may help a parent tell the difference between normal, age-appropriate behavior and early signs of ASD. Also see When Not to Worry About Autism.

At 12 Months

A child with typical development will turn their head when they hear their name.
A child with ASD might not turn to look, even after their name is repeated several times, but will respond to other sounds.

At 18 Months

A child with delayed speech skills will point, gesture, or use facial expressions to make up for their lack of talking.
A child with ASD might make no attempt to compensate for delayed speech or might limit speech to repeating what they hear on TV or what they just heard.

At 24 Months

A child with typical development brings a picture to show their mother and shares their joy from it with her.
A child with ASD might bring their mom bottle of bubbles to open, but they do not look at her face when they do or share in the pleasure of playing together.

More information

How Pediatricians Screen for Autism
Milestones Matter: 10 to Watch for by Age 5
How to Raise Concerns about a Child's Speech and Language
What is Early Intervention?
Language Delays In Toddlers: Information for Parents
Learn the Signs. Act Early (CDC. gov) - Aims to improve early identification of children with autism and other developmental disabilities so children and families can get the services and support they need.

Last Updated: 4/1/2021

Source: American Academy of Pediatrics (Copyright © 2021)

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

"Children of the rain". What you need to know about autism

11 April 2019 12:01

Behind the poetic expression "children of the rain" lies the daily feat of people who are faced with a diagnosis of autism. Children who will never be able to perceive themselves as part of the world around them, and parents for whom every day is a series of battles and victories. First, fighting with yourself, accepting and realizing that their child will never be cured, and then fighting the disease for every gesture, every smile, every look and word of the child - small, but such important victories.

Scientists have not been able to reliably establish the causes of the disease. It is known about the genetic predisposition: signs of autism are more often manifested in people whose family already has an autistic person. Pregnancy in mothers of such children proceeds normally, and the children themselves are often very attractive in appearance - autism, as a rule, does not affect the physical development of the child. However, the development of autism is still in some cases associated with the manifestation of other diseases:

cerebral palsy;
maternal rubella infection during pregnancy;
tuberous sclerosis;
impaired fat metabolism (the risk of having a baby with autism is greater in obese women).

All of these conditions can have a bad effect on the brain and, as a result, provoke symptoms of autism. However, what autism is, and what are the causes of its manifestation, is still not completely clear.

Early diagnosis plays an important role in the further development of an autistic child. Autism in children is manifested by certain signs. Early childhood autism is a condition that can manifest itself in children at a very early age - both at 1 year old and at 2 years old. What is autism in a child, and whether this disease occurs, is determined by a specialist. But you can independently figure out what kind of illness a child has and suspect him, based on information about the signs of such a condition.

Early signs of autism in a child

This syndrome is characterized by 4 main signs. In children with this disease, they can be determined to varying degrees.

Signs of autism in children are as follows:

impaired social interaction;
broken communication;
stereotyped behaviour;
early symptoms of childhood autism in children under 3 years of age.

The first signs of autistic children can be expressed as early as the age of 2 years. Symptoms may be mild when eye-to-eye contact is impaired, or more severe when it is completely absent. As a rule, autism manifests itself very early - even before the age of 1, parents can recognize it. In the first months, such children are less mobile, react inadequately to stimuli from the outside, they have poor facial expressions.

The child cannot perceive a holistic image of a person who is trying to communicate with him. Even in the photo and video, you can recognize that such a baby's facial expressions do not correspond to the current situation. He does not smile when someone tries to amuse him, but he can laugh when the reason for this is not clear to anyone close to him. The face of such a baby is mask-like, grimaces periodically appear on it.

Baby uses gestures only to indicate needs. As a rule, even in children under one year old, interest is sharply shown if they see an interesting object - the baby laughs, points with a finger, and demonstrates joyful behavior. The first signs in children under 1 year old can be suspected if the child does not behave like this. Symptoms of autism in children under one year old are manifested by the fact that they use a certain gesture, wanting to get something, but do not seek to capture the attention of their parents by including them in their game.

An autistic person cannot understand other people's emotions. How this symptom manifests itself in a child can be traced already at an early age. If ordinary children have a brain designed in such a way that they can easily determine when they look at other people, they are upset, cheerful or scared, then an autistic person is not capable of this.

The child is not interested in peers. Already at the age of 2, ordinary children strive for company - to play, to get acquainted with their peers. Signs of autism in children of 2 years old are expressed by the fact that such a baby does not participate in games, but plunges into his own world. Those who want to know how to recognize a child 2 years old and older should simply look at the company of children: an autist is always alone and does not pay attention to others or perceives them as inanimate objects.

It is difficult for a child to play with imagination and social roles. Children 3 years old and even younger play, fantasizing and inventing role-playing games. In autistics, symptoms at 3 years old may be expressed by the fact that they do not understand what a social role in the game is, and do not perceive toys as integral objects. For example, signs of autism in a child of 3 years old can be expressed by the fact that the baby spins the wheel of a car for hours or repeats other actions.

Child does not respond to emotions and communication from parents. Previously, it was believed that such children are not emotionally attached to their parents at all. But now scientists have proven that when a mother leaves, such a child at 4 years old and even earlier shows anxiety. If family members are around, he looks less obsessed. However, in autism, signs in children of 4 years old are expressed by a lack of reaction to the fact that parents are absent. The autist shows anxiety, but he does not try to return his parents.

In children under 5 years of age and later, there is a delay in speech or its complete absence (mutism). The speech is incoherent, the child repeats the same phrases, devoid of meaning, speaks of himself in the third person. He does not respond to other people's speech either. When the “age of questions” comes, parents will not hear them from the baby, and if they do, then these questions will be monotonous and without practical significance.

Stereotyped behavior includes obsession with one activity, repetition of daily rituals, development of fears and obsessions. At the same time, if the sequence of the ritual is violated, the child becomes hysterical or may show aggression or self-aggression.

Can autism be cured and is it curable at all? Unfortunately, there is no cure. How you can help your child depends on each individual case. Drug treatment is prescribed only in case of destructive behavior of a small patient. But, despite the fact that the disease is not curable, it is possible to correct the situation. The best "treatment" in this case is regular practice every day and the creation of the most favorable environment for the autistic. Classes are held in stages:

To form the skills that are needed for training. If the child does not make contact, gradually establish it, not forgetting who it is - autistics. Gradually it is necessary to develop at least the rudiments of speech.
Eliminate forms of behavior that are non-constructive: aggression, self-aggression, fears, withdrawing into oneself, etc.
Learn to observe, imitate.
Teaching social games and roles.
Learn to make emotional contact.

The most common treatment for autism is practiced according to the principles of behaviorism (behavioral psychology). One of the subtypes of such therapy is ABA therapy. The basis of this treatment is to observe what the reactions and behavior of the baby look like. After all the features are studied, incentives are selected for a particular autist. Speech therapy practice is obligatory: if the kid regularly works with a speech therapist, his intonation and pronunciation are getting better. At home, parents help the child develop self-service and socialization skills. Since autists have no motivation to play, they get used to the daily routine, everyday affairs, cards are created where the order of performing this or that action is written or drawn.

Why is early diagnosis important? There are conditions that mimic autism that can be confused with its symptoms. But other methods are used to correct them.

ZPRR with autistic features

The symptoms of this disease are associated with a delay in psychoverbal development. They are in many ways similar to the signs of autism. Starting from a very early age, the baby does not develop in terms of speech in the way that existing norms suggest. In the first months of life, he does not babble, then he does not learn to speak simple words. At 2-3 years old, his vocabulary is very poor. Such children are often poorly developed physically, sometimes hyperactive. The final diagnosis is made by the doctor. It is important to visit a psychiatrist, speech therapist with the child.

Attention deficit hyperactivity disorder

This condition is also often mistaken for autism. With a lack of attention, children are restless, it is difficult for them to study at school. There are problems with concentration, such children are very mobile. Even in adulthood, echoes of this state remain, because it is difficult for such people to remember information and make decisions. You should try to diagnose this condition as early as possible, practice treatment with psychostimulants and sedative drugs, and visit a psychologist.

Hearing loss

These are various hearing impairments, both congenital and acquired. Hearing-impaired children also have speech delays. Therefore, such children do not respond well to the name, fulfill requests and may seem naughty. At the same time, parents may suspect autism in children. But a professional psychiatrist will definitely send the baby for an examination of auditory function.

Hearing aid helps solve problems.

Schizophrenia

Autism was previously considered one of the manifestations of schizophrenia in children. However, it is now clear that these are two completely different diseases. Schizophrenia in children begins later - at 5-7 years. The symptoms of this disease appear gradually. Such children have obsessive fears, talk to themselves, later delusions and hallucinations appear. This condition is treated with medication.

It is important to understand that autism is not a death sentence. Indeed, with proper care, the earliest correction of autism and support from specialists and parents, such a baby can fully live, learn and find happiness, becoming an adult.

How to understand if your child has autism: six tips for parents

Elena Vladimirovna, parents of babies are most afraid of something that might happen to their child? Suddenly autism? How to recognize it?

Elena Orekhova: Autism is now diagnosed solely by behavior. Before the age of one, it is almost impossible to say with certainty whether a child has autism. Until that time, a small child can behave in exactly the same way as all other babies, look into the eyes, react to people. Scientists in the West are doing research trying to understand what are the earliest signs of autism. Parents who already have older children diagnosed with autism are invited to participate in such studies. The risk of autism in younger children in such families is increased, which gives scientists the opportunity to trace the early development of children with this diagnosis. At one time I worked in London in one of the laboratories where such research was carried out. There have been suggestions that children with autism do not need to communicate from birth. But it turned out that this was not the case. At three months, they looked into the eyes of another person even more than ordinary babies. As I got older, eye contact became less and less.

What signs will tell moms and dads that something is wrong with a child?

Elena Orekhova:

1. An important feature: speech delay, which is observed in almost all children with autism. Before a year, a child should be babbling, after a year he says separate words, a little later - sentences. If none of this is present before the age of two, it is not necessarily autism, but there is cause for concern. Most children with autism, although late, begin to speak, but their intonation suffers.

2. Ordinary children raise or lower their tone to emphasize what is being said, while children with autism are often perceived as strange: they either speak monotonously or place accents incorrectly in speech. At the MEG Center, we recently conducted a study in which we found that the left 'verbal' hemisphere of children with autism processes complex sounds differently from normal children. Now we want to find out how this disorder affects the development of speech. We invite both families of children with autism and children with typical development to participate in our study.

3. Another early sign of autism, oddly enough, is the suspicion of deafness. Parents often think that their child has a hearing impairment. They turn to him: "Kolya! Petya! Look ..." But he does not react. In a recent study conducted at the MEG Center, we found that half of the parents of autistic children during the first year and a half of life suspected that the child was not all right with hearing. In fact, his hearing is all right. But he does not respond, because he is completely immersed in the occupation that interests him.

Excuse me, but if a bucket falls with a roar next to an autistic child, will he react to this noise?

Elena Orekhova: Maybe yes, maybe no. These children often react in atypical ways to their environment.

4. The child may be annoyed by a slight noise outside the window, a light touch, a bright light. At the same time, he may not react to the roar, be insensitive to pain.

5. Another hint to parents: it is difficult for a child to ask you for something. Let's say he needs a pencil. He can take your hand and use it to try to get a pencil.

6. An autistic child does not have a pointing gesture. He won't point his finger at his favorite toy and ask for it.

It still happens that mothers in maternity hospitals are sometimes advised: abandon the child, he will not even recognize you. Does a child with autism understand that he has significant adults - parents, does he feel affection for them?

Elena Orekhova: Yes, the child is attached to his parents. He will feel sorry for his mother, because she is in pain, but it is difficult for him to understand feelings of a "higher order" - resentment, insult.

Can a child with autism be sent to a regular school?

Elena Orekhova: Such children often have sensory problems - the school environment can be simply unbearable for them. Flickering, screaming, noise, fuss: all this can cause a lot of stress, not at all contributing to normal learning. To calm down, the child may want to plug his ears, crawl under the desk.

Another problem is the unpredictability of the environment. For a child with autism, it is important that he knows what follows what and in what order. If the daily routine or sequence of events is disturbed in an unpredictable way, this also causes stress. Being among people is also difficult for them because people are often unpredictable. It is difficult for such children to understand the school rules, and they may not behave as the teacher wants. Maybe parents are pleased when such a child goes to a regular school, but, in the final analysis, one must also think about the child himself, create sparing conditions for him. Although, of course, everything is individual. Some children with autism and good speech and cognitive abilities (formerly known as Asperger's syndrome) can go to a regular school. But you need to carefully monitor how the child feels at school. Often such children can be not only uncommunicative, but also clumsy, becoming the object of ridicule and bullying from classmates.

Children are cruel... And not only to special peers

Elena Orekhova: It is necessary to tell schoolchildren that people are different and that this is normal. In Sweden, for example, ordinary schools hold lessons where children are offered to try to ride in a wheelchair, read Braille texts for the blind, and learn some words in the language of the deaf and dumb. They are told that there are people with special needs and that everyone should be treated with respect and no one should be offended. At the same time, correctional classes and schools have been preserved there. And in Sweden, the diagnosis of autism is by no means a sentence. There was a case in Gothenburg when a girl graduated from a technical university, then a medical one, and got a job in an ambulance as a doctor.

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