Autism and Early Warning Signs

Thank you Dr. Connolly for this wonderful Guest Post for Autism Awareness Month!

Autism and Early Warning Signs

April is widely recognized as Autism Awareness Month here in the US. As the month draws to a close,
it is a good time for a few reminders about what the condition is and how it can be detected as early as
possible, giving children the best possible chance at a positive outcome.

What Is Autism?

Autism is a complex neurodevelopmental disorder. Research suggests that children with autism have
measurable differences in the structure and function of their brains that affect several different areas of
their development.

While every child with an autism spectrum disorder has a unique pattern of individual strengths and
weaknesses, certain signs are often seen across children with autism spectrum disorders. Children with
autism often have problems and delays in these areas:

Delays in communication and spoken language

May begin talking much later than their peers or may not talk at all.
Children who do develop adequate speech may have difficulty starting and carrying out a
conversation with others.
May use words or phrases in a repetitive manner, such as repeating phrases from television
shows or commercials over and over.
May have difficulty with imaginary play or pretend games.

Delays in social development

May have difficulty using nonverbal cues (e.g. gestures, facial expressions, eye contact) to
help communicate with others.
May have difficulty with responding appropriately to others' attempts to engage them in
social interactions. Or, the child may have difficulty demonstrating empathy toward or
understanding of others' emotional responses.
May not be interested in other children his/her age or may struggle with forming
friendships.
May not seek out others to share interests or enjoyment.

Repetitive and stereotyped behaviors

May display repetitive motor mannerisms, such as hand-flapping or rocking.
May become preoccupied with parts of objects.
May show unusual insistence on particular routines, especially routines that seem to serve
no specific purpose. Children with this symptom may have specific ways that they like to do
things, such as taking a particular route to school or needing to eat food items in a particular
order. They often become highly distressed and agitated when the routine is disrupted.
May have an unusual preoccupation with a particular topic of interest. The interest is
usually abnormally intense or may focus on a subject that is not a typical area of interest
for children (e.g. an 8 year old showing a preoccupation with memorizing stock market
symbols).

Additionally, many children on the autism spectrum show significant sensitivity to different kinds
of sensory input. They are often bothered by certain kinds of stimulation, such as bright lights, loud
noises, or uncomfortable or unpleasant textures in food or clothing.

Rates of Autism

According to data released by the CDC in 2012, the estimated prevalence rate of autism in America
is 1 out of 88 children. This number includes both children diagnosed with autism and other autism
spectrum disorders, such as Asperger's disorder.

Even more concerning are the statistics on the average age of diagnosis for autism spectrum disorders.
According to the CDC numbers, the average age for a first autism diagnosis is 4 and the average age of
a first Asperger's disorder diagnosis is 7. While professionals are becoming more skilled at identifying
children with autism earlier, many children still go undetected during important early learning periods.

Early Warning Signs

In recent years, researchers have identified several early warning signs associated with autism.
Certainly, some children who show these signs never develop an autism spectrum disorder. However,
if you are noticing these signs, it is important to have your child fully evaluated to determine whether
early intervention is needed.

Early warning signs by age:

6 Months
• No smiles or bright, joyous expressions

9 Months
• No back and forth sharing of smiles or warm expressions

12 Months
• No response to calling his/her name
• No babbling, cooing, or attempts to imitate sounds
• No use of gestures to communicate, such as pointing, waving, showing or reaching

16 Months
• No spoken words

24 Months
• No spontaneous two-word phrases

In addition to these signs, children who later develop an autism spectrum disorder may have trouble
with making and maintaining eye contact as a baby or toddler. They may also have trouble visually
following objects or shifting their gaze to look at something when it is pointed out to them.

Some children also have a significant regression in their skill development. If your child loses any
language or social skills, it is important to have him/her evaluated as soon as possible.

Where to Seek Help

If you are concerned that your child is showing early warning signs of an autism spectrum disorder,
listen to your instinct and have your child evaluated. As a parent, you are the world's biggest expert on
your child's behavior, and you are your child's best advocate.

There are several options for investigating your concerns:

1. Talk with your child's pediatrician. Your pediatrician is usually best positioned to assess your
concerns and give recommendations for further evaluation.

2. Seek out a child psychologist or other developmental specialist who can help evaluate your
child and provide guidance.

3. Contact an information or referral service in your area to find out about local early intervention
services. In many areas, you can dial 211 from your home phone for information and referrals.

There are also several websites with helpful referral information:

http://www.autismva.org/ - The Commonwealth Autism Service, located in Richmond,
VA, provides links to resources and providers across the state of Virginia.

http://www.autism-society.org/ - The Autism Society of America maintains a
nationwide information and referral service to connect families with resources in their
communities.

Sometimes obtaining an evaluation can be a lengthy process. If you find yourself feeling discouraged,
remember that the process is difficult for everyone. The earlier the diagnosis and treatment are
obtained, the better the outcomes are for the child. The helpguide.org website also has resources for
parents and suggestions for things you can do while waiting for an evaluation and official diagnosis -
http://www.helpguide.org/mental/autism_help.htm.

Bio

Nicole Connolly, Ph.D. is a licensed clinical psychologist in Santa Clarita, California. After obtaining
her Ph.D. from UCLA, Dr. Connolly completed a postdoctoral fellowship in autism spectrum disorders
at the Help Group in Sherman Oaks, California. She currently operates a small private practice in
Santa Clarita, specializing in working with individuals with high functioning autism and Asperger's
disorder.

In addition to providing direct services to individuals and families, she also blogs regularly on
topics related to mental health, parenting, and relationships on her practice website at http://
drnicoleconnolly.com. You can follow her blog at http://drnicoleconnolly.com/news or follow her on
Twitter (@DrNConnolly).