In the September blog post titled “More Than Words”, I introduced the key social communication milestones that infants and toddlers should be exhibiting between 9-16 months. I also shared that if a child is delayed in acquiring these social communication milestones, they may be at risk for developmental delays, including autism spectrum disorder (ASD). But what is autism or ASD? What symptoms or behaviors should you be looking for? What do you do if you have concerns? And why does it even matter? Read on to learn more…
Autism Spectrum Disorder (ASD) is a brain-based, developmental disorder that affects an individual’s ability to relate and socialize with others and to effectively communicate verbally and nonverbally. It is also accompanied by restricted, repetitive patterns of behavior, interests or activities. Symptoms of ASD are typically evident in early childhood, before age three, and it is considered a lifelong diagnosis. However, with appropriate early intervention, many children with ASD do well in school, participate in various activities that they enjoy, and go on to lead productive, inclusive, and fulfilling lives.
Many people recognize some of the more overt, stereotypical behaviors associated with ASD, such as hand flapping or rocking, but when observing young children who may be at risk of ASD, the focus is more often on what they are NOT doing compared to typically developing children, or even those with other developmental delays, versus what behaviors they are exhibiting. Symptoms or behaviors associated with ASD are grouped into two domains: Social Communication/Social Interaction, and Restricted, Repetitive Patterns of Behavior.
Social Communication and Social Interaction
Repetitive Behaviors & Restricted Interests
The American Academy of Pediatrics recommends that all children be screened for ASD at 18 and 24 months of age. But often these screenings are either not being completed, or folks are employing the “wait and see if they grow out of it” mindset. This approach can be detrimental to a child’s development and lead to lifelong challenges.
If you note any of the above red flag behaviors in your child or a child you serve, consider referring them to a diagnostic professional right away. An experienced professional can make a diagnosis of ASD as early as 18 to 24 months of age; but often ASD is not diagnosed until at least 5 years of age or later, after the window of opportunity for very early intervention.
Early diagnosis is critical because the core deficits of ASD – such as deficits in social communication and interaction, restrictive and/or repetitive behaviors or interests – can interfere with a child’s ability to access learning opportunities which may lead to a cascading effect on development. In toddlers we often see an unfolding of symptoms of autism. At 12 months the red flags may be subtle and easy to miss. A toddler may just appear to be quiet and minimally engaged with others in his environment. But because he is not engaged and not paying attention to important information in the learning environment, he may begin to exhibit increasing deficits in social communication and brain development. So that by 2 years of age, he is exhibiting a lot more obvious signs of ASD such as delayed language, limited nonverbal communication, lack of social reciprocity, and repetitive behaviors.
If you have concerns for a child you know, there are a number of resources and services available:
If a child is exhibiting red flags for ASD, or if you think there could be a problem with a child’s development, I urge you to talk with the child’s parents and share your concerns. Don’t wait. Encourage them to talk with their doctor or contact their Area Education Agency (AEA) and pursue early evaluation and intervention. For children younger than three years old, referrals to Early ACCESS can be submitted via the website here. For children three years and older, visit the AEA website here. This sensitive time of brain development is too important to take the “wait and see” approach. We need to change our thinking to “let’s just see” and evaluate any child who might be falling behind so that they can benefit from additional support if needed. We need to ensure that our infants and toddlers have a strong start in life and the support they need to reach their maximum potential.
The Department of Human Services releases the new Mandatory Child Abuse Reporter Training on the Iowa DHS Training website on July 1, 2019.