Did you know that early signs of autism spectrum disorder (ASD) can show up in toddlers as young as 12 months old? With this knowledge in hand, parents and caregivers can look out for specific behaviors and missed milestones and get your child the help they need to learn, grow and thrive.
“‘We just knew something was different,’
— that’s a sentiment we hear all too often from parents,” says Ann Baloski, founder and CEO of BehaviorWorks ABA in Indianapolis. Learning to recognize the early markers of ASD can be a challenge, but it’s important for early intervention.
For instance, a lack of babbling or language development (very few or no words by 16 months, or very few or no meaningful two-word phrases by 24 months) can be one sign. Not making eye contact or turning toward the person speaking is another marker. Also, if the child doesn’t point at people or objects, imitate sounds or movements, or has little to no response if their name is called, these are some other behaviors to watch out for. Children with ASD may also become upset by slight changes in routine, or be more sensitive than others to sensory input such as light, noise, clothing or temperature.
“Some parents have reported noticing symptoms as early as the first few months of age,” Baloski adds. “Although not all children will display signs or symptoms this early, some children may not show symptoms until 24 to 36 months of age.”
Dr. Casey Nelson, PsyD, HSPP, the clinical psychologist with BehaviorWorks ABA, recommends looking at the child’s social behaviors with caregivers and other children. Are they interested in other people, smiling, waving, and babbling? These are generally positive signs.
“Does the child only want to play with one toy in one specific way?” Nelson asks. “Repetitive patterns of behavior can be a hallmark sign of ASD. Parents often report behaviors like rocking or body posturing and restricted interest in toys or activities.”
In addition to repetitive behaviors, parents can keep an eye out for maladaptive behaviors — including tantrums, hitting, kicking, or screaming — that fall outside of the child’s expected typical development, explains Jennifer Lanham, M.A., board certified behavior analyst and president of Circle City ABA. Not all children with autism show all the signs, and many children who don’t have autism will show a few. That’s why professional evaluation is crucial.
Testing and Diagnosis
An autism diagnosis may be received as early as 18 months, yet the average age of diagnosis in the U.S. is around 4 years. “Early diagnosis and treatment of ASD is imperative to achieve the highest level of independence and quality of living,” Lanham says. When a parent suspects a child may have key indicators of ASD, a first step is to contact their primary care physician for a complete check-up to rule out other medical concerns.
According to Lanham, the gold standard of testing for ASD is the Autism Diagnostic Observation Schedule (ADOS-3), paired with the Autism Diagnostic Interview-Revised (ADI-R). If a diagnosis is received, the parent can ask for a therapy referral.
Children with ASD can benefit greatly from Applied Behavior Analysis (ABA) therapy. “ABA works with the child and family to build skills needed to fill in gaps in learning, while reducing or replacing behaviors that are not appropriate,” Lanham says. One reason why ABA therapy is so crucial for children with autism is that it provides a framework for learning emotional regulation skills.
Children who receive support earlier often have much better outcomes, according to Baloski. “For example, if tantrums result in caregivers offering up multiple solutions (favorite blanket, toy or drink), then tantrums will be the path that becomes stronger.” But with early intervention, the child learns new skills little by little, their neural pathways are strengthened, and the child learns to ask for the blanket, toy or drink in a way that caregivers understand.
ABA therapy can also help parents learn new ways to help provide the structure and security children with ASD need to thrive. In ABA therapy, parents can learn to:
- Be consistent.
- Stick to a schedule.
- Reward good behavior.
- Create a home safety zone.
- Look for nonverbal cues.
- Figure out the motivation behind the tantrum.
- Make time for fun.
- Pay attention to your child’s sensory sensitivities.
ABA therapy can take place in a variety of settings. For example, BehaviorWorks ABA offers therapy in the clinic, in schools, and in-home. “Each environment has different advantages, but regardless of the environment, the therapy service is the same,” Baloski says.
Baloski encourages parents to be fearless in seeking support for their child. “A parent is a child’s best advocate — do not hesitate to explain the challenges you are having with your child,” she says. “As a BCBA with 20 years of experience, I wish I could say I have heard it all. Try to reduce fear and stigma. It is also so important to celebrate their differences.”
Dr. Nelson also recommends that the parents of children with ASD remember to take care of themselves. “Self-care is important,” Nelson says. “Parenting a child with ASD can be difficult, leading to increased stress. When we don’t deal with the stress in our lives over time, increased stress can take a toll on our physical and mental health.”
Connecting with other parents who are facing similar challenges can be a helpful way to combat stress. Organizations like Autism Speaks (www.autismspeaks.org) or Help Guide (www.helpguide.org) are good places to find out more about ASD, find additional resources and connect with other parents.