Medically Reviewed By Sonam Kothari, Written By Tejasvi Parekh
Observing a baby grow is a remarkable experience, filled with many memorable moments. Although each child develops at a unique pace, missing certain developmental milestones can be a cause for concern and may indicate autism spectrum disorder (ASD).
Signs of autism can sometimes be noticed as early as 6 to 12 months, and in some rare instances, even in newborns. It is crucial to recognise these early signs because timely diagnosis is essential for effective management of the condition.
The Centers for Disease Control and Prevention (CDC)Trusted Source reports that most parents with autistic children notice some signs within the first year, and 80 to 90 per cent observe developmental differences by the time their child is 2 years old.
Typically, early indicators of autism manifest within the first two years of life. While some children may exhibit numerous signs, others might show only a few.
The number and type of signs can vary significantly depending on the child's age and developmental stage. Over time, these signs might change or become more apparent as the child grows older.
Identifying early signs of autism can help in seeking appropriate interventions, which can significantly impact the child's development and quality of life.
Being attentive to a child’s developmental progress and consulting healthcare professionals if there are concerns can ensure that any necessary support is provided promptly.
Autism can sometimes go undetected in childhood, with a diagnosis only emerging in adulthood. Children with mild autism may exhibit subtle neurodivergent behaviours that blend in with typical actions, often perceived as mere personality traits. While some caregivers might notice unusual behaviours, these may not lead to an immediate diagnosis.
Signs of autism can be evident from infancy and may become more pronounced with age. Early intervention is generally more effective, underscoring the importance of parents, guardians, and caregivers monitoring developmental milestones.
To facilitate understanding, here is a timeline of early autism signs:
From Birth: A child may struggle to maintain eye contact or avoid it altogether.
By 6 months: The child might not show engaging expressions, smiles, or emotions.
By 9 months: There could be limited or absent reciprocal exchanges of sounds, smiles, or facial expressions. The child’s facial expressions might not reflect emotions like anger, joy, or surprise. Additionally, the child may not respond to their name.
By 12 months: The child may focus more on inanimate objects than people and not participate in interactive games like peek-a-boo or pat-a-cake. Common gestures for communication, such as pointing, waving, or reaching out, might be absent. Language skills may develop but then decline.
At this age, babbling might be absent or not conversational. The child may not smile back when smiled at.
By 15 months: The child might not share interests with others, such as showing a favourite toy or sharing with peers. They may struggle to understand simple instructions.
By 18 months: The child might appear unresponsive when spoken to directly and may speak few to no words. They might not engage in pretend play, like playing house or having a tea party, and might have unusual ways of playing with toys. Pointing at things or following others' points may be absent.
By 24 months: The child might fixate on specific topics or objects and repeat words or phrases without understanding them. They may use few or no meaningful words or phrases.
Social isolation and self-injurious behaviours, like head-banging, might occur. The child may not show interest in playing or engaging with peers, preferring routines and consistency, such as specific shapes for food or a strict bedtime ritual.
Recognising these signs and seeking early intervention can significantly affect the child's development and overall well-being.
During the first year of life, observing a child's social interaction and communication development is crucial for identifying early signs of autism. Typical developmental milestones in this area include responding to their name, making eye contact, and using gestures to communicate.
Autistic children might show variations in these behaviours. For instance, they may not consistently use eye contact to capture attention. A child might not look at you and then at a desired snack to indicate they want it or may fail to look back at you when they see something exciting.
Additionally, they might seldom point to or hold up objects to share interest. For example, they may not point to a dog and check to see if you noticed it or might drop a toy in your lap and walk away rather than show it to you and seek your reaction.
Consistent responses to their name might also be lacking. Autistic children often do not use gestures independently, such as waving goodbye, clapping, nodding for yes, or shaking their head for no, without prompting. Smiling back at familiar faces might also be infrequent.
They might rarely mimic actions, such as combing their hair when you comb yours. Their babbling may not mimic conversational patterns, or they might not babble at all. Understanding simple instructions, like "Give me the block" or "Show me the dog," can be challenging for autistic children by the time they are one to two years old.
Eye contact is another important marker. Babies usually start making eye contact from a very young age, and by two months, they can locate faces and maintain eye contact proficiently. This behaviour is foundational for building social connections and understanding their environment.
However, research indicates that babies who later develop autism begin to make less eye contact around two months of age. This reduction in eye contact might serve as an early indicator of autism.
Recognizing these signs early can be pivotal in seeking timely interventions, which can significantly impact the child's social and communication development.
A significant developmental difference between children with autism spectrum disorder (ASD) and those without is the delay or absence of joint attention. This skill is often delayed in most children with ASD.
Joint attention involves shifting focus between an object or event and another person, thereby creating a shared connection. This ability is crucial as it lays the groundwork for future social and communication skills.
Reciprocal social interaction, characterized by a series of exchanges involving emotional expressions, sounds, and gestures, is built upon joint attention.
Joint attention develops in stages during infancy and toddlerhood, with children on the autism spectrum often displaying delays or deficits in these social communication skills at each stage.
For instance, babies typically start using and understanding gestures at specific ages, whereas children with autism may show marked differences.
By around six months, babies begin using eye contact to communicate, such as looking at a caregiver and then at a toy to express interest. In contrast, an autistic child might not use eye contact consistently to share their focus.
By nine months, infants usually point to objects and look back at their caregiver to ensure shared interest. However, children with autism might rarely point or fail to check if the caregiver is also engaged.
By twelve months, toddlers commonly hold up objects to show others, inviting shared experiences. An autistic child might simply drop a toy in someone’s lap and walk away, rather than holding it up and making eye contact.
By eighteen months, typical children engage in more complex reciprocal interactions, like following a caregiver’s gaze or pointing, while autistic children may struggle significantly with these back-and-forth exchanges.
Gesturing is one of the earliest forms of communication, typically developing before speech. However, autistic children generally point and gesture significantly less than children without autism. This reduced use of gestures can sometimes indicate a potential language delay.
Children on the autism spectrum often exhibit delays in both nonverbal communication and spoken language. These differences can manifest in various ways.
One notable aspect is the use of labels. While autistic children might use words to label objects, they may not use them to make requests. They often learn words for objects before they start using words for people or family members, which differs from typical language development patterns.
Another characteristic is echoing and repeating. While many young children go through a phase of repeating what they hear, those on the autism spectrum may continue this behaviour for a longer period.
They might echo dialogue from movies or conversations, often mimicking the exact tone and inflexion they originally heard. This phenomenon is known as parroting or echolalia.
Interestingly, some children who are later diagnosed with autism may appear to meet early language milestones. However, their language use can be peculiar. For instance, they might speak with an adult-like sophistication rather than using typical toddler speech patterns.
These language differences highlight the unique ways in which autistic children develop communication skills. Understanding and recognizing these signs can lead to earlier diagnosis and intervention, which are crucial for supporting their development.
Regression, where an infant or toddler loses previously acquired skills and abilities, can be a sign of autism and is often a deeply distressing experience for parents and caregivers. The reasons behind regression remain a mystery, with no established links to childhood experiences, illnesses, or medications.
Research indicates that up to one-third of autistic children experience skill loss after infancy and before preschool. Most commonly, this regression involves language skills, with around 94 per cent of affected children losing their ability to babble, make eye contact, gesture, and engage in other social behaviours. If a child stops displaying these abilities as a toddler, it is crucial to discuss these changes with the paediatrician.
Approximately 25 percent of children later diagnosed with autism spectrum disorder may initially develop language skills, only to suddenly or gradually stop using them. This typically occurs between 15 and 24 months of age. Alongside the loss of language, these children might also become more socially withdrawn, a phenomenon referred to as regression in skills.
Witnessing a child regress can be particularly challenging, emphasizing the importance of early observation and intervention. By monitoring these changes closely and seeking professional advice, caregivers can help ensure timely support and resources are provided to assist the child's development.
If a baby displays potential signs of autism, it is essential to schedule a visit with a paediatrician to discuss developmental concerns and undergo an evaluation. Early diagnosis is crucial as it allows for the initiation of developmental and behavioural interventions at a younger age, significantly enhancing outcomes.
Early intervention is designed to help autistic children reach their full potential. The young brain is particularly receptive to treatments, making early interventions more effective.
As the child grows, these interventions might include speech therapy, occupational therapy, and mental health counselling. The aim is to manage symptoms effectively and improve the child's quality of life.
Intervention strategies are tailored to meet the specific needs of the child, focusing on enhancing communication, social skills, and overall development.
In addition to traditional therapies, other supportive measures may include specialized educational programs and family support services. The collective goal of these interventions is to create a supportive environment that fosters the child's growth and well-being.
When someone is diagnosed with autism, they must receive the right support, care, and assistance to meet their requirements as they develop and change, as well as the support of their loved ones and carers.
The ultimate objective of early diagnosis and intervention is to make autism symptoms more manageable and to enhance the child's life as much as possible.
By addressing developmental challenges early on, children with autism can achieve significant improvements in their social interactions, communication skills, and overall adaptive functioning, allowing them to thrive and lead fulfilling lives.
