Diane Munz, a developmental paediatrician in Montreal who has worked with children on the spectrum since 1980, has some straightforward advice on the signs of autism. “The things that alarm me at six months are kids who don’t make eye contact, who don’t have a social smile, who are not cooing in response to their parents and are unresponsive socially. When that’s happening, you should probably start investigating.”
Still, for children that young, Munz acknowledges it’s more a case of flagging suspicions and early signs of autism than actively seeking out a diagnosis. In fact, she always checks a six-month-old’s vision and hearing before testing for anything else. She strongly recommends waiting until a kid reaches the cognitive age of 12 months (cognitive age can be defined as a kind of baseline of language, social skills and play interests for your child) before testing for autism with the expectation of a definitive diagnosis.
A major area of concern is regression. One-third of children who end up being diagnosed with autism start out meeting their early milestones and developing typically, and then suddenly, inexplicably start falling behind their peers. “If they’re saying a few words or even babbling at 12 months and, by 18 months, they’re not saying anything at all, that’s a real alarm bell,” Munz says.
Other signs of autism include what might be described as idiosyncratic behaviour. This can mean peculiar play—like lining up toy cars rather than driving them along the floor—a desire to be isolated or an acute sensitivity to loud noises or bright lights. Behaviours like hand flapping, toe walking, self-isolation and repetition of words or actions are also autism signs to look out for.
Here’s what to look out for—and when—if you suspect your child may need further testing for autism spectrum disorder.
1. Limited or no eye contact by six months of age 2. No smiles or other non-verbal communication by nine months 3. No babbling by 12 months 4. Not using gestures to communicate—pointing, reaching, waving—by 12 months 5. Not responding to their name by 12 months 6. Not pointing at objects to show interest by 14 months 7. No words by 16 months 8. Not playing “pretend” games by 18 months 9. No meaningful two-word phrases by 24 months 10. A loss at any time of previously acquired speech, babbling or social skills