By Jocelyne Durrenberger, DNP
Department of Pediatrics 

It’s not unusual for young children to experience delays in their development. Sometimes these development delays can be a sign of Autism Spectrum Disorder (ASD).  It is important for parents to know the signs of ASD, which usually appear from infancy to age 3. The first signs are delays in development, such as learning to talk, play, and interact with other children and family members.

Some symptoms may be noticeable in the first few months, such as not developing smiles or not developing a social gaze. However, many other symptoms may not show up until 24 months of age or later. Some children with ASD seem to meet development milestones until around 18 to 24 months of age. Then, they do not continue learning new skills at the rate of their peers, or they seem to lose the skills they once had.

What causes ASD? We know that there’s no one cause of autism. Research suggests that autism develops from a combination of genetic and nongenetic, or environmental, influences. We also know that vaccines do not cause autism.

Early and intensive therapies can be effective in helping a child with ASD to develop to their full potential.

Signs your child may have autism spectrum disorder:

By six months:

• Few or no big smiles or other warm, joyful and engaging expressions
• Limited or no eye contact

By nine months:

• Little or no back-and-forth sharing of sounds, smiles or other facial expressions.

By 12 months:

• Little or no babbling
• Little or no back-and-forth gestures, such as pointing, showing, reaching or waving
• Little or no response to name

By 16 months:

• Very few or no words

By 24 months:

• Very few or no meaningful, two-word phrases (not including imitating or repeating)

At any age:

• Loss of previously acquired speech, babbling or social skills
• Avoidance of eye contact
• Persistent preference for solitude
• Difficulty understanding other people’s feelings
• Delayed language development
• Persistent repetition of words or phrases
• Resistance to minor changes in routine or surroundings
• Restricted interests
• Repetitive behaviors (flapping, rocking, spinning, etc.)
• Unusual and intense reactions to sounds, smells, tastes, textures, lights and/or colors

In my 20+ years in practice, there are some specific behaviors I’ve noted in some children with ASD. For instance, a desire to line things up – toys, cars, vegetables, etc.; and strong reactions to disturbing this arrangement. Occasionally, children with ASD tend to memorize songs, phrases, even whole scripts from cartoons.

There are no simple, quick tests that can diagnose Autism Spectrum Disorder.  Your primary care pediatric provider is trained to recognize the early signs of autism. They can answer your questions and arrange a formal assessment by a child developmental specialist.

Be sure to take advantage of services once you know your child has a developmental delay, whether they have signs of ASD, or other concerns.  Massachusetts has a program, Early Intervention, for children from birth to three years of age. These professionals treat children with (or at risk for) developmental delays, working with the families and the child. Children diagnosed with ASD will build the most skills in these early years, so early intervention is essential.

Fortunately, research shows that early intervention and support can greatly help the overall development of a child with ASD.

Do you wonder if your child under the age of 3 shows signs of Autism Spectrum Disorder? The MCHAT is a validated screening tool for autism, available online: https://www.autismspeaks.org/screen-your-child