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Published on August 30, 2017

Recognizing the Early Signs of Autism

As a parent of a young child, you spend what seems like every waking hour meeting your little one’s needs and helping them progress to the next milestone in life. While the timing of those milestones will vary to some degree, your pediatrician will provide you with basic guidelines on what to expect and when — from babbling and crawling to taking first steps and speaking first words.


"I urge parents to remember that early childhood development is generally a dynamic evolution of maturation with milestones often reached at varied times,” said Steven A. Shapiro, DO, chair of the Pediatrics Department at Abington-Jefferson Health. “Don't compare! Let your pediatrician help you understand what kind of advocacy makes sense for all of your concerns."

If your child doesn’t reach a milestone when they should, there’s no reason to panic — but it may be time to ask questions.

“You’re smart to be vigilant about your child’s development and talk frequently with your pediatrician about any concerns,” said Roseann C. Schaaf, PhD., professor and chair of the Department of Occupational Therapy at Jefferson Health. “Any parent who is concerned about their child’s development should see their pediatrician and ask for an early screening for autism spectrum disorder.”

What is Autism Spectrum Disorder?

Autism spectrum disorder (ASD) is the most common neurodevelopmental disorder of childhood. It’s present from early childhood and is characterized by difficulties with communication, social interaction, hyper- and/or hypo-reactivity to sensory stimuli (such as pulling away from touch) and a restricted or repetitive range of behaviors (such as lining up toy cars).

“Currently, one in 68 children have ASD,” said Dr. Schaaf. “The prevalence of autism has increased over the last 10 years, mainly due to better diagnostic procedures to identify autism and changing diagnostic criteria that more specifically identify those with autism.”

Dr. Schaaf recommends being aware of some of the early signs of autism, which can include lack of a social smile, limited or no eye contact, limited language and vocabulary, limited communicative gestures such as waving goodbye or pointing to a parent or a glass to request a drink, failure to respond to a name, and a preference for being alone.

Autism advocacy organization Autism Speaks provides helpful guidelines for these potential signs of autism by age range:

  • By six months, no social smiles or other warm, joyful expressions directed at people
  • By six months, limited or no eye contact
  • By nine months, no sharing of vocal sounds, smiles or other nonverbal communication
  • By 12 months, no babbling
  • By 12 months, no use of gestures to communicate (e.g. pointing, reaching, waving, etc.)
  • By 12 months, no response to name when called
  • By 16 months, no words
  • By 24 months, no meaningful, two-word phrases
  • Any loss of any previously acquired speech, babbling or social skills

“It is important to note that children may display these behaviors and not have autism,” said Dr. Schaaf. “A full diagnostic assessment by a trained psychologist or therapist is needed to confirm the diagnosis.”

The Importance of Early Intervention

In every state, children with developmental delays related to health conditions such as ASD are eligible for early intervention services. Early intervention will help provide the necessary support for your child’s development and learning.

“Early in life, children learn new skills more quickly, so getting help early is beneficial,” said Dr. Schaaf. “Early intervention for children with autism often consists of an educational program with support services such as occupational therapy, speech and language therapy, and behavioral therapy.”

Dr. Schaaf also reminds you not to panic or despair if you suspect your child may have ASD. Great strides have been made in helping children with autism lead successful and meaningful lives.

“Educate yourself with reputable sources of information from universities or organizations such as Autism Speaks,” said Dr. Schaaf. “These will help you learn about autism. Also, find a support group of parents who can provide emotional support and help you find the services you need.”

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