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“Autism is a spectrum of closely related disorders with a shared core of symptoms. Autism spectrum disorders appear in infancy and early childhood, causing delays in many basic areas of development such as learning to talk, play, and interact with others.

The signs and symptoms of autism vary widely, as do its effects. Some autistic children have only mild impairments, while others have more obstacles to overcome. However, every child on the autism spectrum has problems, at least to some degree, in the following three areas:

  • Communicating verbally and non-verbally
  • Relating to others and the world around them
  • Thinking and behaving flexibly

There are different opinions among doctors, parents, and experts about what causes autism and how best to treat it, and much that we still don’t know. But on one fact, everyone agrees: early and intensive intervention helps. For children at risk and children who show early signs, it can make all the difference.” – Helpguide.org

The following delays warrant an immediate evaluation:

  • By 6 months: No big smiles or other warm, joyful expressions.
  • By 9 months: No back-and-forth sharing of sounds, smiles, or other facial expressions.
  • By 12 months: Lack of response to name.
  • By 12 months: No babbling or “baby talk.”
  • By 12 months: No back-and-forth gestures, such as pointing, showing, reaching, or waving.
  • By 16 months: No spoken words.
  • By 24 months: No meaningful two-word phrases that don’t involve imitating or repeating.

Other possible early warning signs include:

  • Poor eye contact or lack of appropriate eye gaze
  • Doesn’t smile when smiled at
  • Doesn’t follow objects visually
  • Delayed or lack of pointing or waving
  • Does not gesture to communicate
  • Doesn’t follow gesture when you point
  • Doesn’t make noises to get your attention
  • Doesn’t initiate or respond to cuddling
  • Doesn’t imitate movements or facial expressions
  • Doesn’t reach out to be picked up
  • Doesn’t play with other people or share interest and enjoyment
  • Doesn’t ask for help or make other basic requests
  • Appears disinterested of other people and what’s going on around them
  • Doesn’t know how to connect with others, play or make friends
  • Prefers not to be touched, held or cuddled
  • Doesn’t play pretend games
  • Doesn’t engage in group games
  • Doesn’t use toys in creative ways
  • Has trouble understanding or talking about feelings
  • Appears to be deaf at times
  • Repeat words or phrases over and over (echolalia)
  • Give unrelated answers to questions
  • Get upset by minor changes
  • Have obsessive interests
  • Flap their hands/arms, rock their body, or spin in circles
  • Have unusual reactions to the way things sound, smell, taste, look, or feel
  • Only interacts to achieve a desired goal
  • Has flat or inappropriate facial expressions
  • Does not understand personal space boundaries
  • Is not comforted by others during distress
  • Delayed speech and language skills
  • Reverses pronouns (e.g., says “you” instead of “I”)
  • Talks in a flat, robot-like, or sing-song voice
  • Does not understand jokes, sarcasm, or teasing
  • Lines up toys or other objects
  • Plays with toys the same way every time
  • Likes parts of objects (e.g., wheels)
  • Is very organized
  • Has to follow certain routines
  • Hyperactivity (very active)
  • Impulsivity (acting without thinking)
  • Short attention span
  • Aggression
  • Causing self injury (head banging, biting, pinching, hair pulling, etc.)
  • Temper tantrums
  • Unusual eating and sleeping habits
  • Lack of fear or more fear than expected
  • Loss of any language or social skills at any age
  • Odd or repetitive ways of moving fingers or hands
  • Preoccupations with unusual interests, such as light switches, doors, fans, wheels
  • More interested in looking at objects than at people’s faces
  • Prefers to play alone
  • Seems to be “in his/her own world”
  • Doesn’t respond to parent’s attempts to play, even if relaxed
  • Avoids or ignores other children when they approach
  • Resists learning
  • Uses people as “tools” to satisfy their needs
  • Inappropriate laughing or giggling
  • Not cuddly (body is limp or stiff)
  • Spins self or objects
  • Fascination with flowing water
  • May repeat words or phrases verbatim, but doesn’t understand how to use them
  • Moves constantly
  • May be unusually sensitive to light, sound and touch, and yet oblivious to pain
  • Soothes with objects
  • Lack of separation or stranger anxiety
  • Repetitive play
  • Difficulty with loud or sudden sounds (may cover ears)
  • Unusually high or low pain tolerance.
  • Becomes overwhelmed with too much verbal direction
  • Tends to either tune out or break down when being reprimanded
  • Calmed by external stimulation – soothing sound, brushing, rotating object, constant pressure
  • Exceptionally high skills in some areas and very low in others
  • Difficulty with reading comprehension
  • Difficulty transitioning from one activity to another
  • Walks on toes
  • Unusual gait
  • Difficulty changing from one floor surface to another (carpet to wood, sidewalk to grass)
  • Difficulty moving through a space (bumps into objects or people)
  • Walks without swinging arms freely
  • Gastrointestinal issues
  • Allergies and food sensitivities
  • Apparent lack of concern for personal hygiene (hair, teeth, body odors)
  • Preoccupation with hands
  • Desire for the same daily schedule, toys, type of clothes or an insistent on “sameness”
  • May respond negatively to crowds
  • Sensitivity to tags in clothes, coarse clothing, lights, and smells
  • Frequently uses peripheral vision to track items (e.g., rolling car along counter top at eye-level)

Note that individuals with Autism will not exhibit every one of these traits, but all will demonstrate impairments in communicating verbally and non-verbally, relating to others and the world around them and thinking and behaving flexibly. Many people on the autism spectrum also experience gastrointestinal issues, allergies and food sensitivities and sensory processing issues, although they are not a required criteria for diagnosis.

If you are concerned that your child may have an Autism Spectrum disorder, have your pediatrician refer them for a developmental evaluation. Many pediatricians will try to impose a “wait and see” approach, but this is unacceptable. If you child’s doctor will not refer them, then you need to find someone who will. In the meantime, contact your counties health department and schedule an early intervention evaluation. If your child demonstrates developmental delays, a diagnosis is not required in order to begin early intervention therapies.

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