Autism - the earliest signs

Recently, I’ve been finding myself talking about Autism with an increasing frequency. Whether it’s about epidemiology, symptoms, perceived increases in prevalence or very early warning signs. Often we hear parents describe the onset of symptoms at about the age of 2.

A close friend with a one-year boy asked me just the other day if I thought her child’s head size was bigger than average because she was told that he’s too young to make assess for Autism. She was told for example to look for delays in language and/or the child’s ability to respond to his name, etc. I am over simplifying this particular case because I wanted to contrast these with the subtle and earliest signs, like lack of joint attention, gestures, or social reciprocity.

It is therefore imperative that parents chronicle the developmental milestones and share them with their pediatrician. The following are by no means definitive markers for Autism but signs that can be examined and discussed with practitioners.

At 4 months, is your child

•   Following and reacting to bright colors, movement, and objects?

•   Turning toward sound?

•   Showing an interest in watching people's faces?

•   Smiling back when you smile?

Other early red flags

•     No big smiles or other warm, joyful expressions by six months or thereafter

•     No back-and-forth sharing of sounds, smiles, or other facial expressions by nine months or thereafter

•     No babbling by 12 months

•     No back-and-forth gestures, such as pointing, showing, reaching, or waving by 12 months

•    Loss of speech

•     Any loss of speech or babbling or social skills at any age

In the second year of life common signs for autism may include

•     Lack of showing

•     Lack of gestures: pointing, reaching, waving, showing

•     Lack of sharing interest or enjoyment with others

•     Repetitive movements with objects

•     Lack of appropriate eye gaze

•     No words by 16 months

•     Lack of warm, joyful expressions

•     Unusual prosody (rhythm and intonation of language)

•     Repetitive movements or posturing of the body

•     No two-word meaningful phrases (without imitating or repeating) by 24 months