Wednesday, August 29, 2012

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

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