What are the signs of autism? That’s a question that’s as tough to answer as, “What does a snowflake look like?” Every case is different, and no two kids are the same.
Could your child be on the spectrum?
Autism is a spectrum disorder (in fact, that’s what the common abbreviation ASD stands for), which means that people diagnosed with autism don’t fit neatly along a line from mild to severe. Each symptom comes in a variety of shades, and then are mixed and matched in a million different ways.
There is currently no blood test and no definitive genetic testing available to diagnose Autism Spectrum Disorders. The autism diagnosis is currently made based on observations — to check if a child (or even adult) shows numerous specific behaviors from a list of characteristics common to people affected by the condition. Even then, there’s no foolproof method, as one version of autism may be completely different to another.
In the case of my son (shown below), the three main indicators — after his notable lack of speech at 21 months — were that he liked to stack and line up toys, loved to spin around in circles, and never pointed.
But then there are probably autistic kids who talk lots, don’t stack objects, don’t like to spin, and do point at things. To confuse the picture, my kiddo was great at making eye contact and loved to cuddle, both of which are often thought to be indicators of neurotypical (non-autistic) development.
Is autism the answer?
If you want to get an idea of whether or not your child’s at risk before getting an evaluation with a pediatrician or an appropriate specialist, here’s where you can start. Please note that this is not an exhaustive list, but merely a basic tool to help give you a general idea. As always, if you are concerned about your child’s health or development, please contact his or her pediatrician or another qualified healthcare professional.
The major focus is on the following types of possibly autistic mannerisms:
Frequency of vocalization (verbal language) directed to others
Unusual (or no) eye contact
No responsive social smile
Little to no shared enjoyment in interaction
No showing/sharing of objects, people or surroundings, and will not spontaneously draw attention to something for the benefit of someone else by way of eye contact, gesturing, etc.
How he or she plays with objects
Whether or not he engages in imaginative/creative play
A basic questionnaire
Here is a more extensive list of some of the most common signs of autism — but remember: not every sign here means autism… and by the same token, just because your child does not exhibit certain characteristics listed here also does not guarantee that he or she is developing typically.
You might want to put a checkmark next to any of the signs that seem to apply to your child.
This isn’t a score sheet, but if your child displays several of these traits, you should talk to your pediatrician. He or she might then give you a referral to a developmental psychological or other specialist. (Still other symptoms are more prevalent in kids with Asperger’s Syndrome, another condition on the autistic spectrum.)
___ Doesn’t make many (or any) gestures — such as pointing, waving goodbye or holding out arms to be held.
___ Makes little or no eye contact, and/or it’s hard to catch his eye.
___ Pays not attention to other children and doesn’t engage in play with other kids.
___ Might ignore everyone but parents or a regular caregiver.
___ Squirms, cries and/or otherwise resists being held or cuddled, and may arch back instead.
___ Gets very upset when spoken to or touched by a stranger.
___ May ignore — or laugh at — someone who is crying or angry, with no comprehension or concern.
___ Tunes people out/seems to be in his own world.
___ May take things (food, toys, pencil, paper) from another person with no hesitation.
___ Does not realize his impact on others, nor care what anyone else thinks about him.
___ Does not talk at all.
___ Does not understand what you are saying.
___ Has language skills which have been slow to develop or delayed speech.
___ Repeats words or phrases he’s heard, with no regard to or understanding of their meaning (echolalia)
___ Speaks in an unusual manner, such as with a singsong voice or monotone robot-like speech.
___ Often repeats the same words or phrases over and over.
___ Cannot explain what he/she wants.
___ Doesn’t respond or seem to recognize when you use his name.
___ Is mostly silent — not babbling — at 12 months.
___ Doesn’t have any single words by 16 months.
___ Has no spontaneous two-word phrases (all done, want more, go now, hold me) by 24 months.
___ Has lost any once-held social or communicative skills, regardless of age (regression).
___ Often has repetitive movements, such as rocking, swaying, twirling fingers or hand-flapping.
___ Won’t imitate another person’s gestures or movements.
___ Likes to spin around in circles.
___ Has odd movement patterns.
___ Walks on his/her toes.
___ Prefers to play alone.
___ Spends a lot of time stacking and/or lining up toys and other things, or keeps them in a very specific order.
___ Doesn’t play with toys in a “typical” way (examples: rolling a train along a track, throwing a ball through a hoop).
___ Does not engage in pretend play, such as acting like a toy faucet works or that a bowl is a hat.
___ May be fascinated by a specific part of an object (examples: the wheels on a toy car or a doll’s hand).
___ Can focus for long periods of time on an activity or pastime, such as playing with Lego or watching TV.
___ Shows unusual attachments to toys and other items (examples: always carries around a certain special t-shirt or a set of toys).
___ Can be very active, enjoying the physical sensory stimulation of jumping, swinging or stomping.
___ Often becomes obsessed with one particular book, piece of music, movie or TV show.
___ Does not follow directions.
___ Cannot/does not show you where he hurts.
___ Doesn’t ask for help when needed.
___ Often repeats the same tasks over and over.
___ Is very independent for his/her age.
___ Has selective hearing — like he’s deaf sometimes, yet you know he can hear based on his other behavior.
___ Fearless — has no sense of danger, and will go into a pool or walk into the middle of a busy street without fear.
___ Likes very few foods/won’t try new foods (sometimes refusal is only based on a glance, smell or touch)
___ Has difficulty moving on to other activities until he completes a task or routine.
___ Becomes upset about even a slight change in environment or of routine.
___ Is not gentle with babies or other children, and seems oblivious to the need.
___ May need a very specific routine or object to calm down.
___ Has difficulty falling asleep or staying asleep.
Other atypical characteristics
___ Must follow very specific rituals and routines, often self-created.
___ May sometimes laugh out of the blue with no obvious reason.
___ Is fearful of certain things or places for no obvious reason.
___ Has prolonged or particularly intense tantrums.
___ Might seem to be oblivious to pain.
___ Resists or does not understand the concept of potty training.
___ May be unusually sensitive to light, sound and/or touch.
___ Does some things early compared to other kids, such as writing or creating patterns.
___ May find a mirror in order to observe himself crying.
___ Seems uninterested in what is going on around him.
___ Benefits from firm pressure (such as from heavy blankets or being tucked in tightly)
If you’re reading this because you have concerns about someone, we encourage you to keep two things in mind: First, don’t forget that these tests are not definitive. In just the same way that you would never be able to describe every one of your own behaviors, there’s no way for anyone create a completely thorough catalog of every autistic symptom.
Second, the main purpose of a diagnosis is to help a person with autism to receive the care and services he or she may need to life a full life… but a new label doesn’t change who that person is, was, or will be.