September 26, 2017

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Recognizing Early Warning Signs of Autism

kidJames is a sweet little boy, one of the many little ones I see in my pediatric practice at ACMC. He’s almost two, and he’s hit a lot of milestones, but he seems detached. He’s not as social as other kids his age. He doesn’t seem interested in things other kids find interesting. And even though he’s almost two, he doesn’t speak much. James is autistic.

Autism affects a person’s ability to communicate with and relate to others. Autistic people often have difficulty regulating their emotions and their social interaction is often stilted, which affects their ability to develop relationships.  Autism is a brain disorder seen in about one of every 68 children, and boys like James are five times as likely to be autistic as girls. The exact cause of autism is unknown, but it tends to run in families so it’s thought genes may play a role. No link has been found between vaccines and autism.

Autism is typically diagnosed in young children, though it’s often present at birth. Because autism is a spectrum disorder, people with autism can experience anywhere from a very mild form to a much more severe case of autism. Typically the more severe a case is, the more severe the behaviors a child will display.

There is no sure fire way to tell if someone is autistic just by looking at their physical appearance, and many children aren’t diagnosed until preschool or kindergarten. But these early warning signs and discussion with your child’s doctor may help you determine if your child is autistic.

Warning Signs in the First Year

Even young infants are social.  At this age, a child with an autism disorder may:

  • Not respond to his/her mother’s voice
  • Not react to his/her name
  • Not look people in the eye
  • Not babble or point by the time they turn one
  • Not smile at or respond to social cues from others

Warning Signs in the Second Year

Autism is a little more noticeable in a child’s second year. While other children I see in my practice are forming their first words and phrases and pointing to things they want, a child with autism typically does not. Things to watch for at this age include:

  • Not using single words by 16 months or two-word phrases by age two
  • Not playing pretend games by 18 months
  • A loss of language skills
  • No interest when someone points out objects that typically interest young children such as a plane flying overhead or a puppy playing in the grass

Other Classic Signs of Autism

As children grow, they may begin to show more classic signs of autism such as:

  • Self-stimulating behavior like hand-flapping, finger-flicking, rocking and twirling the body and audible stimulation like off-key humming
  • Repetition
  • Delayed response
  • Disassociated speech
  • Unusual voice tone
  • Lack of eye contact
  • Nonverbal or impaired expressive communication
  • Unusual or unbalanced gait
  • Noticeable sensitivity to events happening around them
  • Increased tolerance for pain

Sometimes people with autism have physical symptoms, including digestive problems or sleep issues. Autistic children often have poor coordination of the large muscles used for running and climbing or the smaller muscles of the hand. And nearly a third of people with autism have seizures. Those with more severe forms of autism will often have psychiatric disorders like bipolar disorder, depression, OCD or ADHD.

Just because your child may be displaying one or more of these signs doesn’t mean they have autism. In my 22 years in medicine, I’ve seen children who’ve had similar tendencies that they’ve outgrown.

Your doctor should screen for autism at your child’s 18-month and 24-month visit and as needed for children who display autistic behaviors. If you’re concerned that your child may be autistic, don’t be afraid to talk about it with your child’s doctor.  Getting treatment early, ideally before a child turns three, can greatly improve their overall development and can help you understand how to parent a child with autism. Children with autism need to feel protected, responding best to highly structured and specialized treatment. Providing this structure can help improve communication, social, behavioral, adaptive and learning aspects of an autistic child’s life.

IMG_6817Dr. Atul Mishra is a pediatrician at ACMC in Marshall. A pediatrician specializes in the care of infants, children and adolescents as a primary care provider or by referral for more serious health issues.

ACMC pediatricians provide well-child visits, outpatient and inpatient care for ill children, and coordinate and manage care with other specialists.