Data from March 2014 provided by the Center of Disease Control and Prevention (CDC) indicates that 1 in 68 children have been identified with an autism spectrum disorder (ASD). This prevalence has a significant impact on our society, including our education system. Special education programming and interventions within schools are continuing to become more necessary based on our rising student numbers with ASD. Furthermore, both within and beyond the school setting, early identification and early intensive intervention services for individuals with ASD has shown to improve progress and long-term outcomes (Lovaas, 1987).
Based on continued research that demonstrates early intervention can promote lifelong positive outcomes for individuals with ASD, it is imperative to understand and promote early identification of ASD. Currently, the mean average range of diagnosis for ASD in the United States is at approximately 4 to 5 years of age (Zwaigenbaum et. al, 2015). Within range, parents of children with ASD generally first report concerns before the child is 18 to 24 months old. Therefore, identifying early symptoms and concerns and following up on these concerns can provide an earlier diagnosis, which can then maximize opportunities for early intensive interventions for these children, optimizing long-term outcomes.
Social, communication, and/or behavioral differences can all be early signs and symptoms of ASD. These signs may be recognized in infants between 12 and 24 months. However, as other developmental milestones may be met on time (i.e., crawling, walking), sometimes these early indicators of ASD may be less noticeable. Furthermore, individuals with ASD can vary greatly from one another in terms of the specific behaviors as well as severity of symptoms, which can also make it more difficult for parents to recognize early signs.
Some early indicators of social differences in infants can include limited eye contact and non-responsiveness to others’ facial expressions. Another early indicator of ASD for an infant is limited joint attention. Joint attention occurs when two individuals share an interest in an object. In other words, joint attention is utilizing eye contact and cues to coordinate the attention with other individuals to share in the same experience. Joint attention emerges around 9 months of age and is established by 18 months for typically developing infants. Research has shown a correlation with individuals diagnosed with ASD and joint attention limitations during infancy (Gillespie-Lynch, 2015).
Both expressive and receptive communication difficulties can be noted as early indicators of ASD. Expressively, an infant may not point at various items to indicate a need for the items in the environment. Receptively, he/she may not respond to his/her name when called. Another indicator is the delay or absence of spoken language. For example, an 18-month-old may point, gesture, or use facial expressions instead of having verbal language skills. Yet another indicator of ASD is echolalia, which occurs after verbal skills are developed. The child who demonstrates echolalia will repeat exactly what someone else says without understanding the meaning of what is said. Other early communication indicators of ASD include not seeming to want to communicate or have conversations with others (American Academy of Pediatrics, 2015).
Individuals diagnosed with ASD may also demonstrate early behavioral signs. Stereotypic behaviors may include rocking, spinning, or hand flapping. When playing with toys, the young child may play with a part of the toy instead of the whole object. Also, the young child may use an unusual gaze when playing with toys or looking at objects. For example, the young child may look at his/her toys from an unusual angle. Another behavioral indicator may be that the young individual prefers routines and has difficulty when routines are changed. Sensory sensitivity, such as to smells, sounds, lights, and textures, may also be noted (American Academy of Pediatrics, 2015).
Although there are social, communication, and behavioral differences that may be noticed in infancy and throughout early childhood, one should not jump to conclusions that a young child has autism based on one or two social, communication, and/or behavioral indicators observed. Rather, it is important to understand child development as well as the potential early indicators of ASD. If concerned, the adult(s) should consult a pediatrician to discuss their observations and potential next steps in screening and diagnosis. It may be difficult for parents to begin those conversations with their physician, yet it is important to remember that, if an individual does exhibit behaviors consistent with ASD, early intensive intervention services can benefit the individual’s long-term progress and outcomes. Recognizing symptoms and becoming involved with early interventions will be advantageous for the parent(s) of children diagnosed with ASD to promote their knowledge, support, and specific programming for their child from infancy through school-age and beyond.
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