• Understanding Autism from the Inside

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Autism in Toddlers: Early Signs

signs in toddlers

Early Warning Signs of Autism in Toddlers

A child showing early signs of autism may not display big smiles or warm expressions by the time they are six months old, lack back and forth sharing of sounds by nine months, and not reach, point, or show you things. You may notice that they fail to respond to their own names, appear not to hear you at times, and may avoid looking at you (poor eye contact). They also may be resistant to being held or cuddled. Delays in language development—no speech, or no words by 16 months, or meaningful two-word phrases by 18 months—or any loss of previously acquired ability to say words or sentences (regression) are all “red flags” that should be discussed with your physician. Your child may also repeat words or phrases verbatim, echolalia, but doesn’t understand how to use them. You may notice your child rocking, spinning, or flapping his hands and feet, walking on tip toes—moving constantly. They may be overly sensitive to light, sound, or touch, have very picky eating habits, or eat things that are not food like chalk or dirt. The appearance of frequent “temper tantrums” or meltdowns and self-harming behavior like head banging causes many parents to become concerned. If your child is exhibiting these behaviors, or you are concerned about their development, talk to your doctor at your next appointment to discuss autism screening.

Should My Child Be Screened for Autism?

Developmental screening is routinely done by pediatricians during normal “well baby” visits. However, if your child is at a higher risk for autism, a more in-depth evaluation may be warranted. Studies have shown that there is a genetic (heredity) link to autism spectrum disorders (ASD). Children who have a sibling or parent with an ASD should be monitored more closely for early warning signs. Infants born prematurely or with low birth weight are also at a higher risk for developmental disorders, including autism spectrum disorders (ASD). Early screening tools are utilized to identify children who are “at risk.”

Modified Checklist for Autism in Toddlers (M-CHAT)

The M-CHAT is an autism screening tool used to identify toddlers, between 16 and 30 months of age, who are “at risk” or showing early signs of ASD or developmental delay. Parents answer twenty-eight screening questions that their doctor will review to assess if the child is showing possible early signs of autism or developmental delay. A determination of “at risk” on the M-CHAT will indicate further evaluation is necessary. This diagnostic tool is also available online at m-chat.org.

Screening Tool for Autism in Toddlers (STAT)

When your child is assessed as “at risk” on the M-CHAT, a STAT will likely be recommended. Unlike the M-CHAT, which can be filled out by parents, the STAT must be administered by a doctor or psychologist who is experienced with assessing autism in young children. This interactive evaluation, consisting of 12 activities, is designed to assess play, communication, and imitation skills. The STAT takes approximately 20-30 minutes to complete.

Jeannie Davide-Rivera

Jeannie is an award-winning author, the Answers.com Autism Category Expert, contributes to Autism Parenting Magazine, and the Thinking Person's Guide to Autism. She lives in New York with her husband and four sons, on the autism spectrum.