A Pediatrician’s Guide to The Early Symptoms and Signs of Autism
Not one single test can diagnose autism. This is not surprising given the complexities of the neurodevelopmental condition, some of those we do not understand fully. What is known is that the earlier it is diagnosed the earlier interventions can be started and the outcomes tend to be more positive.
So what do you look for? What are the signs?
The real answer is it can vary depending on the child, key to early diagnosis requires a partnership between the parent and the child’s doctor. Any concerns a parent has about development should be looked into further. In other cases, concerns may arise after standard developmental screening which occur at each well-child visit. Standard autism screening should occur between 18-24 months of age.
Autism, or ASD (Autism Spectrum Disorder), is a neurodevelopmental condition that may include difficulties with social skills, behaviors of repetitive nature and difficulties with verbal and nonverbal communication. It’s estimated that 1 in 59 children are affected by autism in the United States today. ASD is a complex disorder that presents with varying degree symptoms ranging from mild to severe. There is no single cause, and at this time both genetic and environmental factors are thought to contribute. More importantly no reliable studies to date have shown a link between ASD and vaccines.
Some early signs include:
- Delays in development like delayed babbling or cooing
- Lack of social smile by age 6 months
- No pointing or waving by age 12-14 months
- No single words by age 15 months
Having a pediatrician recognize these signs is one of the reasons it’s important to keep your child up to date with well-child visits. The visits typically include questionnaires about development and this is an opportunity to identify any of these delays early.
Some children may have delays only in one area and no other difficulties. Standard screening tools exist to help your doctor identify other problems which may indicate autism as a possible diagnosis.
One of the most widely used screening tools is MCHAT-R (Modified Checklist for Autism in Toddlers, Revise). This checklist is a series of 20 yes/no questions. The scoring of this screening tool gives a low, medium or high risk for ASD. All children with medium/high risk results should have appropriate follow up which may include referral to a developmental pediatrician or a trained psychologist for formal ASD testing.
What if the screening is negative, but the parent has concerns?
A detailed history regarding the concerns also may lead to referral for further testing even if the screening is negative. The reason for this is because ASD has such a wide presentation of symptoms it may eventually be diagnosed when symptoms are more subtle.
Since every child with autism is different, the treatment recommendations will vary for every child depending on the difficulties they are having. The current evidence supports the following effective treatments for autism: ABA (Applied Behavior Analysis), speech therapy, occupational therapy and treatment of any other co-existing condition of course.
We know early diagnosis leads to early intervention, which has been shown to improve behavior, skills and language development. Early intervention helps with the outcomes of children diagnosed with autism. It’s important to bring up any concerns to your child’s primary care provider as soon as you have any worry that “something may not be right.”
Get to know Bianka Soria-Olmos, D.O.
Dr. Soria-Olmos is a Cook Children's pediatrician in Haslet. She was born and raised in Fort Worth, Texas, so Cook Children's has always had a special place in her heart. She came to know Cook Children's when she was just a kid herself. She went to the medical center a number of times with her active younger brother, who needed care following several mishaps with broken bones. The visits inspired her to decide, "I want to be a Cook Children’s doctor one day."
In pursuit of her dream, Dr. Soria-Olmos attended Texas Christian University (TCU) for a degree in biology and to fulfill the pre-medical school requirements. After graduating from TCU, she chose to stay local and attended medical school at University of North Texas Health Science Center/Texas College of Osteopathic Medicine in Fort Worth. She completed part of her pediatric clerkship at Cook Children's, learning about pediatric medicine by attending rounds with pediatric hospitalists. It was then she knew she wanted to be a pediatrician.
She began her career with Cook Children's in 2014 as a pediatric hospitalist caring for sick children admitted to the hospital. Today, she works at Cook Children's primary care office in Haslet. Her special interests include child safety, child development and asthma.