Some children show signs and symptoms of ASD in early infancy, such as reduced eye contact, lack of response to their names, or indifference to caregivers. Other children may develop normally for the first few months or years of life but then suddenly become withdrawn or aggressive or lose language skills they've already acquired.
By age 2, signs and symptoms are usually clear. Your doctor may recommend developmental tests to identify if your child has delays in cognitive, language, and social skills; if your child doesn’t:
- respond with a smile or happy expression by 6 months
- say two-word phrases by 24 months
- mimic sounds or facial expressions by 9 months
- babble or coo by 12 months
- gesture - such as point or wave - by 14 months
- say single words by 16 months
- play "make-believe" or pretend by 18 months
- say two-word phrases by 24 months
Each child with ASD is unique, and the severity of the condition can range from low functioning (severe ASD) to high functioning (mild ASD). Therefore, the severity of ASD can sometimes be challenging to determine. However, it is generally based on the level of impairments and the child’s ability to function in their social environment.
Some common signs of ASD can be found in a child's social communication, social interactions, and behaviours.
Social communication and interaction signs
A child may show social interaction and communication challenges such as:
- Not responding to their name
- Resisting cuddling, holding, and seems to prefer playing alone
- Having poor eye contact and lacking facial expressions
- Delayed or absent speech, or losing previous ability to say words or sentences
- Difficulty starting a conversation or keeping one going, or only starting a conversation to make requests or label items
- Speaking with an abnormal tone or rhythm and using a singsong voice or robot-like speech
- Repeating words or phrases verbatim not not understanding how to use them
- Not understanding, or appearing to not understand simple questions or directions
- Not expressing their emotions or feelings and seeming unaware of others' feelings
- Not pointing at or not bringing objects to share an interest
- Inappropriately approaching a social interaction by being passive, aggressive, or disruptive
- Having difficulty recognizing nonverbal cues, such as interpreting other people's facial expressions, body postures, or tones of voice
Patterns of behavious
A child may show interest in or show repeating behaviours such as:
- Performing repetitive movements, such as rocking, spinning, or hand flapping
- Performing activities that could cause self-harm, such as biting or head-banging
- Developing specific routines or rituals and becoming disturbed at the slightest change
- Having problems with coordination or having odd movement patterns
- Being fascinated by details of an object, or being fixated on an object or activity with abnormal intensity or focus
- Being unusually sensitive to light, sound, or touch, yet being indifferent to pain or to temperature
- Not engaging in imitative or make-believe play
- Having particular food preferences, such as eating only a few foods or refusing foods with a specific texture
ASD has no single known cause. However, experts believe that genetic, biological, and environmental factors play a combined role.
There is no known link between vaccines and ASD; no studies have shown a link between the two. For more information on this topic, visit the Center for Disease Control (CDC) website.
The number of children diagnosed with ASD is rising. However, it's unclear whether this is due to better detection and reporting, an actual increase in cases, or both.
The known risk factors for ASD include:
- Your child's gender. Boys are 4X more likely to develop ASD than girls.
- Family History. Families who have one child with ASD have an increased risk of having another child with the disorder. In addition, if a parent has ASD, their child is more likely to have ASD.
- Other disorders. Children with certain medical conditions have a higher-than-average risk of ASD or ASD-like symptoms.
- Extremely preterm babies. Babies born before 26 weeks of gestation may have a greater risk of ASD.
- Parents' ages. There may be a connection between children born to older parents and ASD, but more research is necessary to establish this link.
There's no way to prevent ASD, but there are treatment options. Early diagnosis and intervention are most helpful and can improve behavior, skills, and language development. However, intervention is beneficial at any age.