Recognizing the Early Signs of Autism

As a parent, sometimes you just have a gut feeling that your child is sick or struggling with a challenge – even if they can’t communicate it. Many parents of children with autism spectrum disorder (ASD) start investigating the early signs and symptoms of autism because they have this same type of intuitive feeling about their child.

The earlier you recognize the warning signs and symptoms of ASD, the better. Intensive therapy and intervention during the critical developmental windows of early childhood can help to reduce – and sometimes reverse – the developmental delays and symptoms of autism spectrum disorder.

“I have seen parents in denial because they don’t want to think there is anything wrong with their child, even if there are obvious delays,” says Nandini Iyengar, M.D., director of Developmental Pediatrics at Crozer-Keystone Health System. “We tell parents not to worry about labels and if they don’t want a diagnosis of autism because of a stigma, that’s OK as long as you start early intervention services.”

What Should You Look For?

First, keep in mind that autism manifests itself in different ways, so not every child with autism will have the same symptoms. This is why it’s called a “spectrum” disorder. Both the symptoms and their severity will vary from child to child.

Children with autism will have challenges in three general areas: Communicating both verbally and non-verbally, interacting with the world and people around them, and inflexible behavior and routines.

Signs and symptoms of early autism can be hard to identify when children are very young. These symptoms will typically start when a child is between 12 and 18 months old. Early on, you may notice your child doesn’t respond to his name, make eye contact or smile at you, gesture or make noise to be picked up, or imitate your facial expressions. They may also not respond to cuddling and contact in a way that you expect.

Missing developmental milestones is also another potential red flag for autism. Keep in mind that children develop at different rates, so missing these milestones is not a time for panic. However, you and your pediatrician should keep a close eye on delays in the following areas:

  • By six months: No big smiles or happy expressions
  • By nine months: No back-and-forth sharing smiles, sounds or facial expressions
  • By one year: Not responding to their name, babbling, or gestures like pointing, reaching and waving
  • By 16 months: No spoken words
  • By 24 months: No two-word phrases that do not involve imitating you

If any of these developmental delays become a concern for you or your pediatrician, your doctor will likely perform an evaluation called an M-CHAT (Modified Checklist for Autism in Toddlers). It’s a simple test that you, as the parent, complete with yes or no answers. It’s designed to help you determine if you should seek further help from a specialist.

Don’t Take “No” for an Answer: Early Intervention Is Important

Again, if your gut is telling you that your child needs help, don’t be content with a “wait and see” approach. If your child does have autism or another developmental delay, she will need therapy as soon as possible.

The type of therapy your child will receive, which is usually arranged through the county or local municipality, is called Early Intervention. Early Intervention is tailored to the specific needs of your child, and may include a combination of speech therapy, physical and occupational therapy, behavioral therapy, and counseling.

“Another important fact we emphasize is that autism is not the parents’ fault, as parents tend to feel guilty and think they did something wrong,” Iyengar says. “We also try to provide support to parents by suggesting parent support groups and local resources so they can find advice and not feel alone.”

If you have concerns now or recognize any of these early warning signs, talk to your pediatrician soon. You will be the best advocate for getting your child the help that they need.

About Crozer Keystone Staff

Crozer-Keystone Health System’s physicians, specialists and advanced practitioners are committed to improving the health of our community through patient-centered, quality care across a full continuum of health services. Crozer Brinton Lake is Crozer-Keystone’s comprehensive outpatient care facility in western Delaware County, offering primary care, specialty services, outpatient surgery and advanced cancer treatment. Contact us: 300 Evergreen Drive, Glen Mills, PA 19342 1-855-254-7425



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