A child’s development is a complex interaction of the child’s brain with the environment in which they are placed. We evaluate children’s development by looking at several milestones.
Milestones, simply defined, are skills or tasks of importance that the child is expected to develop at a specific period as per their age. Parents understand if their child has an overall (global) delay in milestones, and these problems are easily picked up during routine paediatric follow-ups.
However, certain kinds of delays, especially in speech and social development, are at times neglected. For decades, we have been used to following a wait-and-watch approach for children with isolated delays like delayed speech. With the renewed understanding of the importance of early identification and intervention, the focus has shifted to identifying early signs of autism. Today, we are able to make a diagnosis as early as 18-24 months and start meaningful and useful interventions to help the child adapt and improve.
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Autism spectrum disorder is a group of neurodevelopmental disorders characterised by problems in social communication, and having abnormal repetitive behaviours and restrictive and abnormal play behaviours. These children often have some early signs that can cause concerns for parents.
Earliest signs of autism
Lack of social smile at 6-8 months
A child is expected to be able to make good eye contact and smile by 6 months. Children with Autism may not be interested in making eye contact and smiling at individuals around them.
Poor response
Children may react to loud sounds that interest them, but do not do so when their name is called or when parents try to engage the child’s attention for activities.
Poor gesturing
By 9-12 months, children show joy in sharing things that they are playing with and look for parental approval or reaction during their play time. By 12-18 months, toddlers use joint attention consistently to share excitement or request help. They begin to check back and forth, looking at an object, then the caregiver, then back to the object, to ensure the experience is truly shared. Children on the autism spectrum have difficulty indicating needs, use passive pointing or are unable to use gestures or verbalise preferences.
Speech delay
Look out for signs of speech delay in toddlers.
Loss of learnt speech or skills
At any point, if the child seems to have suddenly lost learnt skills like speech and hand use. This would definitely warrant a detailed evaluation.
Though none of these signs alone are definitive indicators of autism, these are important early signs for parents to observe to make the first contact with a treatment provider.
(The author is a paediatric psychiatrist at KMC Hospital, Mangalore)
The opinions expressed in this article are those of the author and do not purport to reflect the opinions or views of THE WEEK.