When I sit in the waiting room of my therapy centre, gossiping with the other parents, one of the questions that most often comes up is how young my little boy is. The average age for an autism diagnosis is four and my son was diagnosed at 19 months.
The way I did this? Well, I just watched him, used Google, and ignored everyone in my life that told me ‘not to compare him to others’ and ‘all kids develop in their own time’. The Youtube video above helped. I also did the free online Modified Checklist for Autism in Toddlers that told me he was at risk for autism.
Although it doesn’t seem so at the time, an autism diagnosis can be a great thing. It means Michael has had therapy since he was 20 months old and by the time he is four, he will be miles ahead of where he would be otherwise. We have been doing 30 hours of ABA therapy with him every week. He has already improved a lot in imitation, social skills, cognitive skills and fine motor skills.
Often the parents are the first to notice the subtle early signs of autism. The grandparents/aunties/uncles/GP will mention nothing at all, even if they have 200 children and 500 grandchildren between them. They will tell you that all children develop differently and point to your uncle who didn’t talk until he was four. You need to ignore them. The thing with autism is, that it is hard to notice these early signs unless you are with the child all day every day. And even then, parents can be prone to denial. And high functioning children, especially girls, can present very few of the signs listed below.
Any concerns should be checked out immediately with a developmental paediatrician or even a general paediatrician with a special interest in autism and developmental delay.
Sign 1 – sleeping and feeding issues
The earliest sign of autism is usually sleep and feeding problems. I know, this probably encompasses all babies. But unless you’re an autism parent you don’t really know what sleep disturbance is. You might be upset because your little one wakes up three times at night even though she’s six months old? My baby woke up every five minutes. Every five minutes. I will repeat that, every five minutes, until we fixed it.
Other babies used to fall asleep quickly with a dummy. My baby didn’t take a dummy and took two full hours to get to sleep at night, and only after a very large amount of rocking (and swearing under my breath). In the first three months he would only sleep in a sling on my chest, otherwise it would take us two hours to carry him to sleep and he would wake up five minutes after being put down in the bassinet.
Other babies eat spaghetti, try new foods, gag a little and learn. My baby narrowed himself down to just soy milk and biscuits until I put in a special program to fix this. He still chokes on bigger pieces of food even though he’s two and a half. He hates spaghetti and all other foods, unless I specifically target and teach him new foods over months and months.
Sign 2 – limited social interaction
One of my first clues that something wasn’t right with Michael was when he was eighteen months old.
Michael was happiest when playing on his own in the corner with his flashcards or puzzles. One of the most obvious signs that of course I as a first time parent did not pick up was that he never involved me in his games. He didn’t point at all, and he never looked at me or gestured to show me anything he liked. He loved playing with flashcards or shiny toys that squeaked but he never showed it to me, or shared his enjoyment with me.
I used to joke that Michael treated me as furniture. He used to climb on me to get to the couch and couldn’t think of many other uses for me. I would sit at the side with a toy and try to interest him in it. He would ignore me. But if he wanted something he would just come and take it and play with it on his own, or step on my head to get to the couch.
If he did something that made me laugh, or if he accidentally hurt me, he didn’t react.
He also never did anything in the ‘look at me’ or ‘look at this’ way. I remember seeing one of his cousins stand in the middle of the room dancing, while all his aunts and uncles clapped for him and chanted his name. He loved it! Michael would never do anything like that. He didn’t ask for attention, either for himself or for any other interesting items.
Sign 3 – enjoys sensory experiences or is super sensitive
Children on the spectrum love or hate sensations, there is rarely an in-between. Some sensations, Michael loves. He loves the feel of the wind in his face (he always laughs on a windy day). He loves watching leaves moving in the wind or shadows dancing on the ceiling.
Other things he is super sensitive to. When he was little I used to go to ridiculous lengths to keep his face out of the sun, because if even a tiny drop of sunlight wandered over it accidentally, he used to go absolutely ballistic. Even if a muslin wrap muted the sun, it was still unacceptable. I used to look at all those calm babies lying in their prams and just shake my head in disbelief. He also hated hats, getting dressed, getting undressed, going in the bath, coming out of the bath, sweaters, and blankets of any sort.
Another way this manifested itself was with his weird way of playing. He used to turn cars over and spin the wheels. He loved watching them spin, but he rarely played with cars in a ‘normal’ way. Actually, he never did.
Sign 4 – repetitive behaviour
Children on the spectrum often have obsessive, repetitive behaviours. Michael loved to slide things behind him. He would take cars, puzzle pieces, anything, and just slide it behind him. Other children enjoy other ways of playing. For example, some children at the milder end of the spectrum often love stacking things, sorting them, lining toys up endlessly and very neatly. If you try to stop them from stacking/sorting/lining them up, or a sibling comes along and messes it up, they will get very upset. Yes, this is a euphemism for punches-sibling-in-the-face-and-screams-very-loudly.
sign 5 – does not imitate or engage in pretend play
The most common, and easiest way, for a small child to learn is through imitation. They imitate your vacuuming, sweeping, playing with toys, whatever you do they imitate. They also engage in pretend play. They might have tea parties with their soft toys, pretend they are cooking, ‘talk’ on the phone.
A child on the spectrum often has a lot of trouble learning because they do not imitate and have to teach things to themselves from scratch. They don’t look at how their big brother goes up the stairs so they have to learn how to do it by themselves. They don’t throw tea parties. They don’t pretend to drink tea or eat a toy pizza.
Sign 6: hand flapping, jumping, and other self stimulatory behaviour
When Michael was six months old, one of his favourite activities was flapping his hands in front of his face, and passing flash cards around. I remember my mother in law saying that she had never seen another child do that, and how mysterious it is. I used to joke that one day when Michael was bigger we would ask him why he did this. Well, we know how. Hand flapping is one of the early signs of autism that we, of course, missed. It’s called ‘stimming’.
Another sign was the hyper-activity.
As soon as he learned to walk on his own at fifteen months, he ran around everywhere. He didn’t stay still for a second and the only way I could change his nappy or get him to sit still at the doctor’s was with a cartoon.
sign number 7: very little eye contact
When Michael was a baby, his eye contact was fantastic. He did that whole baby thing of staring at you without blinking like you’re absolutely insane. I used to make faces at him, tickle him, go nuts and he loved it! He used to flirt with total strangers in the lift.
Then at around 15 months he did it less and less. By 18 months there was almost no eye contact and he was much more interested in objects or the feel of the wind in his face than in the people around him.
He didn’t look back at me for approval or reassurance. He didn’t look at me or my husband when we came into the room or left. He very rarely looked where we were looking. If I pointed he only rarely followed the point to see what the fuss was about.
The one thing that used to upset me the most is the way he looked right through me if I was trying to get his attention, like I wasn’t there. He loved me and came to me for hugs every five minutes but it was always on his terms. He just didn’t seem to understand that I was trying to get his attention.
Sign number 8 – dislikes change, loves consistency and routines
I must admit that for us, personally, this has rarely been an issue. Michael takes change in his stride and in fact loves exploring new places. He does cling more to us in a new setting, at least if there are other people there, but otherwise he loves everything new.
With many other children on the spectrum though, this can be one of the first signs parents notice. Their imitation and eye contact might be fine. Yet they are considered to be ‘problem kids’ at their preschool or kindy because of how they react to change and how badly they handle social interactions with other children. The stacking of blocks/lining up of toys and lack of pretend play are also a giveaway but this particular sign can be the most…vocal.
They might get really upset if daddy goes away on a business trip. They might hate it if you said you were going to go to the shops first and then go to the park, but then changed your mind and decided to go to the park first. They will memorise the way that you drive to preschool and back, and get seriously upset if you take a different way. They don’t like surprises, even good ones.
Sign number 9 – issues with speech
Children on the spectrum often have very delayed speech. Something about the language centre of the brain is affected strongly by autism and even when they do talk, they often forget words, or simply echo something they see on TV. Sometimes they actually talk early, but just copy the ads or cartoons they see on TV. They are known to memorise whole phrases. A speech therapist’s office is often the first place a parent will hear the word ‘autism’.
Get a professional opinion
Of course, reading about any disease always convinces you that you have it. That’s how Google works. Do not panic if your child is ten months old and hasn’t said a word yet. Look at all the other signs before you book them into speech therapy. However it is better to check something out and be proved wrong than not to check it out and be proved right. You stress much more in the pre and immediately post diagnosis stage than at any other point. And therapy is so wonderful, it is almost a miracle what it can achieve if started early enough.
So if you have any suspicions at all about your child, do some research and book them in to see a paediatrician with an interest in autism. You’ll be making an enormous difference in their lives.