Could my child have autism?

Could my child have autism?

The frequent press coverage that autism has received over the past several years has led many parents of young children to wonder whether their child might be showing signs of autism. Here is some information to consider as you observe and interact with your child.

The diagnosis of autism is based on a pattern of behavioral symptoms in two areas: (1) social interaction and communication, and (2) restricted and repetitive interests or activities. Symptoms in both areas must be present for a child to receive a formal diagnosis of autism. However, these two behavioral symptoms can be expressed very differently from one child to another. In fact, there is a common expression that “if you know one child with autism…..you know one child with autism.”

Social Interaction and Communication

Almost from the moment of birth, infants are very social beings. They enjoy close physical contact with caregivers, like looking at faces, turn toward voices, and smile at family members. As toddlers, they show interest in other children, and they learn how to interact by watching and imitating how others talk, play, and behave. Even before they learn to talk, they communicate nonverbally, using eye contact, facial expressions, gestures, and body language. They enjoy the give-and-take of social engagement and seek it out. In contrast, children with autism may not show the expected development of early social interactions. They may be less interested in playing social games (such as pat-a-cake) with caregivers, or may prefer to play alone with favorite toys rather than having others join in their play. Some parents find that the best way to engage their child with autism is through physical activities, such as rough-and-tumble play. Children with autism may have difficulty communicating their needs or desires by using eye contact, facial expressions, or gestures. They may initiate interactions with caregivers only “on their own terms,” to get something they want, instead of communicating to share their interests or enjoyment with others. They may be less interested in watching, playing with, or imitating the actions of other children.

Restricted, Repetitive Interests or Activities

Children with autism may become preoccupied with certain activities, toys, or interests in a way that is unusual in its intensity. For example, they may spend hours opening and closing objects with hinges, or lining up puzzle pieces over and over, without actually putting them in the puzzle. They may also find comfort in predictable routines, such as always drinking out of the same cup or going through the same exact sequence of activities before bedtime every single night. Sometimes if their activities are interrupted, or their routine changes, they can become very upset or distressed. They may have very focused interests that differ from those of their peers, such as learning about different types of vacuum cleaners or ceiling fans. They may also show unusual body movements, such as body tensing, toe-walking, or arm flapping. Unusual reactions to sensory stimuli can also be seen in children with autism. Some children may be very interested in visually examining objects by holding them close to their eyes, others may seek out certain textures to touch, and still others may find certain sounds disturbing or be hypersensitive to the feel of new clothes.

Keeping Perspective

Many of the individual behaviors described above also occur in some form among children with typical development. But if these social and behavioral symptoms occur in combination, persist over time, and occur across a variety of different contexts, then a conversation with your primary care provider may be warranted. The Caregiver Observation Checklist (see below) may be helpful in observing your child’s behavior and communicating your concerns to your doctor or other service provider. Please note that some of the items on this checklist are not meaningful for children less 14-15 months old, so we recommend that it be used only for children who are at least 14-15 months old. Also, please note that this checklist is not designed as a screening tool; rather, it is designed as a tool for observing and communicating about your child with others.

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Caregiver Observation Checklist

Download Caregiver Observation Checklist

When you smile at your child, does s/he smile back?
- □ Rarely □ Sometimes □ Often
- Most likely times:
- Least likely times:

When your child is playing by him/herself and you call his/her name, does s/he look at you?
- □ Rarely □ Sometimes □ Often
- Most likely times:
- Least likely times:

When you point to show your child something, does s/he follow your point?
- □ Rarely □ Sometimes □ Often
- Most likely times:
- Least likely times:

When you try to join in your child’s play activities, does s/he share his/her toys and play interactively with you?
- □ Rarely □ Sometimes □ Often
- Most likely times:
- Least likely times:

When you show your child a different way to play with a toy, does s/he watch you and then try it?
- □ Rarely □ Sometimes □ Often
- Most likely times:
- Least likely times:

When a familiar adult greets your child, does s/he respond by looking at the person?
- □ Rarely □ Sometimes □ Often
- Most likely times:
- Least likely times:

When your child is enjoying an activity, does s/he look at you and smile to indicate his/her pleasure?
- □ Rarely □ Sometimes □ Often
- Most likely times:
- Least likely times:

When you laugh at something your child does, will s/he repeat the action to see if you will laugh again?
- □ Rarely □ Sometimes □ Often
- Most likely times:
- Least likely times:

Does your child point to things or show you things just to share his/her interest or excitement with you?
- □ Rarely □ Sometimes □ Often
- Most likely times:
- Least likely times:

Does your child try to get you to play with him/her, such as handing you toys while looking at you?
- □ Rarely □ Sometimes □ Often
- Most likely times:
- Least likely times:

Does your child approach other children and try to play with them?
- □ Rarely □ Sometimes □ Often
- Most likely times:
- Least likely times:

Does your child look at you when you are talking to or playing with her/him?
- □ Rarely □ Sometimes □ Often
- Most likely times:
- Least likely times:

Does your child play with toys or other objects in unusual ways?
- □ Rarely □ Sometimes □ Often
- Most likely times:
- Least likely times:

Does your child move his/her hands or body in unusual ways?
- □ Rarely □ Sometimes □ Often
- Most likely times:
- Least likely times:

Does your child seem to be unusually interested in seeking out certain types of sensory stimulation?
- □ Rarely □ Sometimes □ Often
- Most likely times:
- Least likely times:

Does your child seem to be unusually sensitive to, or disturbed by, certain types of sensory stimulation?
- □ Rarely □ Sometimes □ Often
- Most likely times:
- Least likely times: