When To Screen Children For Autism And Other Pervasive Developmental Disorders

Popular media is now teeming with stories about the dramatic rise in autism. Several celebrities have spoken publicly and advocated for increased research on assessment methods and treatment options. Parents are now more keenly aware of even minor deviations in their child’s developmental milestones, and they worry that these delays could be the first signs of a debilitating life-long disorder.

With all of the increased attention being paid to autism, many families wonder how to make sense of the myriad checklists and screening tools available online. In addition, parents struggle to decide if their child’s repetitive behaviors and singular fascination with toys and movies are age-appropriate.

The worry is not just paranoia – researchers have repeatedly concluded that early intervention leads to optimal outcomes for children with autism and other pervasive developmental disorders. To determine whether or not to call your pediatrician, you can look at the key variables that clinicians use in assessing autism..Below are some factors we look for when evaluating a young child (2 to 4 years old).

6 Factors To Look For When Exploring A Possible Autism Diagnosis

1. Shared Interest

Children will begin to develop this skill at around 10 to 12 months of age. Essentially, shared interest is the child’s strong desire to share emotional feelings with others. After this age, when children are confronted with novel and exciting stimuli (bubbles, balloons, etc.) they frequently look from the stimuli to their parents and back. While seeming to be a simple action, this reflects a child’s social connection to their parent and desire to engage them. The absence of this reaction is reason for concern.

2. Stereotypical Behaviors

This one is a bit tricky. Children at this age will frequently jump, flap their arms or show similar reactions when excited or emotionally activated. This can still be normal. However, hand flapping, staring at their hands, rocking in the middle of tasks such as playing or drawing is unusual and warrants further investigation.

3. Social Language

By this age, children should demonstrate interest in what others are thinking and feeling. This does not mean they will ask you about your day. However, some questions that go beyond basic “I want…” should be occurring. In addition, non-verbal cues such as pointing, facial expressions to enhance meaning, and eye contact when speaking should occur.

4. Pragmatic Language

This is a broad category; but in this case it refers to sarcasm, jokes and literal versus intended meaning perspective taking. These skills can be absent in children who have other delays in receptive and expressive language, so they are not always unique to autism.

5. Obsessive Habits

Frequently lining up toys and becoming disturbed when they are moved, restricted clothing, food or hygiene problems and all-encompassing interests are often causes of concern. While children at this age may watch the same movie or play with the same toy repeatedly, extreme responses to changes in these activities are unusual.

6. Sensory Dysregulations

This one is a bit of a wild card. Children do show defensiveness at young ages to loud noises, unpredictable sounds, textures of clothing or food. While not always indicative of autism, these symptoms are over-represented in autism, ADHD and anxiety disorders and may still merit consultation.

If some or all of these problems are occurring in a child between 2 and 4, they merit consultation. Early intervention is not just helpful for autistic disorders. All children benefit from attention to the developmental areas. Only a trained professional can tell you if these symptoms are signs of autism or a developmental delay.

However, most families avoid the first contact with professionals because of a fear that their child will be labeled. In reality, most of the parents I see report extreme relief following the first session, as we are able to make a plan to reduce the symptoms and facilitate development regardless of whether their child has autism. Ultimately, the happiest families are the ones who see progress, and that starts with the first visit.


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