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Parent and Child Psychological Services PLLC 
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Signs and Screening for Autism                                      by Kirsten M. Ellingsen, PH.D.

11/9/2018

5 Comments

 
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Autism is now one of the most commonly diagnosed developmental disabilities in early childhood. It is estimated that about 1 in 59 children in the United States has an autism spectrum disorder (ASD) (https://www.cdc.gov/ncbddd/autism/data.html). Children with an ASD have difficulty in reciprocal (back and forth) communication and social interactions, as well as problems with restricted or repetitive behaviors. Symptoms start in early childhood and can affect a child’s daily functioning and participation in play and learning activities.  Early concerns for ASD may begin around 9-12 months, but more subtle signs and behaviors are more often recognized when a child is around 24 months.
 
A screening is the first step to help determine if an evaluation is needed. The list of signs and symptoms presented below can help flag behaviors that might be concerning and require follow-up with a physician or psychologist.  A screening questionnaire can also help identify possible problematic behaviors. (A widely used autism screener, the M-CHAT, is available for free online (www.mchatscreen.com; http://www.firstsigns.org/downloads/m-chat.PDF and in an electronic format (https://www.m-chat.org/mchat.php; https://www.autismspeaks.org/). 
 
Very early indicators or possible signs of an ASD in infancy:
  • No babbling or pointing by age 1
  • No single words by 16 months or two-word phrases by age 2
  • Not responding to name by 12 months of age
  •  Not pointing at objects to show interest (e.g., pointing at an airplane flying over) by 14 months
  • Loss of language or social skills
  • Poor eye contact
  • Excessive lining up of toys or objects
  • No smiling or social responsiveness
 
Possible signs or indicators during toddlerhood include:
  • Limited interest in social and reciprocal face-to-fact interactions (unless interactions are also physical such as rocking, tickling, tossing in the air)
  • Seeking physical comfort from parents infrequently
  • Limited response to name
  • Fleeting eye contact or eye contact that is not consistent with social interactions
  • Communication that is scripted, repetitive or with unusual pitch and intonation
  • Limited creativity or pretend in play
  • Uses few or no gestures
  • Moving quickly between toys and objects, stereotypical play, or unusual sensory interest in exploring objects (e.g., licking toy, sniffing objects, rubbing toy on face)
  • Not engaging in "pretend" games/activities (e.g., pretend to "feed" a doll) by 18 months
  • Motor mannerisms such as hand flapping, toe walking, repeatedly opening and closing doors
  • Flat or inappropriate facial expressions
 
Later early childhood behavioral indicators include:
  •  Avoiding eye contact and wanting to be alone
  •  Having trouble understanding other people's feelings or talking about their own feelings
  • Impaired ability to make friends or develop relationships with peers
  • Impaired ability to initiate or sustain conversations with others
  • Does not share interests with others
  • Absence or impairment of imaginative and social play
  • Stereotyped, repetitive, or unusual use of language
  • Excessive use of repetitive words or phrases (echola     Giving unrelated answers to questions
  • Restricted patterns of interest that are abnormal in intensity or focus
  • Preoccupation with certain objects or topics
·         Getting upset by minor changes
  • Delayed speech and language skills
  • Inflexible adherence to specific routines or rituals
·         Having obsessive interests
  • Does not understand jokes, sarcasm or teasing
 
It is important to consider that it is the combination of different behaviors that would lead to a referral for a more comprehensive evaluation to determine if a child meets criteria for an ASD diagnosis. Autism is a complex neurodevelopmental disorder that is best diagnosed by experienced professionals using standardized measures of functioning and a thorough assessment of a child’s medical and developmental history.  Early identification and accurate assessment of developmental disabilities is critical so that targeted support and evidence-based interventions can be accessed to facilitate optimal development and functioning for children.
 
If you have concerns about your child’s behaviors or development you can contact us to schedule a consultation or talk with an early childhood psychologist or pediatrician to determine if a diagnostic evaluation is needed.
 
 
REFERENCES  & RESOURCES
 
Ellingsen, K., Boone, D, & Chavis, L. (2016). Assessment related to developmental disabilities and psychological disorders during early childhood. In A. Garro (Ed.), Early Childhood Assessment in School and Clinical Psychology (pp. 203-231). NY: Springer Publishing. (https://www.springer.com/us/book/9781493963478)
 
Centers for Disease Control and Prevention: https://www.cdc.gov/ncbddd/autism/index.html
 
Milestones Tracker: https://www.cdc.gov/ncbddd/actearly/milestones/index.html
 
Autism Speaks: https://www.autismspeaks.org/what-autism/symptoms
​
5 Comments
site at link
7/30/2019 10:49:13 am

An interesting discussion is worth comment. I think that you should write more on this topic, it might not be a taboo subject but generally people are not enough to speak on such topics. To the next. Cheers

Reply
https://www.resumeshelpservice.com/ link
1/12/2020 06:22:09 pm

Autism is a major thing, and we need to understand that. I feel like people do not take into consideration just how big of a thing autism is. I know lots of people who use it as a joke, and it is not funny. If you are the one who has autism, then you wouldn't make fun of it. I hope that we all grow up and become a lot more mature. Autism is serious, let that sink in.

Reply
John R. Smith link
1/18/2022 09:01:57 am

This is a very insightful and informative comment. Thank you to the author for sharing this information.

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Luke Smith link
5/19/2022 04:44:04 pm

I didn't know that children with autism got problems with making eye contact, thanks for pointing that out. My brother just learned that his daughter got autism and we're trying to research on how to deal with it. I heard there are autism treatments too and we're thinking of having her take that treatment.

Reply
Mia Evans link
8/2/2022 07:46:24 pm

It really helped when you said that autism would be complex which is why it has to be diagnosed by professionals using standardized measures for a thorough assessment of the child. I will share this information with my sister because she thinks that she might need to get her daughter checked when she reaches the age of seven. It seems that she would need a certain autism spectrum treatment to help her cope with learning in school, because she still hasn't been able to identify letters and numbers until now.

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    Parent and Child Psychological Services is a private practice serving children and families in the Sarasota, Florida area. The practice is owned and operated by Dr. Gibson, a Licensed Psychologist who is Board Certified in Clinical Child and Adolescent Psychology. ​

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Parent and Child Psychological Services PLLC 
info@childtherapysrq.com
941.357.4090 (Office)
727.304.3619 (Fax)                                                                                                                                                               
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