As a parent, you just want your child to develop and thrive. Most of us can't help keeping an eye on their milestones - the things they can do with the passing weeks and months. But what if your child displays some developmental delays and you begin to wonder if they might have an autism spectrum disorder (ASD)? Should you simply wait and see 'how things go'? Is it better to wait for someone else to voice their thoughts, or is it best to leap into action the moment you're concerned?
As they get older, the signs of an autism spectrum disorder in a child can be very diverse. They might have impaired social skills, speech and language difficulties, make repetitive actions and have obsessive behaviours, activities and interests. These behaviours may be more easily spotted in an older child, but the signs and symptoms of an ASD can in fact be detected in infancy.
If so, intervention and treatment can have a huge effect on the child, and it's worth being aware because otherwise some of the earliest symptoms can be misinterpreted as signs of a 'good' baby or child; one that is quiet, independent, and undemanding.
Early signs of autism can show themselves in a variety of ways. A baby or toddler may not make eye contact, or smile back at you, or respond to their name or familiar voices, or imitate your facial expressions and movement. You may notice that they don't track objects visually, follow your finger if you point at things, wave goodbye or make other communicative gestures, reach out to be picked up, or seem responsive to cuddling. Other signs to look out for are not wanting to interact with others or share their interest and enjoyment in things. They may not seem to notice or care if you appear to have hurt yourself in some way or be upset.
You may well be monitoring whether or not your child hits their key milestones. The relevant things to watch here are not the physical development areas, but the social, emotional and cognitive ones. Remember though, every child is different and develops at a different rate - and any delays don't mean autism is definitely the cause. If your child is at nursery, staff there may also raise the matter or mention their observations and will be well-positioned to observe how well your child is playing, talking and responding, so do also talk to them.
If you do suspect a problem, then seek advice. Family or friends may tell you not to worry, and see how things go, but this probably won't stop you worrying and you may risk losing valuable time that could benefit your child. Where autism is involved, developmentally delayed children are unlikely to just 'grow out of it' - and the sooner they can access extra help and targeted treatment the better. There are also online tests that take the form of short self-test questionnaires about your child's behaviour and abilities. These can be useful in shaping your observations and suspicions, but be aware that these are not scientific and do not give you any kind of formal diagnosis.
Depending on your circumstances you may want to raise your concerns with your health visitor, doctor or other health professionals with whom you may already be in contact. At any subsequent appointment, they will evaluate your child, and ask you some straightforward questions about their behaviour - covering the signs and symptoms noted above. At the end of this, you may be offered a referral to a child development specialist - but if not you may want to get a second opinion, or else be a bit pushy and try and insist on a diagnostic screening to get clarity on the situation. You know your child better than anyone else, so don't be afraid to speak up.
If you do get to see a specialist, your child will have a comprehensive screening and evaluation - and it could lead to a formal diagnosis being made. It's not always clear-cut with a young child, but diagnosis is often possible from eighteen months onward where there is a strong grouping of autism-associated symptoms. You may wish to reduce any waiting times by securing a private consultation - it can mean a diagnosis in weeks, rather than waiting for months for an appointment via your GP.
Whatever the results and if you do get a diagnosis for an autism spectrum disorder, remember that the outcomes can be very different - it's called a spectrum for a reason. For some children, the effects may only be mild, while others may need to face and overcome more difficult challenges. In any scenario, early intervention and treatment can reduce the effects, and make a major difference to their ongoing development, so if you do have concerns, it's always better to act early, than to just wait and see.
UK - NHS - Getting Diagnosed with Autism
Ireland - Society for Autism