“Does My Child Have Autism?” – What You Need To Know
Are you wondering, "does my child have autism?" Here's what you need to know about diagnosing, and about supporting your child every step of the way
When a child seems ‘different’ in some way, we often wonder if they are autistic. This is a common assumption people make, but it’s not always accurate. There’s more to autism than being ‘different’.
So, what are some autistic traits in children? Autistic children tend to struggle socially and emotionally. As a result, they often seem disengaged. Children with autism may not speak clearly, and some do not speak at all. Also, autistic children enjoy routine and predictability. Some autistic children have exceptional talents.
The definition of autism is a point of controversy. Some people believe autism is a disability, whereas others see it as a unique personality-type that should be celebrated. As parents, we simply want the best for our children, so negotiating these issues can be tough.
How does autism present in children?
Contrary to popular belief, autistic children are not disinterested in the world around them. In fact, they are overstimulated by the world around them, and this can lead to disengagement. Disengagement can present itself in the following ways:
- A reluctance to make eye contact or engage with others
- Speech delays
- Eating problems
- Self-soothing behaviour – such as tapping, clapping, pacing, or rocking
- An inability to cope with change and a reluctance to try new activities
- Becoming fixated on one hobby or interest
- Some children may have aggressive outbursts
Some of these traits are more common at certain ages. For example, most autistic toddlers avoid eye contact, but some autistic teens do not. We’ll show you how to recognise autism at each stage of childhood, but first, let’s explore autism in a bit more detail.
What is autism?
According to the National Autistic Society, autism spectrum disorder (ASD) is “a lifelong developmental disability”. ASD is a disability rather than a disease because it’s not something that can be cured. Although people with ASD cannot be cured, they can be given support.
Some people disagree with the term “disability” because it creates stigma. In fact, organisations such as Transforming Autism see autism as a personality type rather than a disability. Nevertheless, they say that autistic children need support to reach their full potential.
So, whether autism is a ‘disability’ or not, most people agree that support is crucial.
In terms of its prevalence, ASD affects 1 in 88 children. Also, studies show that males are four times more likely to be autistic than females. Autism is a spectrum disorder, so characteristics can vary significantly.
What causes autism?
In 1998, Dr Andrew Wakefield claimed MMR vaccinations cause autism. This caused mass panic at the time, but was later found to be untrue. So, what does cause autism?
Scientists aren’t sure, but the following factors may play a role:
- Genetics – According to Dr Wendy Chung, between 200 and 400 genes are responsible for ASD. This explains why there is such a spectrum of disorders. These genes may pass from parent to child, or they may originate in the child as a genetic mutation.
- Epilepsy drugs – If a mother takes anti-epilepsy drugs during pregnancy, the child’s risk for developing ASD increases.
- Age of parents – According to NCBI, older parents (i.e. 38 years and older) are more likely to have an autistic child. The reasons for this are unclear.
Is autism on the rise?
During the last decade, autism rates have skyrocketed. According to several news sources, we are now facing an “autism epidemic”. But is autism really on the rise?
Well, according to Dr. Chung on YouTube, autism rates are probably the same as they’ve always been. It’s just that we’re getting better at diagnosing autism in childhood.
When do autistic traits begin to appear?
If your child is very young, you might be wondering if it’s too early to detect the signs of autism. Well, according to Great Ormond Street Hospital, autistic traits usually appear in the first three years of life.
Some parents sense their child is ‘different’ as early as 6-12 months old. But, because children develop at different rates, this is too early for a diagnosis. The earliest age for an accurate diagnosis is 2 years old. Having said that, most diagnoses occur aged 3 or older.
In the UK, all children have a developmental review at 2 years old. During this appointment, parents can voice any concerns they may have.
How to recognise autism in toddlers
As mentioned, autism can affect children differently at different ages. Signs of autism in toddlers include:
- A lack of eye contact – This is the clearest feature of autism in toddlers.
- Disengagement – Autistic toddlers do not usually respond when you call out their name.
- An inability to respond to facial expressions – So, if you smile at an autistic toddler, they may not smile back.
- No imaginative play – Most toddlers will play dress-up, or they’ll role play with other children. Autistic children may think creatively, but they rarely express creative behaviours.
- Weak upper body strength – Autistic toddlers rarely crawl or roll. As a result, they have weak upper body strength.
- Poor hand-eye coordination – An autistic toddler may struggle with hands-shoulders-knees-and-toes. In fact, copying other people’s movements can be really difficult.
- Speech problems – Typically, autistic children start talking 6-12 months later than their peers.
- A reluctance to eat solid food – Autistic toddlers tend to prefer pureed food.
- Crying – Autistic toddlers may kick up a fuss if they are asked to do something new.
It’s worth remembering that all toddlers will cry and refuse food from time-to-time. In fact, most toddlers are tricky to handle when they are very tired.
Signs of autism in school-aged children
When children reach school age, their autism may start to manifest itself in different ways. For example:
- Video games – It might sound cliché, but studies show that autistic boys are more likely to play video games than their peers. This may be because video games allow them to disengage.
- Special talent – Some autistic children develop special talents. For example, they may become exceptional at spelling, algebra or art.
- Few friends – Autistic children don’t have a wide circle of friends. If their school environment is supportive, they’ll usually develop one or two close friendships.
- Problems reading aloud – At primary school, children are often asked to read aloud to the class. Autistic children may read very slowly or jumble the words up.
Some autistic children are very adaptive and don’t necessarily need a diagnosis to thrive. However, many autistic children will benefit from extra support at school.
How to recognise autism in teenagers
Teenagers with undiagnosed autism might not seem autistic. This is because they’ve found ways to adapt. Nevertheless, they may still benefit from a diagnosis. Common traits and behaviours include:
- Feeling that they don’t fit in – No matter how hard they try.
- Online relationships – Autistic teenagers often form friendships online rather than in-person. Sometimes, these online relationships develop into in-person relationships.
- Taking things literally – This can sometimes cause friendships to break down. For example, “See ya’ later” is a common slang phrase for goodbye. An autistic person may interpret this to mean that the other person will definitely see them later that day.
- Excessive sleeping and daytime naps – Daytime naps are one way to cope with over-stimulation.
- Avoiding social events – Autistic teens may avoid proms, parties, and other social events.
Conditions that mimic autism
Autism has been discussed widely in the press, so it’s on most parents’ radars. Autism awareness is a great thing, but we should remember that autism is still relatively rare. So, when children present with seemingly autistic traits, there could be other reasons for this. For example:
Delayed speech is common in autistic children, but a child with delayed speech is not necessarily autistic. Speech delays can occur for several reasons. Firstly, children develop at different rates, so a short delay could be perfectly normal. In other cases, the delay may be caused by:
- Tongue or lip problems
- Hearing problems (perhaps caused by an ear infection)
- A learning disability such as dyslexia or dyspraxia
So, how can you tell if the speech delay is due to autism? Well, autistic children tend to avoid eye contact, whereas other children with speech delays do not.
Kids Health provide a list of the key language milestones. If your child is not meeting these milestones, talk to your General Practitioner (GP). Your GP may refer you to a speech and language therapist for further investigation.
Shy children can behave in a similar way to autistic children. For example, shy children tend to avoid eye contact and may struggle to eat in public. Also, they tend to prefer routine and predictability.
So, how can you tell the difference between shyness and autism? Generally speaking, shy children will warm up to a situation over time. For example, they’ll gradually make more friends during the school year, and they’ll maintain eye contact with these friends. Also, a shy child will actively seek out new activities/experiences once they become comfortable in their environment. In contrast, young autistic children find eye contact hard (even with people they are close to). Also, they don’t usually try new activities unless pushed.
Dyslexia is a condition that affects the way information is processed in the brain. As such, dyslexic children tend to muddle their speech. They also struggle with hand-eye coordination. As mentioned, these are also autistic traits, so the two conditions can be confused. If you think your child might have dyslexia, it’s best to speak with your GP or health visitor.
Diagnosing autism – is it necessary?
Some parents worry about getting a diagnosis because of the stigma attached to ASD. Diagnosis is a personal choice. If you are feeling torn, you might find it helpful to speak to a counsellor.
From a purely pragmatic perspective, early diagnosis allows you to access support for your child (should they need it).
Autism therapies and interventions
According to NICE guidelines, children with ASD should be offered a “psychosocial intervention”. These types of interventions aim to improve a child’s social, cognitive and motor skills. The interventions may include sessions with a speech and language therapist. The child’s nursery or school may also be involved.
Over the years, we’ve seen many different autism interventions. Some of these have been more controversial than others. To be specific, Applied Behavioural Therapy (ABA) and antidepressants are particularly controversial. If you’d like to know more, Research Autism evaluates ASD interventions.
I think my child has autism – what next?
If you believe your child may have autism and you wish to pursue a diagnosis, here are the steps you can take (in the UK):
- If your child is approaching 2 years of age, you can discuss your concerns at your child’s compulsory developmental review. Alternatively, make an appointment with your GP. Your GP may refer your child for a paediatric assessment.
- If your child is diagnosed with ASD, discuss this with your child’s nursery or school. If they do not have the resources to support your child, you can ask your local authority to carry out an Education, Health and Care Plan (EHCP). If deemed appropriate, your child may be offered a place at a different school.
- You may be eligible for additional support such as the Disability Living Allowance.
If you pursue a diagnosis, it’s important to tell your child what is happening. Sometimes, it’s easier to do this when you are sitting next to your child rather than opposite them.
Above all, remember to be gentle. Autistic children are not detached from the world around them. On the contrary, they are hypersensitive to the world and the judgement of others. If you pursue the diagnosis too aggressively, your child may feel something is ‘wrong’ with them.
Autistic adults tell us time and again that what they really craved as children was acceptance. So, keep this in mind when seeking a diagnosis for your child.