According to the Centers for Disease Control and Prevention, nearly one percent of American children are challenged by one of the Autism Spectrum Disorders. Some autistic children can be diagnosed and offered early intervention before age two, but this requires that their parents and pediatricians recognize how these children’s behavioral milestones differ from normally developing toddlers. An online tool, the Modified Checklist for Autism in Toddlers (MCHAT) makes it easy to screen toddlers at home.
Communication Symptoms
Autism in child between age one and two year presents as a combination of communication, social and behavioral dysfunctions, and one of the earliest noted is a lack of give and take in their communication, according to the Centers for Disease Control and Prevention’s Guidelines for the Diagnosis of Autism. Pediatricians refer to this as a lack of reciprocity.
The toddler who is at risk for autism will not be using one and two word phrases in a meaningful way. He may echo some words he hears, but he will not engage in back and forth conversations, even in his babblings, and his vocabulary will remain limited to things he can touch or see.
Children start speaking and build their vocabularies at an individual pace. But autistic children do not engage in non-verbal interactions either. For example, when a parent makes a silly face, the expected outcome is that the child of a year or more will giggle, but the autistic child simply stares. Autistic children do not communicate even as much as children with other severe language deficits, according to Dr. Noterdaeme's team, reporting in the December 2000 issue of the "European Child and Adolescent Psychiatry."
Joint Attention Deficit
To autism researchers, like Geraldine Dawson, M.D. of the University of Washington, joint attention deficit, or JAD, is thought to hold answers to the way autism disrupts normal development. Joint attention is a normal part of human behavior that helps children make sense of the world and develop an expanding circle of awareness. It begins when a child notices a new object or experiences something he wants to share. He then grabs the attention of his parents or another person and finally he shows the object to them. JAD exists when a child can not or does not attempt to share something he sees, or experiences with others, even non-verbally. The autistic child can not accomplish joint attention.
The Lack of Imaginary Play
Toddlers begin to imitate the adults in their lives between 12 and 15 months of age, according to the CDC Milestones of Child Development. Autistic children are often not engaged enough in the process of observing others to imitate their actions and because this developmental step is missed, they fail to build a repertoire that other children can use later on as they engage in more interactive play.
The Lack of Eye Contact
When parents of autistic children are asked what they first noticed was different about their child's development, they often cite their child's lack of eye contact. The child with autism is often said to stare past people rather than making eye contact. When this is noticed, the first thing to ascertain is whether the child's vision is normal. Then a pediatrician will need to observe the child's interactions when he is well rested and alert, so that the lack of eye contact is not mistakenly attributed to fatigue.
Repetitive Motion
One of the diagnostic criteria for autism is the repetition of movements that have no purpose other than to self soothe, such as hand flapping and spinning. The difference between other behaviors toddlers exhibit, such as thumb sucking or twirling hair, and the autistic repetitive motions, is the autistic child's inability to engage in the behavior and focus on anything else. A healthy child can suck her thumb and listen to a story; the autistic child becomes lost in the action itself and usually isolates.
References
- "Morbidity and Mortality Weekly Report: CDC"; Prevalence of Autism Spectrum Disorders; Carolyn Rice; December 18, 2009
- European Child and Adolescent Psychiatry"; Diagnostic Assessment of Communicative and Interactive Behaviours in Children with Autism and Receptive Language Disorders; M. Notredaeme, et al; December 2000
- "Pediatrics"; Randomized, Controlled Trial of an Intervention for Toddlers With Autism, Denver Model; Geraldine Dawson, PhD, et al; November 30, 2009,
- Centers for Disease Prevention and Control: Know the Signs. Act Early.
