Psychologists call autism a spectrum disorder, meaning that the severity and presentation of symptoms varies from child to child. Nonetheless, autism symptoms center on three main categories, according to the 4th edition of the "Diagnostic and Statistical Manual of Mental Disorders" (DSM-IV), the guide psychologists use for diagnosis. Signs of autism may be subtle before 18 to 24 months of age, but they are present if you know what to look for.
Behavior Disturbances
Children with autism tend to need routines, becoming agitated when changes occur, the Mayo Clinic says. One of the hallmark features of autism is the presence of stereotyped and repetitive behaviors, such as hand flapping or the spinning of objects. The Center for Autism and Related Disabilities (CARD) at the University of Florida notes that children with autism may also engage in laughing that is inappropriate to the situation and/or in play that is “odd” and that continues uninterrupted for long periods of time.
Social Skill Impairments
One of the earliest signs of autism is an unwillingness to snuggle against a caregiver. As a result, infants with autism may feel “board-like” when picked up. Infants and children with autism also tend to have poor eye contact, the Mayo Clinic says. As they get older, social skill issues appear in the form of the child wanting to play alone, being apathetic about other children and a lack of sharing, according to the CARD. For example, most 3-year-olds who discover a new bug in the yard would run over to tell a caregiver about it. A child with autism would not likely make any efforts to share the discovery.
Language Impairments
Language impairments vary widely between children with autism. Some children produce no intelligible speech, while others can speak words and sentences fluently but do so abnormally. Language impairments may take the form of echolalia, the CARD reports. In echolalia, a child is able to repeat only what others say. For example, if you said, “Hi, John. How are you?” to a child who shows echolalia, he would say “Hi, John. How are you?” Even when children with autism produce meaningful, novel speech, they may use “a singsong voice or robot-like speech,” says the Mayo Clinic.
Other Signs
A group of psychologists created a checklist of autism symptoms, called the Checklist for Autism in Toddlers (CHAT), to be used when a child is 18 months of age. The CHAT, which has been peer-reviewed and published, includes signs that the DSM-IV omits. Most notably, the CHAT notes that an absence of pretend play may be indicative of autism if observed in combination with other symptoms. The CHAT also assesses protodeclarative pointing, or pointing to direct someone else’s attention toward something. Children with autism often fail to point themselves and tend not to look at others’ fingers when others point.
