Deficits in Social Interactions and Communications Skills:
There may be a lack of eye contact, lack of verbal communication, and lack of response.
Children with autism usually avoid making eye contact with people. They seem not show interests in their peers. Sometimes they prefer to talk or play with older kids or adults. They do not communicate their needs in typical ways, for example, pointing to the thing they want. They might have tantrums until they get what they want, or pull someone’s hand to grab it for them. They do not share their attention with others; for example, if you show them something interesting by pointing to it, they will not look at the thing you point to.
They have difficulty understanding body language, facial expressions, emotions and feelings of other people. This skill is called “Theory of mind”, and develops on its own in ‘normally’ progressing children. The difficulty of predicting or understanding others’ thoughts and feelings in children with autism is usually called “mind-blindness”, which causes them huge problems when they need to socialize with their peers. Some children with autism may desire to play with others, but they do not know how to play appropriately and might scare other kids away. Children who can communicate, may talk inappropriately or be too straightforward; for example, they may say something like “you are so fat like a pig” right in front of your face and they are not aware that it will hurt your feelings. Many people may think that these children are simply are rude and ill-behaved; so, it is not a big surprise that they may prefer to be “aloof” or live in their own world.
Restrictive and Repetitive Behaviors and Interests:
Repetitive behaviors are usually seen in younger children; for example, hand flapping, finger flicking and body rocking or they might stare at some object for hours. These behaviors are thought to be the way they self-soothe when they are over or under sensitized. Autistic children can be either extremely sensitive or not sensitive at all to their own pain or that of others or their surroundings and emotions. For example, they may not cry at all when they feel pain, but they may cry and react unusually to new sights, smells, textures and sounds. When they grow up, these behaviors usually fade away, but can persist in severe cases or in the case of intellectual disabilities.
Restrictive interests and fixed routines are very common in children with autism. They are very sensitive to changes. Changes make them feel uncomfortable, so they prefer to have the same daily routine, in the same environment, with the same people. Changing one of their routines can cause excessive crying or unstoppable tantrums. They may insist on following a rigid routine, eating the same foods from the same plate, sitting on the same chair. Their interests are also very narrow. They can play with dinosaurs or blocks all day, even if they have lots of toys nearby. Some children may have very high levels of intellect for their age, and be able to do things like memorize the names of dinosaurs or all the different bus routes, depending on their topic of interest.
What should I do, if I think my child could have Autism?
Whenever you suspect that your child has autism, you should bring them to see a pediatrician as early as possible, because early detection will lead to early intervention (treatment) and the best outcome for your child. You should trust your own instincts, because you know your child best. If you feel that something is wrong with your kid(s), even if everyone around you says that there is nothing wrong, it is worth it to see a specialist for the proper assessments. Additionally, there are a few standardized diagnostic screening questionnaires available free online for parents to be able to get some idea of what is happening before bringing kids to see their pediatrician. Two examples include the Modified Checklist for Autism in Toddlers (M-CHAT) [2] and the Autism Quotient (AQ) [3].
It is still very important for you to bring your kids to see a pediatrician regularly to check their developmental milestones, whether you suspect autism or not. The standard recommendation from the American Academy of Pediatrics and The Royal College of Pediatricians of Thailand, is that every child should be assessed for their development by standardized screening tools, at the ages of nine months, 18 months, and 24 to 30 months old. These recommendations give children the earliest possible likelihood of diagnosis of developmental problems and most effective treatments, for the best outcome. For autism, the early signs can be seen by the 9-month visit. If there is no sign at that point, the 18-month old visit will be a cornerstone for detecting of autism.
