Recognizing the Warning Signs of Autism: New Guidelines Help Make it Easier

Parents often have a gut feeling that something's not right. But they may not share their concerns. And it can take months or years for doctors to make a definite diagnosis of autism.

The American Academy of Pediatrics issued new guidelines in October 2007 to help parents and doctors identify early warning signs of autism so that treatment can begin sooner. Although there's no cure for autism, early intervention can help a child reach his full potential.

The new guidelines call for screening much earlier than before. They now suggest screening all children for signs of autism at 18 and 24 months of age, whether or not a parent has any concerns. Doctors can use autism screening tools that assess language and other aspects of development at well-child visits.

Major risk factors for autism include a sibling who has been diagnosed with autism or concern from the child's parent, another caregiver or the child's doctor. If two or more of these risk factors are present, then a referral for a more complete evaluation is recommended.

Early signs of autism, even in the first several months, can signal a problem. Looking for these symptoms in your child can lead to earlier diagnosis and treatment. Tell your doctor if you notice that your baby:

• Smiles late or very little. Babies begin to smile as a way to engage others in the first few months of life.
• Seldom makes eye contact with people. From about two to four months old, babies make eye contact with mom, dad and other familiar people.
• Doesn't turn when you say his or her name. This normally occurs around age eight to 10 months.
• Doesn't turn or look when you point or say, "Look at this." This happens around age 10 to 12 months.
• Doesn't point at objects or people at about 12 to 14 months old.
• Doesn't babble back and forth. This usually begins at about 6 months of age. Between eight and 10 months, babbling becomes more complex with more syllables ("ba-da-ma"). They also start to mimic the pitch and tone of their native language.

Doctors consider the following red flags that warrant immediate evaluation:

• Not babbling or pointing by 12 months of age
• Not using single words by 16 months of age
• Not using two-word spontaneous phrases by 24 months of age
• Loss of language or social skills at any age

Share with your doctor any other concerns you have about your child's language development and social skills, especially if your child has lost language or social skills. About one in four children with autism and other conditions related to autism begin to say words, but then stop speaking. This may happen between 15 and 24 months of age. They may also lose other communication skills, including pointing, waving and eye contact. This is called regression, and a parent should always alert their doctor about this.

Treatment can start even before a formal diagnosis of autism. Early intervention, including speech and language therapy and behavioral interventions, appears to have long-term benefits for kids with autism and can help them lead more normal lives.

Related Articles A Head Start for Children with Autism

External Sources Plauche Johnson C, Myers SM, Council on Children with Disabilities. Identification and evaluation of children with autism spectrum disorders. Pediatrics. 2007;120(5):1183-1215. Accessed October 29, 2007. Behrman RE, Kliegman RM, Jenson HB, eds. Nelson Textbook of Pediatrics. 17th ed. Philadelphia, Pa: Saunders; 2004.

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