New guidelines from the American Academy of Pediatrics (AAP) recommend screening for autism spectrum disorder (ASD) at the ages of 9 months, 18 months, and 24 months. The AAP recommends evidence-based intervention treatments such as speech therapy as early as possible. Experts say early intervention therapy for autism at an early age produces the best outcome for children.
Many of the diagnostic criteria for ASD are related to difficulties in social skills and communication. Therefore, Speech-Language Pathologists (SLPs) have a great deal of experience in treating children with ASD. As part of a team, an SLP can provide a lot of information that goes into a diagnosis of ASD.
Typical signs of Autism
The following is a list of “typical” signs seen in infants/children with a diagnosis of ASD; however, these symptoms must not be viewed on their own but as a group of symptoms. In other words, some children who are not on the autism spectrum may exhibit some of these symptoms, and some children who are on the autism spectrum may not exhibit all of these symptoms.
Possible Signs of Autism in Infants & Toddlers
Baby is not smiling socially (i.e., doesn't smile when interacting with people, does not smile when smiled at)
limited eye contact
limited vocal use, absence of babbling and social smiles
limited join attention
limited nonverbal communication/gestures (e.g., pointing, waving, reaching to be held)
limited vocal use (words or babbling)
crying is erratic and not communicative in nature. For example, most normally developing infants will cry to communicate discomfort (hunger, wet/soiled diaper, cold, fatigue) or protest; however, the cries of a child with ASD are not easily interpreted by the caregiver and may be random and/or unpredictable
doesn't respond to his/her name
doesn't follow simple directions (e.g., “waving bye”, or “get the ball”)
no meaningful words
absence of symbolic play (e.g., does not pick up toy food and pretend to eat it, or “play house” with household objects)
verbal output is either absent or not functional/meaningful (e.g., may be limited to reciting alphabet, numbers or colors/shapes, repeats verbatim what is heard on TV shows)
not combining meaningful 2 word phrases (e.g., children with ASD may be able to verbally recite long songs, rhymes or frequently heard commercials, but be unable to spontaneously generate single words which are socially meaningful)
requesting is not verbal (e.g., may pull the caregiver by the hand to the desired object instead of verbally requesting it)
loss of previously acquired verbal output (e.g., may have used words or babbled sounds in the past which become “lost” and not heard again)
Possible signs of Autism (any age)
lack of eye contact
prefers to play alone
delayed speech and language milestones
repeats frequently heard phrases over and over (echolalia)
rigidity to routine and is easily upset if routine changes
interests may be unusual and/or limited
performs repetitive behaviors to seek stimulation (e.g., hand flapping, rocking, spinning)
sensory issues with loud sounds, bright lights, colors
limited tolerance for varied tastes, food textures or smells
non-symbolic play (e.g. spinning the wheels of a toy car repeatedly)
When a speech therapist evaluates or provides treatment to a young child or toddler at this age, they are able to monitor and very accurately report on many of the items listed above. From how a child plays to meeting speech or language developmental milestones, from sensory issues and severely limited food preferences.
As part of a multi-disciplinary team, SLPs can help parents identify red flags and make suggestions for further evaluations. Because as Susan Hyman (on of the researchers on the study) stated, “Interventions work best when they are early, when they are intense, and when they involve the family.”
To get help with diagnosis or treatment, or to schedule a free consultation with a speech therapist, please contact me at Speech Therapy that Works.