Clinical Psychologist Jaimie Bloch on detecting ASD in babies and toddlers

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Did you know that about one in 150 Australians are affected by autism, and boys are four times more likely to have it than girls? In fact, autism is so common in our society that most of us either know someone who has it (if not several people) or know of someone who has it. With notable celebrities like Australian comedian Hannah Gadsby and South African-born American entrepreneur and CEO of Tesla Elon Musk talking publicly about being on the spectrum, ASD is far less ‘otherised’ than it once was – even 10 years ago. 

Autism Spectrum Disorder (ASD) speaks to a broad spectrum of behavioural symptoms and levels of functionality, whereby the brain develops differently. ASD is described by Health Direct as, “a lifelong developmental disorder that affects how people behave and interact with the world around them. It may be mild, moderate or severe”. While it sometimes gets confused, autism is neither a mental health condition nor an intellectual disability – although some people with autism will experience those medical conditions as well.

ASD symptoms tend to be present in babies, but may not become noticeable until the child is around two years old, and as Clinical Psychologist and Director of MindMovers Psychology Jaimie Bloch explains, “Diagnosis is normally best done through multiple professionals and with specific testing tools”. 

Thanks to the United Nations General Assembly, World Autism Awareness Day is recognised internationally on the 2nd of April. The annual day encourages Member States of the United Nations to raise awareness about people with ASD around the world – and bring autism into greater cultural and social visibility. 

Keen to encourage the conversation and learn more about autism and how it can express itself in babies and young children, we asked Jaimie some questions about early ASD signs, diagnoses and what exactly is, the ‘spectrum’… 

What are the early warning signs for autism that parents can look for? 

Early warning signs are just signs. They could occur for a range of reasons, and you must start the process of investigation. Remember that signs must occur in clusters, rather than one singular behaviour you notice. 

If you’ve noticed any from the list (below), it’s important to speak with your pediatrician or book a diagnostic appointment with a psychologist who tests for autism to start the process to rule in or out autism. 

Signs to look out for autism…

By 12 months your child: 

  • Does not pay attention to or is frightened of a new face
  • Does not smile, does not follow moving objects with eyes
  • Does not babble and laugh
  • Does not turn their head to locate sounds, and appears not to respond to loud noises
  • Does not push down on legs when feet are placed on a firm surface (looks like tiptoe walking)
  • Does not use gestures such as waving, pointing or clapping

Tip: A good way to assess these behaviours is by playing peek-a-boo.

By 24 months your child:

  • Cannot walk by 18 months or walks only on their toes, and cannot push a wheeled toy
  • Does not speak; does not imitate actions, cannot follow simple instructions
  • Does not appear to know the function of common household objects such as a mobile phone by 15 months
  • Does not respond to his or her name by turning their head, providing eye contact or verbally acknowledging you

During this age, there may be language regression; about 25% of parents with children with autism report their child developed language which was no longer present by the age of 2.

By 36 months your child…

  • Has very limited speech, does not use short phrases, has difficulty in understanding simple instructions
  • Has little interest in other children, has difficulty separating from their primary caregiver. Typically, children may watch other children playing and some may want to join in by pointing, showing interest and sharing enjoyment, however, children with autism may not show these behaviours of interest.
  • Difficulty in manipulating small objects
  • Has little interest in ‘make-believe’ play

Other signs can look like… 

  • Difficulty interacting and communicating with others…
  • Lack of eye contact
  • Limited use of words or gestures when communicating

Narrow interests…

This often looks like limited and restricted interest in specific areas such as they only play with a part of toy cars rather than the whole toy or very rigid interest in a specific character and won’t deviate to other play, even when with other children. They may also find it challenging to adapt to trivial changes to their routine by displaying intense emotional distress and challenging behaviours.

Children with autism may also display sensory seeking behaviours, such as pressure on their body, lights, signs, sounds and specific touch. They may also be highly sensitive to sensory input which they can become aversive towards, including loud noises and textures on clothing.

Repetitive behaviour, like making repetitive noises or repetitive movements, is also common.

How early can autism be diagnosed?

Diagnosis can occur from as early as 12 months but is often diagnosed from the age of 2 and older. Diagnosis is normally best done through multiple professionals and with specific testing tools. 

When we talk about ‘the spectrum’, what does that actually mean? 

The spectrum means that there are no two people alike who experience autism the same. It means that there is a spectrum of behaviours, social and play skills that are affected to different degrees. This spectrum tries to encompass the variation and degree of functioning a child diagnosed with autism has.

The spectrum ranges from low functioning to mid-range functioning to higher range functioning. It is important to note, children and even adults may present with some behaviours, typically seen in those with autism. This is also part of the spectrum, however, a diagnosis is not made unless there are multiple symptoms of autism that contribute to challenges in functioning in everyday tasks.

If you believe your baby, toddler or child is displaying signs of autism, it’s important that you talk with your family doctor or paediatrician. That way you can get referred to a psychologist and other specialist support. Although it’s a broad spectrum, with the support available to Australian families dealing with ASD today (NDIS is a game-changer for families!) – along with growing community and cultural awareness, children diagnosed with ASD can live happy and healthy lives. 

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