What to Expect: The Signs of Autism and Diagnosis
As a parent you are always in tune with the beat of your children. Even amongst the many busy days of life, parents have a unique ability to identify when something about their child feels off, or unusual. We are here to further your super powers, and support you, as professionals working with children diagnosed with Autism Spectrum Disorder.
Early signs may include: Fleeting or no eye contact, not sharing interest or showing items, not responding to sounds, voices or name, loss of skills at any time, no vocal language by 18 months, fixation on unusual objects or one particular toy, lack of social engagement, or repetitive motor behavior. (Boyd 2010)
It is very important to minimize the time between identifying early signs and a child receiving a diagnosis, as it is crucial for improving the long-term outcomes (Elder 2017). If you think you’ve identified a few of the above signs, it never hurts to dig into it further. The MCHAT, a resource provided to parents, is a screener that will ask a series of 20 questions about your child’s behavior. The results will let you know if further evaluation may be needed. The MCHAT and its results are a useful tool, but it does have its limitations according to research (Yuen 2018). Please keep in mind that the MCHAT is not a means for diagnosing your child. That is why it is important to further discuss your concerns with your child’s primary healthcare provider. Below are a few examples of how these signs may be observed in an everyday setting:
Lack of coordination of verbal and non-verbal communication
Typically, children may be able to communicate their wants and needs using their words or even guiding you towards what they want. Children with Autism tend to have deficits in communication skills, so instead of using words they may engage in a tantrum or other types of problem behavior, in an attempt to get their needs met.
Few social initiations and responding
If you were to observe children playing on a playground, you may notice quite a handful of interactions occurring. Kids requesting things from one another, giving each other high-fives, or chasing each other around. A child on the spectrum may be more stand-offish, quiet, and keeping to themselves. A typically-developing child gains skills through learning from their environment, imitating other’s behavior, and learning by trial-and-error. Children on the spectrum are not so readily able to do the same, thus making social interactions more difficult.
Deficits in joint attention, atypical eye gaze
As many objects as there are in our environment, you and I are able to make and maintain eye contact with others. A child may indicate to their teacher that they are ready or need help by simply making eye contact with them. In children with Autism, you may notice an atypical eye gaze. Instead of making eye contact with you, they may be fixated on objects or various things in their environment. For example, when playing with a baby, they may look you in the eye several times to gain your attention or to indicate to continue playing with them. A red flag may be when a toddler or child is looking at everything in their environment, except your eyes or face.
Should your Primary Care Physician suggest further testing after their own assessment, they will recommend you go to a diagnostic center. It is at the diagnostic center where it will be determined if your child is diagnosed with Autism Spectrum Disorder. From your own identification through a diagnosis with a center, it is understandable that you and your loved ones may feel a variety of emotions; this is normal. And while a tall ask through an uncertain period in your life, remember: there are professionals trained to support your child through Autism Spectrum Disorder.
Those professionals typically come in the form of Board Certified Behavior Analysts (BCBA), practicing the science of Applied Behavior Analysis (ABA). Applied Behavior Analysis is an empirically-supported treatment for individuals diagnosed with Autism Spectrum Disorder. ‘Empirically-supported’ means that it is based on observable data! ABA is supported by over 40 years of research conducted in a variety of settings with various populations (Hagopian 2015). Behavior has been analyzed and studied very intensely, and ABA aims to improve socially important behaviors by applying behavioral technologies to individuals of various populations in the real-world (Baer, Wolf, Risley, 1968). One of the fundamental strategies of ABA is positive reinforcement, and behavior analysts are ethically required to use reinforcement in treatment (BACB 2019). ABA creates a positive and socially engaging environment for children to learn in. Several studies over the years have indicated that high-quality early intervention accelerates learning in children with developmental disorders (Wallace 2010).
The good news is, there are a handful of Applied Behavior Analysis centers throughout Southeast Michigan, offering center based and in-home services. It is important to keep effective and ethical treatment at the forefront of your center search. In our post next Monday, we’ll dive deeper into how to find that right center and BCBA to help meet the specific needs of your child.
If you’d like to talk with us further, please feel free to email us at hello@carlylecenter.com or call at 313.288.9459.
You can subscribe to our weekly newsletter by going to our website and heading to the footer of the page, where you have the option to sign up for our updates.
Another great resource is asatonline.org, which helps parents and educators stay informed on what works best for children diagnosed with Autism Spectrum Disorder.
Updates to our Original Post
Babynavigator.com is a new website developed by Dr. Amy Wetherby and her team at Florida State University College of Medicine’s Autism Institute. The link below will take you to a visual of ’16 Early Signs of Autism by 16 Months’. Baby Navigator was developed using the National Institutes of Health-funded research. The website gives access to visuals, videos, and a screening tool to identify signs and symptoms for children ages 9-18 months.
For more information visit here.
16 Early Signs of Autism by 16 Months
Your child’s teacher can play an important role in identifying concerns in their development. A study found that Preschool staff ratings were more accurate than parent’s in identifying children with and without ASD, as well as identifying signs more closely related to clinically-rated symptoms (Jobs, Bölte, & Falck-Ytter, 2019). Teachers spend a significant amount of time with your child as well as with other children. They are able to identify if a child is not progressing at the same rate as others in the class. It is useful to take into account what your child’s teacher reports!
Another option for early screening is to contact your respective counties Access Center. Access Centers are able to decide if you are eligible for publicly provided mental health, developmental disability, or substance use disorder treatment services. Before calling you should prepare with the following information: where you live, insurance, income, and your current concerns. Below you can find information for Macomb, Oakland, Wayne, and Livingston counties’ access hotlines.
Macomb County Access
https://www.mccmh.net/CallingAccessCenter.aspx
Call the Access Center toll free at 1-855-996-2264. You can also use their local line, 586-948-0222.
Oakland County Access
http://www.occmha.org/index.php/access-and-elgibility
Call the Access Center at 248-464-6363
Wayne County Access
https://www.dwmha.com/programs-services/autism/
Call the Access Center at 800-241-4949
Livingston County Access
http://www.cmhliv.org/programsaccessintake.html
Call the Access Center at 517-546-4126
Baer, D. M., Wolf, M. M., & Risley, T. R. (1968). Some current dimensions of applied behavior analysis1. Journal of Applied Behavior Analysis, 1(1), 91-97. doi:10.1901/jaba.1968.1-91
Behavior Analyst Certification Board (BACB). (2019). Professional and Ethical Compliance Code for Behavior Analysts. Retrieved from https://www.bacb.com/wp-content/uploads/BACB-Compliance-Code-english_190318.pdf.
Boyd, B. A., Odom, S. L., Humphreys, B. P., & Sam, A. M. (2010). Infants and Toddlers With Autism Spectrum Disorder: Early Identification and Early Intervention. Journal of Early Intervention, 32(2), 75-98.
Elder, J., Kreider, C., Brasher, S., & Ansell, M. (2017). Clinical Impact of Early Diagnosis of Autism on the Prognosis and Parent-Child Relationships. Psychology Research and Behavior Management, Volume 10, 283-292. doi:10.2147/prbm.s117499
Haopian, L. P., Hardesty, S. L., & Gregory, M. (2015). Overview and Summary of Scientific Support for Applied Behavior Analysis. The Kennedy Krieger Institute and Johns Hopkins University School of Medicine. Retrieved from https://www.kennedykrieger.org/sites/default/files/library/documents/patient-care/centers-and-programs/down-syndrome-clinic-and-research-center/aba-scientific-support-9-2015.pdf.
Jobs, E. N., Bölte, S., & Falck-Ytter, T. (2019). Spotting Signs of Autism in 3-Year-Olds: Comparing Information from Parents and Preschool Staff. Journal of Autism and Developmental Disorders, 49, 1232-1241.
Wallace, K. S., & Rogers, S. J. (2010). Intervening in infancy: Implications for Autism Spectrum Disorders. Journal of Child Psychology and Psychiatry,51(12), 1300-1320. doi:10.1111/j.1469-7610.2010.02308.x
Yuen, T., Penner, M., Carter, M. T., Szatmari, P., & Ungar, W. J. (2018). Assessing the Accuracy of the Modified Checklist for Autism in Toddlers: A systematic review and meta-analysis. Developmental Medicine & Child Neurology, 60(11), 1093-1100. doi:10.1111/dmcn.13964