Trouble with verbal communication
“While babies hit language milestones at various times, if there is a delay beyond certain ages, it’s important to seek a professional evaluation,” says Paul Wang, MD, senior vice president and head of medical research at Autism Speaks. Potential signs include no babbling or no back-and-forth gestures like pointing or waving by 12 months; no words by 16 months; or no meaningful, two-word phrases by 24 months.
Challenges with social reciprocity
“Healthy children show their connections with other people by sharing a smile, a hug, or a knowing look,” says Dr. Wang. If you’re not seeing big smiles or other joyful expressions by six months of age, that is a potential spectrum indicator. Similarly, if your baby is not mimicking sounds, smiles, or other facial expressions by nine months, it’s advisable to seek an evaluation. Eye contact might also be difficult for people with ASD, which affects their ability to read and interpret other people’s facial expressions. “Many children with autism have a hard time relating to others, so they may seem more interested in objects than people,” says Dana Wattenberg Khani, MEd, senior consultant and autism expert for Autism Friendly Spaces, which partners with organizations to make them more accommodating to people with diverse needs. For example, if you show your child a photo of a ball, or give him a ball, he may be more focused on those than on making eye contact with Mom or Dad. He also may prefer to play alone because of difficulties relating to other people.
Loss of speech or social skills
According to research, regression is very common among children with ASD. “Any child who is sick or upset might show a couple of days of decreased language and communication, but if the loss of skills lasts more than a few days, it's important to seek out an expert to figure out why,” suggests Dr. Wang. “Studies have suggested that about one-third of children with autism experience some kind of regression, but most of these children do not have typical development to begin with,” former autism researcher Jennifer Richler wrote on slate.com. “Instead, they have early delays and lose some of the skills they had attained.”
“Hand-flapping, rocking, jumping and twirling, arranging and rearranging objects, and repeating sounds, words, or phrases,” are all common repetitive behaviors characteristic of ASD, according to Autism Speaks.
Children with ASD can become fixated on order when it may not seem to have a purpose. During play, they may spend hours lining up their toys and sorting them by color or size instead of playing with them. “Many children with autism gravitate toward trains,” notes Khani. “They have wheels that go around and around, they move along a structured track, they run on a predictable schedule, and they have numbers or letters assigned to them.” Routines may be unreasonably important, as well. "We all get a little uncomfortable if we have to vary from our usual way of doing things, but if they really have a meltdown, that's a sign of a problem," Tristram H. Smith, PhD, a professor of neurodevelopmental and behavioral pediatrics at the University of Rochester Medical Center, told attn.com. In a young child, this may result in tantrum like behavior. As children get older, they may display repetitive behaviors like pacing or wringing their hands together when they get anxious about a schedule change.
Strong preoccupations or obsessions
Extreme interest in or deep knowledge of an unusual subject matter can also be a symptom of ASD, according to Autism Speaks. They offer examples like an obsession with fans, vacuum cleaners, or toilets and expertise in astronomy or Thomas the Tank Engine. Older children and adults with autism may develop a preoccupation with numbers, symbols, dates, or science topics.
Taking things literally
People on the autism spectrum often have trouble inferring or understanding abstract concepts and idioms. “When I taught second grade, I asked a child to toss me a paper clip,” recalls Khani. “Suddenly, there was a paper clip bouncing off my head when he threw it at me.” Similarly, if you tell a child to “take a seat,” he may ask where he should take it.
“It’s common for people on the spectrum to also be diagnosed with other disorders,” notes Khani. According to Autism Speaks, diagnoses that often accompany ASD include gastrointestinal disorders, seizure disorders, sleep dysfunction, sensory processing problems, and pica (the tendency to eat things that aren’t food).