From a mile to a smile

Symptoms and Signs of Autism

Symptoms of Autism

Most symptoms of autism are observed in toddlers as young as 18 months old, but there are cases which are discovered after the child has entered primary school. This later discovery can be due to some symptoms are only observable in a complex social environment. The common symptoms include their inability to follow social rules, social communication, emotional deficits, and throwing a big tantrum when one tries to stop their rigid and repetitive behaviour. They may also have learning difficulties such as being inattentive during class, leaving seats at an inappropriate time, and being not able to learn through observations. These all affect a person greatly in life.

You should feel concern if more than one of these symptoms has occurred:

  • Not able to point to request
  • Not able to follow other’s pointing (poor joint attention skills)
  • Have difficulties in understanding other’s emotion and expressing own feelings
  • Avoid eye contact
  • Poor perspective taking
  • Poor join-in skills
  • Use repeated words or sentences and speak in incomplete sentences
  • Poor imaginary play skills
  • Repeat same actions
  • Not able to accept changes in rules or routines
  • Hypersensitivity or hyposensitivity to senses (smell, taste, sense of touch, or sound)
  • Regression in skills (e.g., from able to speak in full sentences to not able to speak)
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What is the prevalence of autism?

Autism happens to all race, culture and society, with male affected 4.5 times more frequently than female. In just 10 years, the prevalence of autism has raised from 1 in 150 to 1 in 68 children. In Hong Kong, the prevalence is around 1 in 100 children. The number remains the same between 2010 and 2012. But the ADDM report has suggested that it is too early to confirm the number has stopped rising. Here is a chart taken from CDC website , reporting the prevalence findings of ADDM network between 2000 – 2012.

https://www.cdc.gov/ncbddd/autism/data.html

Risk Factors

Individuals with ASD can be diagnosed at the age of 18 months old or younger. One should be assessed immediately to avoid missing the golden window for interventions, which is normally between the age of 2 to 6. The following groups are at higher risk of having ASD:

  • Among identical twins, if one child has ASD, then the chance for the other child being affected is 36-95%. In the case of  non-identical twins, if one child has ASD, then the chance of the other child being affected is  0-31%.
  • If the first sibling has ASD, there is a 2%-18% chance the second child also has it
  • Children born to older parents are at a higher risk for having ASD.
  • Children who are born with low birth rate (<2500g) and prematurely (<33 weeks) are at greater risk for having ASD. [Read article]

There are couple reasons for the rising numbers

  1. Broader definition of ASD
  2. Better understanding of ASD
  3. Clinicians have become better at identifying features that were previously missed
  4. Rising populations

4 main early signs in toddlers with autism

Many parents are worried about whether their children are autistic. Of course, we encourage parents to seek an assessment as soon as they have doubts. However, parents can use the list below as a reference to see if your child needs an autism assessment. Please keep in mind that early assessment will enable you to grasp the prime time and let your children receive treatment as soon as possible.

Although each child has a different type of autism, the main affected areas include:

Defective language and communication skills

Social skills and social interaction barriers

Poor cognitive and adaptive skills

Limited, repetitive and rigid behavior and interest

Defective language and communication skills

Parents should pay attention to their children’s ability in speaking. Experts suggest that at 16-month old, children in general can use single words to communicate with people, and communicate with 2-word phrases in about 24 months. You may ask, what is communication? Children may use language to seek assistance, request objects, or view objects. Communication should also be spontaneous rather than unilaterally responding to parents’ questions. Therefore, in addition to vocabularies learning, parents should also pay more attention to the spontaneous use of language for communication of their children.

Social skills and social interaction barriers

In general, children are able to use body language i.e. pointing, shaking head, nodding head, after 12 months. They start to have more interaction with others, i.e. smiling while facing each other, pointing to the display of objects, and even trying to communicate with others. In addition to the technical language, generally children will also interact with people through imitation. For example, young children can follow clapping, and so on. Moreover, children should have eye contact with people, which is looking directly at others while talking or getting information.

Poor cognitive and adaptive development

Of course, cognitive ability is more difficult to observe, but parents can observe whether their children are having more difficulties to adapt changes. For example, whether your child would get upset and throw tantrum when you change the transportation to school,  whether your child can adapt to new classes, or find it hard to adopt any small changes in daily life. If so, you may need to seek help from professionals.

Limited, repetitive and stubborn behavior and interest

In terms of play, parents can pay more attention to whether their children have limited interest, such as car-only. Children with autism usually got limited interested and are not willing to try new toys. In play, they may only focus on the smaller parts of toy. For example, keep turning the car wheel or repeatedly switching the toy door. In addition, parents can also pay attention to their children’s play skills: whether their play lacks  imagination and variation, ie. spinning and lining up objects.

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Diminished of eye contacts in Autism

To diagnose autism, one of the important elements is to check whether the child avoids eye contact. A common assumption is that eye contact will make children feel uneasy, hence deliberately avoid it. However, a new study in the United States found the opposite result. Using eye tracking technology, they studied two batches of two-year-old children. The result found that children with normal development focused on other people’s eyes while paying attention to the facial expressions and responding to different facial changes. On the contrary, children with autism also paid attention to other people’s eyes, but did not observe their facial expressions. The study concluded that autistic children are neither afraid of nor uninterested in eye contact. Instead, the findings suggested that children with autism do not understand the meaning of eye contact.

From a Mile to a Smile

If in doubt, seek assessment as soon as possible.