How to identify autism early to avoid complications?

Autism is a developmental disability that affects how a child interacts with the world. It is characterised by two core features, including social communication and restricted and repetitive patterns of behaviour. Statistics suggest that autism affects at least 1 in 65 children between the ages of 2 and 9 in India. Autism is also more common in men than in women.

Know the common signs of autism

One of the most frequent presenting complaints for caretakers of autistic children is delays and variations in language development. There is a delay or regression in spoken language. There is limited use of language for communication. Responsiveness when called by name, shared enjoyment with a caregiver, use of eye contact during communication and use of pointing as a means of communication – all of these behaviours are typically missing in a child with autism.

Autistic children have a preference for solitary play with a lack of participation in social play with others. They might only use other people as tools or “mechanical” assistance, like utilising a caregiver’s hand to get something they want without making eye contact. Stereotype or repetitive behaviours such as flapping the hands, rocking the body or spinning in circles are typical characteristics in a child with autism. He or she insists on the same routines and resists change. Atypical or repetitive play are commonly observed in autistic children, such as opening and closing doors, turning the lights on and off with over-attention to parts of objects such wheels of a toy car.

Ask yourself:

• Does your child respond to your name?
• Does your child prefer to play alone rather than with others?
• Does your child use his/her index finger to show you something?
• Does your child ever bring a toy over to show you?
• Does your child pretend play?

Red flags of autism

Here are the red flags of autism you should know to avoid complications:

• Poor response to name calling by 1 year of age
• Lack of pointing to objects by 14 months
• Lack of pretend play by 18 months
• No meaningful word by 18 months of age
• Fixed patterns of activities
• Decreased interaction with friends
• Has odd movement patterns or repetitive behaviours
• Hyperactive
• Toe-walking
• Repeating words and phrases (Echolalia)

Get autism screening for children at an early age

If you think your child has autism or you think there could be a problem with the way your child plays, speaks, learns, or acts, contact your paediatrician as soon as possible and share your concern. There should be a proper evaluation and screening by a paediatrician and referral to a paediatric developmental expert if needed. The American Academy of Paediatrics (AAP), the Centers for Disease Control and Prevention (CDC), and the Indian Academy of Paediatrics (IAP) recommend Autism-specific screening of all children at 18 and 24 months of age because these are critical times for early social and language development. Every pediatrician should evaluate and screen for autism at this age.

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There are various tools available for screening as well as to diagnose autism. The Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F), is the most studied and widely used tool for screening toddlers for autism. It is a freely available and downloadable questionnaire (in multiple languages) to be completed by parents, which takes about 10 minutes to complete. It uses a simple scoring procedure based on passed/failed items.

If your child does have autism, it’s important that he/ she be diagnosed as soon as possible. This way, they can get help and support early. With appropriate intervention, most children with mild-to-moderate autism can be treated.