A parent’s guide for early detection.
“When did you first think that Taylor may have autism?”
This has been a question I have been asked many times over the years, but it seems like recently I have been asked this more and more. The short answer is, by the time he was 18 months old, but it’s really a bit more complicated than that.
I say that it’s more complicated only because I never thought Taylor had autism. Hell, back then, I didn’t even know what autism was so I certainly wasn’t looking for that as a diagnosis as I explain in one of my older posts, Hearing the Word “Autism”. What first concerned my husband and I was Taylor’s very small vocabulary. It seemed like he really wasn’t very interested in learning new words.
At the time when Taylor was born, we lived in a cute but small neighborhood with several young, married couples. You know that saying “there’s something in the water”? Well, it must have been true because four of us all got pregnant within months of each other. It was really an exciting time and it seemed like all was perfect! We had ready-made play dates for our babies already lined up. Taylor was the first to be born of these four, new little friends. Being the first one born, of course he was also the first to start solid food, the first to babble, the first to laugh, the first to crawl and the first to walk. He was the first to say bye-bye…and then his progression began to slow down. It would be a month before he said another word. As his little friends began to pass him with their speech, Taylor seemed uninterested in talking. Over time, my concern began to grow, but it was only regarding his speech delay. I never once thought of autism.
What is Autism?
Autism spectrum disorder (ASD) is a complex developmental disability; signs typically appear during early childhood and affect a person’s ability to communicate, and interact with others. ASD is defined by a certain set of behaviors and is a “spectrum condition” that affects individuals differently and to varying degrees.Source: Autism Society
Babies and toddlers will develop at their own pace whether they have special needs or not. My own boys are perfect examples of this. Taylor, who has autism, started walking at 10 months old. My middle son, Brendan started walking at eight months! EIGHT. MONTHS. Let me pause a moment to give you a chance to really process that. To say that I was one tired mamma is an enormous understatement! Then my youngest son decided he wasn’t in a big hurry at all. Jordan didn’t take his first step until he was almost fourteen months old.
Autism is very much a communication and social disability. This reason alone can make it more difficult to get an early diagnosis when they are still toddlers. Especially if they are on the higher functioning end of the spectrum like Taylor is. Symptoms of autism could be better characterized by the absences of typical behavior in children, not the addition of abnormal behavior.
There were just a few things that seemed a little off to me when Taylor was a toddler. Knowing what I know now, I see that there were many red flags and that I had every reason to be concerned.
I want to express this strongly…TRUST YOUR GUT. You know your child better than anyone. If you notice anything that seems “off”, tell your pediatrician. If your doctor uses the “wait and see” approach and you don’t feel that is the right thing to do, go get a second opinion.
In my post AUTISM: THE JOURNEY BEGINS I talk about a few of the red flags that I noticed with Taylor in the beginning. Looking back and knowing what I know now, I can see that there were many more that I missed then. So what were they and what should you look for?
12 Signs to look for in your toddler.
1. Lack of speech. By the age of two, Taylor only had a total of 24 words. Most of those words, only my husband and I could understand. Some of those words Taylor had only said once.
If you’re able to understand only a few or none of your 2-year-old’s words, talk to your child’s doctor about scheduling an evaluation. By the age of two, your child should be able to:
- Use simple phrases, such as “more milk”
- Ask one- to two-word questions, such as “Go bye-bye?”
- Follow simple commands and understand simple questions
- Speak about 50 or more words
- Be understood at least half the time by parents or other primary caregiver
2. Babbling or yodeling. Taylor didn’t talk when he was two but he babbled. Mike and I actually called it yodeling because it sounded a lot more like that to us. Like he was babbling but singing it if that makes since. This made it a bit more difficult for people to notice that he wasn’t talking because he wasn’t “quiet”. He would sit and play with his toys while yodeling to himself. It was very cute but it was a red flag we missed.
3. Lining things up. Taylor loved to line up his toys. A lot of toddlers like to do this as well, but Taylor did it with EVERYTHING. I remember one time in particular, I came into the kitchen and saw he had found the coffee filters. He had taken them and lined them up neatly all the way across the kitchen floor. At the time I thought it funny but also peculiar.
4. Not responding to their name. Taylor did not respond to his name until he was over a year old. It was first brought to my attention by his teacher at daycare. My husband and I missed it because he would respond to our voice if we called him, but if someone else called his name, he wouldn’t respond.
5. Pointing, leading and grunting. Taylor was very good at expressing what he wanted. So much so, that one night when my best friend babysat for us, she didn’t even notice that Taylor hadn’t spoken a word to her. If he wanted something he saw, he would point and grunt at it. If he wanted a snack, he would grab her hand to take her, show her and then point to what he wanted. If he wanted to watch a video, he would just bring her the movie he wanted to watch for her to put it on for him. It wasn’t until I gave her a quiz at the end of the evening that she realized he hadn’t really said any words.
6. Sensitivity to sudden loud noises or white noise. An example I will give of this is when Taylor was 18 months old. We were at my dad’s ordaining ceremony. After the ceremony, we went to the fellowship hall for the reception. We were taking family photos so we were one of the last ones in. As we opened the doors to the fellowship hall, Taylor covered his ears and started screaming. We had no idea what was going on. It was like he was in pain. I took him back into the hallway and he calmed down. I tried once again to go back inside and as soon as we stepped in the room he began screaming again. What none of us noticed until Taylor became so upset, was how loud it was in there with so many people talking and laughing and having a great time. To the rest of us, the crowd noise was just white noise. To Taylor, the sound as we opened the doors was like an assault to his ears. It was literally painful to him.
7. Echolalia. Toddlers learn to talk by mimicking others but if that is the only talking they are doing, this is a definite red flag. When Taylor did say words it was almost 95% of the time, echolalia. If we asked him a question, he would just “echo” back the last word of our question to us as his answer. The only time he spoke more than one word at a time was if he was repeated phrases from his favorite videos.
8. Biting. Because being a toddler is not frustrating enough! There is a reason they call them the terrible twos. As their little tempers begin to develop, they learn to speak up (or scream) when they are frustrated, angry or tired. “No!” and “Mine!” were Brendan’s and Jordan’s favorite words. If your child is not talking or able to use any words to express these feelings, many times it will manifest itself as biting.
The first person Taylor ever bit was himself. He was so mad about some toy so he just put his own hand in mouth and bit the crap out of it. This phase started when he was about a year old and only lasted about month. Unfortunately it progressed to biting others kids or adults instead. He would bite you if he was frustrated, mad, scared or startled. Sometimes he would bite me when he was hugging me. Biting, just like talking, is oral. He knows he is supposed to be expressing himself with his mouth and this was his only way he could figure out how to do it. This is not a fun thing at all, for anyone and damn it hurts! Like little vampire teeth! That was a really rough time for me. Three day cares he was kicked out of and so many sleepless nights worrying what to do about it. I learned to have a lot of compassion for other moms and dads who have biters. It really is awful.
9. Sensitive Gag Reflex/Picky Eater. Children with autism are much more likely than typically-developing children to be selective with food.
When we transitioned from the Stage 1 baby food to Stage 2, Taylor would almost always gag up the first spoonful. That was just going to Step 2! Don’t even get me started on Stage 3 Baby Food! He was also very picky about what he would eat. My mom would always tell me, “Make him eat what you make for dinner. He will eventually eat it. He won’t starve himself!” Okay, first of all, that is not true. When I became concerned about how limited Taylor’s diet had become, I tried to take my mom’s advice. So help me, I was going to make him eat what I made him. I mean, he couldn’t just live off Mac and Cheese, right? Didn’t work. Not even a little. I’m almost certain if I had made him go without food until he ate that dinner I made him that night, 22 years later, we would still be sitting at that kitchen table waiting for him to eat that hamburger meat.
10. Stimming. The term “stimming” is short for self-stimulatory behavior and is sometimes also called “stereotypic” behavior. In a person with autism, stimming usually refers to specific behaviors that include hand- flapping, rocking, spinning, or repetition of words and phrases.
Taylor would flap his hands when he was happy or excited. This is one of the most common forms of stimming. Spinning, rocking or repeating a specific word or a phrase over and over again are some other forms of stimming as well.
11. No Pretend Play. People with autism tend to be very literal about everything. As toddlers, this means that pretend play is not something that comes natural. After Taylor was diagnosed, that was one of the things that his occupational therapist had pointed out to me. He always played so well with his toys, it never occurred to me that he wasn’t pretending. He loved his trains and would play with them for hours but it was not very imaginative. He played with his Thomas train on the wooden train track and would make the train sounds…but that is what trains are supposed to do. One day I sat down with him and held a banana up to my ear. I began to talk on it like it was a telephone and then handed it to him to see what he would do. He took the banana to the kitchen and then found my phone and brought it to me. This two year old looked at me like I was a moron. It was a banana, NOT a telephone!
12. Doesn’t make eye contact. Honestly, I hate to even put this one on here, so I have made it last. Why? Because I don’t know anyone that is fantastic with eye contact. When parents ask me if they should be concerned, this is one of the first “symptoms” they said they noticed. That is because they are expecting their child to look them IN THE EYE. Let me ask you this. When was the last time you looked someone directly in the eye when you were talking to them? Think about it? Do you think you did it today? Great! I have a challenge for you right now. Stop what you are doing and go find a friend, your kid, your spouse, anyone, and look right into their eyes and start talking to them about anything you want.
How did it go? A little awkward?
Avoiding eye contact doesn’t mean they are not looking at you in the eyeball, it means that they are not even looking at your face. If they are unable to look in the general direction of where your eyes, your nose or even your mouth is, that is a good measure that they are avoiding eye contact.
These are the most common signs that you can look for if you have any concerns about your toddler. Do they have to meet all of these signs? No, not at all. If you have concerns about any delays your child is having, talk with their pediatrician and have them refer you to someone who can do an evaluation. That is the first step, so start there.
Remember, always trust your gut! You know your child better than anyone.