You know each contour of your child's face. You can count all 10 fingers and all 10 toes. You know the meaning behind every coo and cry that comes out of your child's mouth. But you've seen some things that make you worry about your child's development. How early can you sound the alarm?
Many doctors say an autism diagnosis isn’t considered reliable until a child is about 2 years old.
While you may see very early autism warning signs, doctors tend to hold off on providing a formal diagnosis for many months (or even years). It can be frustrating for parents, but the delays stem from very real concerns.
Why You Might Wait
Autism warning signs appear at different ages in different children. In general, some parents see troublesome issues in very young children.
Autism Speaks says behavioral signs can crop up in children as young as 6 months old. But most medical professionals won't even try to label those issues as autism until the child is at least 24 months old. Some prefer to wait until the child is 3 years old.
Some researchers disagree with that plan. In a California study, for example, researchers demonstrated diagnostic accuracy in younger children. They were screened often by age 2, and 84% who got the label had signs that persisted when they were 3 years old.
Doctors shy away from diagnosing children early due to:
- The nature of testing. While autism biomarkers are known, blood screening is only 80% accurate. MRIs can detect some autism changes, but waiting lists are long. Instead, doctors use observations and interviews. Those are hard to perform on very young children.
- Development. Some children progress at a slower rate than their peers, but they don't have autism. Children like this may seem to fit diagnostic criteria, but they may age out of the diagnosis later.
Your doctor may resist your attempt to nail down a diagnosis despite the things you've seen and the concerns you have. And that could mean your child misses opportunities.
Why Does Early Intervention Matter?
Autism can't be cured, but people with the condition can live long, fruitful, happy lives. Therapy helps them to achieve those goals, and the earlier the work starts, the better.
Experts say that about half of children with autism who are enrolled in an evidence-based early intervention program from ages 3 to 5 gain enough skills and confidence to head into standard kindergarten programs.
It takes time for families to connect with therapy programs that work. You might bump up against barriers, such as:
- Lack of qualified therapists. You may live in a community with few professionals capable of offering the treatments your child needs.
- Insurance barriers. Your insurance company may require proof that your child has autism, and that could mean many more doctor visits.
- Appointment delays. Some doctors and therapists can see you right away, but others have very long waiting lists.
If your child isn't diagnosed until age 3, and you spend months trying to nail down a treatment program, you could be missing essential intervention windows. Your child could be missing meaningful opportunities to learn.
As the Autism Spectrum Disorder Foundation puts it, early intervention gives your child the potential for a better life. It's important, and there are steps to take to make it happen.
How Can Parents Intervene?
You know early detection is critical. Your voice ensures that your child gets the help required. Spot the signs, and don't be afraid to speak up when you see them.
Autism Speaks details symptoms by age.
- By 6 months: Your child makes few engaging or joyful expressions and avoids eye contact.
- By 9 months: Your child doesn't engage you with babbles or smiles.
- By 12 months: Your child doesn't wave, point, babble, or respond to their name.
- By 16 months: Your child has mastered few words.
- By 24 months: Your child knows or uses few meaningful two-word phrases.
The American Academy of Pediatrics encourages parents to trust their instincts. If you spot these signs and you're concerned, talk with your child's pediatrician. If you're not happy with the advice you get, seek out a second opinion.
Talking with a doctor isn't always easy, and some children behave very differently at home than in the presence of an adult. Sometimes, paperwork helps to prove your point.
Download this development tracker from the Centers for Disease Control and Prevention. Check off all the things your child can do, and bring the form with you to your child's appointment. Point out all the gaps you see, and talk with the doctor about next steps.
Autism Tests Your Child May Have
You're not the only one watching your child and looking for autism signs. Your child's doctor is doing the same work during routine office visits. If a concern is spotted, the testing escalates.
The Centers for Disease Control and Prevention explains that doctors do several forms of autism checks, including:
- Developmental monitoring. Your doctor asks questions about how the child is progressing, and the doctor may talk to or interact with the child to test reactions and responses.
- Developmental screening. Tests like this are part of some well-child visits, but your doctor might also use them if you are concerned about your child. You will complete a questionnaire about behaviors you see, and your doctor will do the same thing.
- Developmental evaluation. Trained professionals, including developmental pediatricians, perform these tests. The specialist uses observations, test results, and parent questionnaires to develop a well-rounded understanding of how the child is progressing. Results help experts create early intervention programs.
It takes time to complete each step, and you can't skip ahead and demand higher levels of testing. You must progress through each stage right on schedule. The results can help you understand what type of treatment your child needs.
Treatment Is Available
Appropriate therapy gives children the best opportunity to build on the skills they have and develop new ones too. Every child needs a different treatment program, but most people with autism do best with structured and specialized programs.
Your child's treatment program might consist of:
- Applied behavior analysis (ABA). Therapists determine missing skills, and they develop a program filled with repetition to help the child learn. Your child might practice smiling, pointing, or responding politely.
- Occupational therapy. Your child might build up fine motor skills by stacking blocks, putting together puzzles, brushing teeth, or combing hair. They’ll eventually learn to complete tasks that are necessary in everyday life.
- Speech therapy. Your child might learn to make vowel or consonant sounds. Or your child might learn to use other tools, like picture books, to make needs known. Both verbal and nonverbal communication skills will be built.
- Medical checks. Gastrointestinal problems, sleep issues, and hyperactivity often happen in children with autism, experts say. A medical doctor can soothe discomfort so your child can feel better and focus on therapy.
Your child's treatment plan may include some of these interventions, or your child may get treatment types not mentioned here. Teams work hard to meet children where they are and help them build up the skills they need. Tailored care plans work best.
Autism treatment can be intense, and it's common for children to spend hours each week working with professionals. That investment is well worth it to help children embrace independent lives.
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