Is My Child Autistic?
My son is 2 and isn’t talking yet. He hears okay, but he doesn’t answer us when we say his name. He loves to play alone with his cars. He doesn’t push the cars, but he does like to arrange them in rows like a parking lot. He’s obsessed with garbage trucks and flaps his hands with excitement when they drive by. He doesn’t like getting his hair wet. When he wants something to eat, he will take our hand and put it on the handle of the fridge without looking at us or saying anything. He is a wonderful little boy and loves jumping on the trampoline with his big brother.
My daughter is 4. She loves to play with ponies and always sets them up in their stables in the same way. She doesn’t like it when I move her ponies and will become very upset if I do. She loves to talk, but has a hard time having back and forth conversations. She doesn’t always answer questions we ask her and usually just wants to talk about ponies. She looks at us when she is talking about her ponies, but doesn’t look at us when she is asking for something. She likes to do stuff in the same order every day, like I have to put on my sunglasses before I open the door to leave. If we change something unexpectedly, she usually has a major meltdown and cannot calm down for sometimes up to 45 minutes. She is really picky about food and only eats crunchy things. She is the sweetest thing and really enjoys snuggling and reading books together.
If you are wondering if your child is autistic, you are not alone. Parents of young children watch their child’s development eagerly to look for particular milestones. When a child hits milestones in a different order or a different timeline, parents wonder if this could be a sign of autism or another neuro-difference.
Autism is a developmental difference that impacts children’s overall developmental pattern.
Children and adults with autism typically have challenges in their development of social skills. They engage in repetitive behaviors and/or show strong interest in a particular topic while showing limited interest in other topics or activities.
In young children, sometimes autism is suspected if the child doesn’t talk yet. But many children who aren’t autistic also have delayed speech, so this by itself isn’t a sign of autism. Young autistic children will typically display other traits as well, such as atypical play, difficulty with change/transitions, difficulty communicating without talking, picky eating, frequent tantrums, and/or repetitive behaviors. Sometimes kids talk just fine, but repeat things a lot in an unusual way. Different children look different, so it is important to bring in an experienced professional to help tease out if a pattern of traits qualifies for an autism diagnosis.
If you are curious if your child has autism, we have created a list of common autism traits observed in young children (3 and under) for your reference below. Keep in mind, this list is not a tool for diagnosis of autism spectrum disorder and is being provided for informational purposes only. Rather, having many of these traits would be a greater cause to seek an autism evaluation. We hope you use the list to identify specific behaviors you might be observing so you can discuss them with your doctor. You can bring this list to your child’s pediatrician to talk about together.
The Toddler Talk Autism Characteristics Checklist
Check if Observed - Potential traits & Parent observations
▢ Difficulty understanding language (language comprehension)
▢ Difficulty with verbal communication (language expression)
▢ Regression of skills
▢ Limited functional language, primarily memorized words/phrases
▢ Difficulty connecting with family members
▢ Difficulty with social interactions
▢ Being “in their own world”
▢ Prefers isolated play
▢ Limited eye contact
▢ Playing with toys in atypical ways
▢ Repetitive movements with toys or non-toy items
▢ Repetitive body movements
▢ Difficulty with change or transition
▢ Fixated interest on favorite items or topics
▢ Minimal progress in difficulty areas
▢ Sensory difficulties
▢ Difficult to manage behavior
Get a PDF copy of the Autism Characteristics Checklist so you can print it and fill it out.
In addition, you might find the following screener helpful for children >18 months old (see note below link):
http://www.childbrain.com/patient-education/the-asd-assessment-scale-screening-questionnaire
** Please note we only recommend using this screener for children over the age of 18 months! We have used the screener on our own kids and other children we know, results for children under the age of 18 months are not accurate in our opinion.**
Okay, I suspect that my child may be autistic. What happens next?
If you suspect that your child may have autism spectrum disorder, it is important to seek out a complete Developmental Evaluation for your child because your evaluator will be able to officially rule out or diagnose autism. Go to your pediatrician and discuss what you have observed at home. Ask for a referral for a developmental evaluation to test for autism. The doctor might send you to another doctor’s office, an early intervention program, an autism center, or a school district. The person testing will make recommendations for what types of services might be beneficial to your child and your family.
Any diagnoses given at the appointment, along with specific treatment recommendations, will ensure your child gets the best support possible to help them learn and grow. Sometimes families struggle with their child being given a label. However, because of our society’s medical model of accessing services, having a diagnosis (i.e. a label) often opens doors to access more services. For example, if a child has a diagnosis of “autism spectrum disorder”, their insurance will typically cover more therapies than a child who only has a “speech/language disorder” diagnosis. Getting a label doesn’t change who a person is, but can be useful to getting the help a child needs.
How do I sign up for a Developmental Evaluation?
Depending on where you live and the resources available in your area, there are different ways to access a Developmental Evaluation. I will list several of the different ways that families sign up for Developmental Evaluations.
Here in California, a Developmental Evaluation can be completed through your local Regional Center, which provides early intervention services to children. Many states have a similar program to access early intervention services.
If your child is over 3 years of age, a Developmental Evaluation is often completed through a local school district’s special education department.
Your child’s pediatrician can also refer to a Developmental Psychologist, to be covered by insurance.
Many areas also have private practice Developmental Psychologists that families can pay out-of-pocket (may not be covered by insurance).
Some areas have Autism Centers for evaluation and treatment, where you could potentially access multiple evaluations with autism-focused doctors/therapists
If you’re not sure how to access these services, speak with your child's pediatrician who should be able to guide you more specifically based on your location and available services.
When should I get the testing done?
As we’ve said, it is very important that any concerns about a child possibly having autism are addressed with a complete Developmental Evaluation as soon as possible. If you suspect that your child is autistic, you can get them tested before they are even two years old. We don’t typically recommend a “wait and see” approach, as the first 6 years of a child’s life are when their brain has the most plasticity--ability to change and learn and grow rapidly. This is why early intervention is so crucial. Toddlers and preschoolers who receive appropriate and personalized early intervention services are better able to navigate the academic and social challenges they will encounter when they start school.
If a pediatrician or other provider does not share your concerns, but your caregiver instinct is telling you, “something is going on…”, trust your gut and keep pushing for that evaluation. Some autistic children have less obvious traits when only observing them for a few minutes at an annual physical at the pediatrician’s office. Those of us who have been in the field a long time have encountered many children who were missed by pediatricians because their traits were subtle or well-masked during the office visit. You should absolutely trust your gut and advocate for your child.
What kinds of therapy can my child get?
At your developmental evaluation, the evaluator will end the session with a list of recommendations or a treatment plan. Each child will have their own unique constellation of strengths and weaknesses that will guide their specific treatment plan. Some children would benefit from some therapies more than others, or in a different order than another autistic child. Some possible therapies may include: speech therapy, occupational therapy, and behavior therapy.
Main Takeaway
If you have concerns, or if a teacher, therapist or doctor has shared concerns about autism with you, we strongly encourage you to access a Developmental Evaluation. Getting an evaluation early will provide you with specific insight about your child. The specialist will highlight your child’s current strengths and weaknesses, along with if they qualify for a diagnosis of autism spectrum disorder. Whether they receive a formal diagnosis or not, that information is priceless. You will then be ready to get your family extra assistance if they need it.
A final note: Please be especially cautious of online searching or googling about kids with autism. Remember especially that if a parent online shares about their negative experiences or struggles, that does not mean it will be the same journey for your child. Each person’s life journey is unique and you will make the best decisions for your child.
*There are differing opinions on terminology used to describe autistic people. Some prefer to use person-first language, such as “person with autism.” Others in the autistic community have expressed a strong preference for diagnosis first, such as “autistic person.” In this article we use both. When interacting with an autistic person, you should follow their lead and use the terminology that they prefer.
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© 2020-2023. Stephanie Keffer, MS CCC-SLP. All Rights Reserved.The content offered on ToddlerTalk.com is for informational purposes only. Toddler Talk is not engaged in rendering professional advice, whether medical or otherwise, to individual users or their children or families. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor, speech language pathologist, or other health professional. By accessing the content on ToddlerTalk.com, you acknowledge and agree that you are accepting the responsibility for your child’s health and well-being. In return for providing you with information related to home speech and language practice, you waive any claims that you or your child may have as a result of utilizing the content on ToddlerTalk.com.