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Special Needs Awareness

Infant and Childhood Development and the Early Signs of Autism

July 01, 2008
Last week I was asked by a colleague to talk to a young mother who was concerned about her 4-month-old child. With a broken voice, the first-time mother described that her new son arched his back in his sleep and did not seem responsive to cuddling or physical touch. Anxiously, the mother asked, "Could my son have autism?"

I assured her that if her son was otherwise developing normally, these behaviors were probably not signs of autism. If you have ever had questions about your child's development or concerns about the presence of autism, you are not alone.

Autism is the fastest-growing developmental disability in the United States (approximately 1 in 150 school-aged children are diagnosed with some form of autism), and concerns about the presence of this developmental disorder are common among new parents. The early signs that parents and professionals should look for to alert them that a child may need further evaluation for autism include:

• The absence of response to his name or response to familiar voices by 4 months.

• The absence of smiles by the age of 6 months.

• The absence of babbling, cooing, pointing or other nonverbal gestures by 12 months.

• The absence of imitating others (sticking out tongue, clapping) by 12 months.

• The absence of emotional responses (laughing, initiating smiles) by 14 months.

• The absence of "shared attention" with others toward an object or event by 14 months.

• The absence of single words by the age of 15 months.

• The absence of two-word phrases by the age of 24 months.

• The absence of awareness of when others come and go by 24 months.

• Any regression in development with loss of language and social skills.

Although autism is usually diagnosed after the child's third birthday, parents may suspect that something is wrong much earlier. Quite often, parents may worry about their child's development by 18 months and express concerns to friends, family and professionals by age 2. However, because of the variation in child development, physicians and professionals hesitate to give the diagnosis of autism before age 3.

Be reminded that you are in the best position to observe your child. You know your child better than anyone else. Trust your observations and do not hesitate to discuss any concerns with your child's physician. Some concerns may be early signs of problems that can be corrected. Others may be signs of a more significant developmental disorder.

For a child with a developmental disorder—like autism—early identification and intervention is the single most important step that you can take toward a successful outcome.

Dr. Jim Dalton, Psy.D., HSPP, is a licensed child psychologist, and the senior vice president and chief operating officer at Damar Services, Inc.
Development of all forms in children, especially communication/language, social/emotional, and behavioral functioning, is often watched by parents with both wonder and concern. There is a wide range of "typical" growth and development of children and there may be significant variation in how one child develops as compared to others. Nevertheless, developmental "milestones" can help parents and professionals monitor a baby's learning, behavior, and social development. The following social, emotional and communication milestones are typical and can be used to monitor and gauge your child's development:

4 – 6 Months

* Turns toward sounds

* Follows movement of objects

* Shows interest in faces and changing facial expressions

* Smiles back at parents

6 – 8 Months

* Smiles often when playing

* Babbles and coos when happy

* Expresses joy

* Responds to cuddling

9 – 11 Months

* Reciprocal smiles and laughs

* Responds to eye contact

* Exchanges emotions and gestures with parents

12 Months

* Responds to name

* Plays social games (peek-a-boo; patty cake)

* Waves, points, gestures for needs

* Makes meaningful sounds ("ba-ba," "da-da," "ma-ma," etc.)

15 Months

* Uses and understands at least 3- 4 words

* Draws attention from others to get needs met

* Uses and understands several gestures

18 Months

* Uses gestures with words to get needs met

* Uses and understands at least 10 to 15 words

* Can point to familiar others when names are called

* Pretend play (feeding a baby)

* Knows and can point to several body parts ("Where is your mouth?")

24 Months

* Uses and understands 50 to 75 words

* Uses two and three words together to get needs met

* Shows interest in other children of similar age

* Looks for familiar items when they are out of sight (blanket, sippy cup)

* Can imitate others

36 Months

* Answers what, where, and who questions easily

* Can talk about and reference the past

* Can pretend play (characters, mommy, teacher, etc.)

* Desires play with similar aged peers

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