News and Notes from The Johnson Center

Catching Autism Early

JCCHD | Mon, March 18, 2013 | [Autism Treatment][Assessment Corner]

Doctor consulting woman and child.

Early identification of an autism spectrum disorder (ASD) is critical in order for children to receive the early intervention services that lead to best outcomes. But how early can autism and related ASDs be diagnosed? Recent research is showing that signs of autism, such as social deficits and repetitive behaviors, can be detected as early as 12-18 months. Recognizing early warning signs and symptoms can help children begin the necessary intervention to help decrease further risk. 

Better standardized assessments are being developed that can help clinicians more reliably identify younger children who are at risk of developing autism. The Autism Diagnostic Observation Schedule-Second Edition (ADOS-2) includes a newly developed Toddler Module that can be used for children as young as 12 months of age. The Toddler Module utilizes a “range of concern” scale that can help identify young children who should start early intervention and be closely monitored.

A stable diagnosis is often difficult to confirm in very young children due to their unpredictable developmental paths. Catherine Lord, PhD, an expert in assessment of ASDs and developer of the Autism Diagnostic Observation Schedule, recently published a study that assessed children between the ages of 18 to 36 months suspected of having signs of autism, to see how their symptoms developed over time. The study found that subjects had variable developmental paths including severe and persistent symptoms, worsening symptoms, improving symptoms, and no autism symptoms or diagnosis over time (Lord et al., 2012). The study supports other ongoing research that stresses the importance of early identification, early intervention, and the need for frequent monitoring and assessment of very young children who are identified as at-risk for autism. 

As a parent, it can be very difficult and scary if you are worried that something might be wrong with your child. It is very important not to “wait and see.” If your child is showing any developmental differences or delays, voice these concerns to their pediatrician or a specialist so that your child can be adequately evaluated and can get the help they need (note that sometimes pediatricians wrongly advise a wait-and-see approach—if your instincts tell you something is wrong, push harder).

If your child shows any of the following warning signs, it is important that they be evaluated immediately:

By 6 months: No big smiles or other warm, joyful expressions.
By 9 months: No back-and-forth sharing of sounds, smiles, or other facial expressions.
By 12 months: Lack of response to name.
By 12 months: No babbling or “baby talk.”
By 12 months: No back-and-forth gestures, such as pointing, showing, reaching, or waving.
By 16 months: No spoken words.
By 24 months: No meaningful two-word phrases that don’t involve imitating or repeating.

Click here for more information on the evaluation process, including tips on finding a clinician to evaluate your child, and what tests should be included in an autism evaluation.

Lord, C., et al. (2012). Patterns of developmental trajectories in toddlers with autism spectrum disorder. Journal of Consulting and Clinical Psychology, 80 (3), 477-498.