Signs to look For

I received an email with a question regarding someone who believed a family member might have a child with autism. She was interested in learning more about autism and things you could look for to see if the issues that were being observed could be related to autism. So, I thought I'd take a portion of the email I wrote to her and discuss some of the signs or red flags one might notice in a child as he/she are developing.

Some signs to look for (every autistic kid does not have every one of these -- the severity of the autism has to do with how much, how often and how many of them):

Age Appropriate Toys -- does the child play with age appropriate toys or still hold on to baby toys or cause and effect toys (by 3, children should move on to more imaginary play toys like cars, dolls, action figures, drawing, etc)
Tip toe walking --- some do, some don't, but it is a sign of autism
Hand flapping --- some do, some don't, but another sign of autism (often referred to as "self stimulating behavior" -- if over stimulated, the child may wave his hands up by his face to show excitement or nervousness)
Eye Contact --- many children with autism have no eye contact issues with family and close friends/relatives, but can't look strangers or acquaintances in the eyes -- they may glance, but nothing sustained
Joint attention -- does the child point to objects when asked (whether in a book or out on a walk, like point to the tree, or fire hydrant or stop sign) they look for finger pointing -- actual single finger pointing to an object - autistic children often do not point out things and have "poor joint attention", only picking and choosing what to draw their attention to
Interest in things that spin --- many children will spin themselves (another form of self stimulating behavior, but do not get dizzy); others like objects that spin and will stare at it for unusually long periods of time
Appropriate use of everyday objects -- does the child know how to use a hair brush on a doll or self, or know that a spoon is used to stir, -- autistic kids often need to be taught about what an object is used for and these kids do not learn by imitation; how do they play with cars -- line them up & stare at the pattern or spinning the tires are 2 signs that they look for
Interest in shiny objects --- many kids will stare for unusually long periods to shiny objects
Attention span- many autistic kids have a very short attention span; many can't sit through the reading of a book or show no interest in books as infants/toddlers
Chewing/Mouthing objects -- many autistic kids chew or mouth objects as tiny babies without teeth would do; these kids have shirt collars constantly in their mouths, seatbelt straps, toys, etc.
Interest in new toys - does the child have a hard time wanting or knowing what to do with a new toy; does the child show interest in the new toy or pick it up and then move on
Attention to task - this one has to do with two extremes --- either the child bounces from one task to another without long attention or the child is sooo attentive to the task that they can't move away from it or won't do anything else -- both extremes are signs of autism like behavior
Response to own name - a majority of the time will ignore their own name when called
Speech/Language - Most autistic kids have some sort of language or speech delay; extreme cases never gain speech; some have cognitive/receptive issues; others have pronunciation; many/most have both; almost all are late talkers
Dietary Concerns - many kids are "sickly"; have food allergies, bowel issues, stomach problems; weight loss/weight gain; picky eaters; many hate textured foods; many need food purified -- each need is different but there is usually some sort of "feeding" issue one way or another; some are messy eaters and don't know how to use utensils correctly, others can, but prefer to use hands,
**Sensory Issues - Most kids have some sort of Sensory Integration issues which is the source of the manifestation of some of the above listed behaviors -- the brain processing the sensory information received through the senses incorrectly -- some are "sensory seekers", constantly looking for sensory input -- these kids are "crashing into" things like furniture and people's legs; they might spin and not get dizzy; they love "messy" play like paint and glue and might put it all over their hands and arms -- others "avoid" all the sensory input -- they might hate touching certain textures, glue, sand, etc. --- then on the auditory side, they may fear loud noises, including hair dryers or toilets flushing, while the other extreme is that they don't even notice sound and seem like they might have 'hearing' issues, but test within range for hearing (hence not reacting to own name);
on the sensory issues -- there are a ton -- other issues may be poor gross motor skills -- may walk unstably, may have a hard time avoiding obstacles, may avoid or seek swinging for long periods of time, may feel more "grounded" with feet always touching the floor, so can't sit still at a chair with feet up or on a toilet without feet touching a stool

I have a good book that talks about sensory issues that is a good introduction into children that just seem to be a bit different -- not necessarily autistic, but have Sensory Processing Disorder. It's called The Out of Sync Child by Carol Stock Kranowitz. She also wrote a companion book called The Out of Sync Child has fun, which is a workbook that teaches parents tips to practice in the home to help your child overcome the sensory issues. The good news is that if it's Sensory Processing Disorder by itself, then there are things that you can do that helps the child and makes it go away. Many kids with autism have Sensory Processing Disorder, but not every child with it has Autism. It is a good resource for a parent to read who has just begun to understood their child is a bit "different".

Where Our Minds Go

It's amazing what your brain does once you learn your child has a developmental delay, a disability, or behavior issues. I was talking to another mom whose child was not put on the autistic spectrum, but had other developmental delays. She told me she called her son's therapist panicked one day because her son lined up all the shoes in the closet in a straight line. The therapist laughed and told her to relax. There is no appropriate way to "play" with shoes, so this was not a sign of anything wrong. (many kids with Autism do not know how to appropriately play with certain toys or appropriately use everyday objects). Although autism was ruled out for her son, this mother began looking into everything her child did.

Well, it happened with me today. I took John to the bathroom at a local restaurant. He stopped upon walking in the door, stared toward the wall, and began "flapping" his left arm. He then started giggling. I began thinking "oh no, he's flapping his arms. He has never done that before. why is it starting?"... (many Autistic children engage in self stimulating behavior, including arm flapping). Then, I looked again and noticed that he was looking at the automatic paper towel dispenser. He was "waving" his arm so that it would dispense the paper towel. I can relax now! ;)

Seriously, it's amazing how many things you look at and question, "is it the autism" or how many people just assume "it's the autism" and overlook what is really going on. It's important to remember that John is a little kid, regardless of Autism.