Could Your Child Have Autism?

No single symptom is a sign of autism, and no two children with autism have the same symptoms. There are no medical tests that can tell you whether a child has autism, and there are no hard and fast rules to diagnose it.

In some cases, it can be tough for even a professional to diagnose an autism spectrum disorder. But if your child has several of the following symptoms—and they can't be linked to any other disorder—it might be a good idea to consider an autism screening or evaluation.

Communication Deficits

Children with autism often experience difficulties with speech and language. If they are obvious difficulties, such as a five-year-old with no spoken language, they are easy to spot. But children with autism don't fit neatly into a box of symptoms. For example, a five-year-old with autism may use plenty of words and even use more words than other children their age.

When doctors determine if a child has autism, they look at a child's communication skills. They carefully consider prosody and pragmatic language.

Here are some tips to help you decide if your child is having trouble with communication skills:

• They use few or no spoken words by age two.
• They don't use gestures, gibberish, or other ways to communicate their needs or thoughts.
• They only use words they repeat from TV, movies, or other people.
• Their words aren't used to communicate their thoughts or needs. (For example, they repeat a random phrase from a favorite TV show.)
• They are not hard of hearing, but they don't respond when someone calls their name.
• They don't look into someone's eyes when they speak, even when asked to do so.
• They never initiate interactions or conversations with others.
• They learn to speak when most other children learn, but they use words in a non-traditional way, have an unusually flat voice, or misunderstand the intended meaning of words.

Play Skills

Children with autism interact in unusual ways with objects, toys, and potential playmates. They are most likely to prefer their own company to the company of other children. They may even demand that playmates interact with them in certain predictable ways.

Children with autism often view the world as something concrete and literal. They may struggle with abstract concepts and using their imagination. Here are just a few examples of the way kids with autism like to play:

• Lining up objects or toys instead of using them in pretend or interactive play
• Playing the same way with the same objects (toys, doors, containers, etc.) over and over again
• Acting out the same scenes (often from TV) over and over again in exactly the same way
• Participating in "parallel play" (two children playing near one another but not interacting). This occurs even after the age of two or three when most kids begin to interact with each other as they play.
• Ignoring or responding angrily to other kids when asked to join them in their play or change what they are playing
• Having difficulty with age-appropriate forms of play such as rule-based games, pretend play, organized sports, or other activities that require social communication.

Unusual Physical Behaviors

People with autism often demonstrate unusual physical behaviors that set them apart from other people their age. Children with autism may:

• Rock, flap, or perform other repetitive actions as a way to calm themselves
• Overreact or underreact to pain and other forms of sensory input.
• Refuse to eat foods with particular textures or strong flavors
• Have an unusual way of walking, including toe walking or awkward movements
• Experience angry melt-downs or extreme anxiety when faced with unexpected changes in routine that don't bother other children their age.
• Show behaviors or interests that aren't appropriate for their age
• Experience difficulty learning how to use the potty or dress themselves

Co-Existing Medical Conditions

Children with autism are more likely to experience specific medical conditions commonly associated with autism.

These co-existing medical conditions include the following:

• People with autism typically experience sleep problems. Many kids with autism have trouble falling or staying asleep. Adults with autism often have similar issues.
• Many children with autism have delays in gross and ​fine motor skills; for example, they may have difficulty with using silverware or scissors. They may have trouble climbing, jumping, or performing other basic physical activities.
• Children with autism are more likely to deal with seizure disorders.
• Many children with autism experience gastrointestinal (GI) problems like constipation, diarrhea, and/or vomiting.
• People with autism, no matter what age, are more likely to experience mental health or developmental issues such as social anxiety, generalized anxiety, attention deficit hyperactivity disorder (ADHD), depression, or obsessive-compulsive disorder (OCD).

Less Common Signs

Quite a few people with autism have unusual symptoms that may not cause problems in themselves. But these problems provide a hint that there may be a developmental issue.

These issues may include:

• Hyperlexia: The ability at a very young age to read written language although unable to understand what you're reading.
• Synesthesia: Unique responses to sound, color, letters, or numbers (for example, some people with synesthesia "see" sounds or "hear" colors.
• Savant syndrome: Autistic savants represent a small percentage of people with autism. They have amazing abilities to memorize information, do complex math problems, play piano, and so forth. This is much like the character of Raymond in the movie "Rain Man."

When to Seek an Evaluation

If you've read through this checklist and find that your child seems to show some of these symptoms, now is the right time to seek an autism evaluation.

Contact your pediatrician and ask for a referral to a clinic, developmental pediatrician, or another specialist. If your pediatrician can't help, consider contacting your school district for suggestions.

You can also seek an evaluation before your pediatrician suggests it. Parents are often the first to notice their child's differences and delays. That's because pediatricians only see children once a year or when children are sick. He or she may not have a chance to see what you notice every day.

There really is no downside to getting an evaluation for your child. While you may discover that your child is not autistic, chances are you've discovered some issues that should be addressed while your child is young.

If your child has autism, now is a great time to start providing therapies that can give your child the tools he or she needs to be successful.