Could my child be autistic?
For most parents, the pending arrival of a new baby is filled with a sense of awe and excitement. And once that precious life is safely delivered, it’s not long before the good news is eagerly shared with friends and family. As the months go by, parents take pleasure in the baby and celebrate each milestone with feelings so deep they’re hard to explain. As one parent said in a recent email to me, “… words cannot describe what joy he brings me. Even when I go to work, I yearn to be able to play with him and make him giggle.”
That intense joy, as every parent knows, often comes hand-in-hand with another less pleasant emotion. Worry. Why is my baby crying? Why isn’t my toddler speaking? Why isn’t my child doing what other children do?
Worries, for the most part, are short lived. They come and they go. Fevers disappear, toddlers learn to walk, and words eventually begin to surface. But sometimes worries linger. Sometimes things do not resolve by themselves. Of course, no parent wants to hear that something is not quite right. That sort of information flies in the face of hopes, expectations, and the belief that your beautiful child is perfect in every way.
If you find yourself in that situation and you’re wondering whether autism might explain some of the behaviours your child shows, allow me to share some things you may find helpful. Confronting a possibility like this is hard – no question – but waiting and wondering can be even harder. In the words of Khaled Hosseini, author of “A Thousand Splendid Suns” – “Of all the hardships a person had to face, none was more punishing than the simple act of waiting.”
Parents often assume and are sometimes told that they have to wait until their child is 3 or 4 years old before a diagnosis can be considered. Actually, experienced clinicians can assess children as young as 2 years of age. The benefit of an early assessment is that the waiting and wondering is put to bed and you can move forwards with strategies to support your child. Research also shows that early intervention is associated with better outcomes.
Before getting into the detail of how autism presents in a young child, a quick note about the diagnostic process. It involves a detailed developmental history and an assessment of your child’s social communication skills and other behaviours. Autism is diagnosed by finding a pattern of distinguishing characteristics. There is currently no blood test, scan or other quick test which will answer the question. And whilst your child may display some traits, it does not necessarily mean that they are autistic. It is the combination of various social communication features and behaviours plus a particular developmental history which is necessary for a diagnosis.
Autism is distinguished from other communication difficulties by looking at the manner and quality of a child’s communication and social interaction along with evidence of inflexible thinking and other behaviours. It is separate from intellect and therefore, occurs in children with intelligence ranging from severe learning difficulty to well above average cognitive ability.
Regarding communication, an autistic child may or may not develop words at the appropriate age. What is typical however, is difficulty using skills for communication purposes. So, a child may be able to label objects in a book but not use those same words to ask for something. They know, for example, the word apple but do not say it when they want an apple to eat. In addition, they don’t tend to compensate for this by using other forms of communication, such as, gestures. Whereas a deaf child would get around the problem of not having words by pointing, gesturing, and using eye contact, the autistic child does not. More commonly, young autistic children communicate their wants and needs physically, for example, by taking Mum or Dad to the thing they want. It is also typical for young autistic children to use communication for fewer purposes. So, your child may communicate when they want something but not for other reasons such as greeting, commenting, sharing, and showing. And lastly, your child may use communication skills (such as eye contact, words, gestures) on their own but not fluidly combine those skills so their communication comes across as somewhat stilted and unnatural.
Socially, an autistic child typically has difficulties with shared attention. Your child may be less responsive when you try to engage them. They may enjoy things like tickles or bubbles but ignore you when you try to involve them in other ways, such as, reading a book or playing peek-a-boo. Your child may respond to you (albeit inconsistently), but less frequently try to gain your attention and involve you in their play. Parents sometimes describe their child as being very undemanding and easy to look after because they are quite happy to play alone with things that interest them. Some children engage reasonably well with adults but have more difficulty interacting with other children of the same age. A common misconception is that autistic children aren’t affectionate and don’t show empathy. This is simply not true. Many autistic children will offer cuddles and respond when they see a person who is upset.
Inflexible thinking is another feature that is typical of autistic children. This shows up in a preference for same-ness – wanting to eat the same foods, watch the same TV programmes and play with the same toys. It’s also evident in the way that a child plays. Autistic children may show repetitive behaviours, such as, lining up their toys or performing the same actions over and over again. Many enjoy construction toys (like Lego) but show relatively little interest in pretend play.
Lastly, autistic children may show unusual mannerisms, such as, flapping or moving their hands, arms, or body in a strange way - especially when excited. Some show heightened sensitivity to sensory information, for example, reacting negatively to certain noises, smells, or touch (e.g. labels in their clothing). Others seek out sensory experiences, for example by licking, feeling, or smelling objects.
Someone once said that if you’ve met one person with autism, you’ve met one person with autism. Although we look for patterns of behaviour when making a diagnosis, we know that each child is an individual. The features described above are by no means comprehensive and this article is not meant to give you a way to diagnose your child. What I hope it does do, is give you a greater understanding of autism and the courage to seek an opinion if you find yourself in that place of wondering with negative anticipation.
In the words of the eminent Nelson Mandela … “I have learned that courage was not the absence of fear, but the triumph over it. The brave man is not he who does not feel afraid, but he who conquers that fear”.
To you and your parenting journey!
Linda Philips
Parenting Autism
