March 22, 2013
Dear Mayo Clinic:
What symptoms should parents watch for if they are worried a young child may have autism? Is it possible to diagnose autism before age 2?
With careful evaluation by an expert, diagnosing a child younger than 2 with autism is possible. More often, however, autism is identified in children between the ages of 2 and 3. The signs and symptoms of autism vary quite a bit, depending on the severity of the disease and the individual child. But it is important that parents understand and watch for symptoms of autism. Early diagnosis and treatment can make a big difference in a child's ability to manage autism.
Autism is a serious developmental disorder that affects a child's ability to communicate and interact with others. For reasons that are not clear, the disease is three to four times more common in boys than it is in girls. Autism often appears in early childhood, usually before a child is 3.
In general, autism affects three areas of a child's development: language, social interaction and behavior. Some children may show symptoms of autism in early infancy. Others develop normally for the first several months or years of life, with symptoms appearing later. Most children with autism have significant symptoms by the time they reach their third birthday.
All children develop at their own pace. A child who, for example, doesn't begin to talk at the same time his or her peers do, or who doesn't interact with other children the way a sibling did at the same age does not necessarily have autism. There are some behaviors parents should watch for, though, that could signal a problem.
If an infant does not make eye contact, does not seem to enjoy the touch of a parent, or resists holding and cuddling, that may be a concern. By their first birthdays, most children smile, giggle and laugh when another person is laughing. When someone points, they look in that direction. Children also typically babble and coo, and mimic sounds and facial expressions by their first birthdays. If a child does not show these behaviors by the time they are 1, it may be a sign something is wrong.
In children between the ages of 1 and 3, some additional common symptoms of autism include repetitive movements, such as flapping their hands, rocking or spinning. They may get particularly upset when routines change or during times of transition. Many children who have autism do not engage in make-believe or other types of play that involve imagination. They may not speak, or their speech development may be delayed.
If you suspect your child is showing symptoms of autism, make an appointment to see your child's doctor. The doctor can assess your child and may refer you to a specialist who treats children with autism.
No one medical test exists to definitively diagnose autism. In many cases, a team of medical professionals who are familiar with autism work with children and parents to do a formal evaluation that assesses a child for the disease. This evaluation may include developmental tests that cover speech, language, behavior, communication and social interaction.
If a child does have autism, early diagnosis is critical. Although there is no cure for autism, interventions can be helpful in developing language, managing behavior, dealing with social interactions and learning other crucial skills. Because a young child's brain has great capacity for learning, the sooner these interventions start, the greater and better their impact is likely to be.
— Peter Jensen, M.D., Psychiatry and Psychology, Mayo Clinic, Rochester, Minn.