Five possible indicators of autism spectrum Disorder (ASD)

In my experience evaluating children, I've noticed that a common red flag for potential autism spectrum disorder is a notable delay in nonverbal communication skills, such as gesturing and pointing. In our daily lives, verbal communication is often complemented by nonverbal cues, and many experts emphasize the significance of nonverbal communication in human interaction. Typically, by the age of 18 months, most children exhibit a variety of gestures to express different meanings. Absence of pointing or gesturing during an assessment has often been a noteworthy indicator for a potential autism spectrum disorder diagnosis. 

Children naturally vary in the frequency of their eye contact with adults or peers, displaying a range of comfort levels. Similar to adults, this diversity is observed in how often individuals tend to look towards others. Eye contact is a fundamental means of connection, and it is one of the earliest skills witnessed in neurotypical infants. When assessing a child for diagnosis, I go beyond merely noting the presence or absence of eye contact; I also examine the purpose and quality of their gaze. As social beings, humans are naturally drawn to each other's eyes. If a child doesn't engage in eye contact, even during what would typically be a highly motivating moment (such as making requests or seeking comfort), it may raise suspicion for autism. 

In assessing younger children, our expectation is to observe social interest and engagement not only with family members but also with individuals outside the family circle. When a family notes that their child, when taken to places like a playground or a swimming pool, shows more interest in plants, engages in repetitive behaviors in the water, or focuses on specific items in the environment rather than interacting with other children, it provides supporting evidence for a potential ASD diagnosis. Younger children with ASD typically exhibit a lack of social interest. In contrast, older children often display an interest in other children but may encounter challenges related to social boundaries and communication. 

Imitation is a natural and essential aspect of human learning, often considered 'hardwired' in our behavior. Typically, neurotypical children readily imitate their caregivers, peers, and even characters on television or animals in books. However, when a child faces difficulties in imitating when instructed or lacks spontaneous imitation, it raises a red flag for further evaluation. Imitation is a foundational skill crucial for learning, and in the context of an ABA program, it serves as a cornerstone. Without the ability to imitate, the learning process becomes challenging. 

Individual interests make each of us unique, and during ASD assessments with children, I offer a variety of toys and activities to engage them. A noteworthy observation is when children show disinterest in toys, are more intrigued by non-toy items, or exhibit highly specific toy preferences (e.g., focusing on the sheen of a block or consistently interacting with a ladder on a fire truck). Other instances include limited play with specific toy parts, like spinning an airplane's propeller, or an excessive attachment to tablet devices, requiring them to be moved during testing.

While one isolated sign may not conclusively indicate autism spectrum disorder, the presence of multiple signs suggests the need for a diagnostic assessment. It's important to note that this list is not exhaustive, and a comprehensive evaluation considers various behaviors and skills. A complete autism assessment includes structured observational measures, detailed developmental history, insights into day-to-day functioning, and collaborative information sources. By collecting and analyzing this data, a diagnostic determination can be made.

If you notice these behaviors in your child and seek a diagnosis, Arizona Autism Diagnostic Center offers a comprehensive evaluation led by a Licensed Clinical Psychologist. Our evaluation includes:

• In-depth parent interview focusing on each child's history and daily functioning.
• Structured observations, including the administration of the ADOS-2.
• Parent-friendly reports encompassing diagnosis and recommendations.
• A feedback session, providing parents an opportunity to discuss assessment results, diagnosis, and recommendations for each child."