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Autism: Studies Look at Babies and Toddlers for Earlier Diagnosis


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Toddler with autismAutism affects about 1 in every 110 children in the United States, according to the Centers for Disease Control and Prevention. It occurs more often in boys than girls, by a ratio of 4:1, and it’s usually diagnosed when a child is 3 or 4 years old.

But studies are currently being conducted with younger children to see if and when certain behaviors may indicate the onset of autism. The earlier the disorder is diagnosed, the sooner treatment can begin.

“Some children show clear signs of autism at 12 to 16 months, but screening [typically begins] at 18 to 24  months,” says Yvette Janvier, MD, a developmental/behavioral pediatrician at Children’s Special­ized Hospital at Toms River. That could mean a whole year between the time a child displays signs of autism and the time the child receives help. An early diagnosis and intervention are keys to a more favorable outcome.

Signs & Symptoms

Here are some signs in babies and toddlers that may indicate a problem:

  • Lack of babbling or cooing. “All children with delayed babbling or speech should have their hearing checked,” says Janvier. If a hearing problem is ruled out, lack of babbling or cooing could point to autism.
  • Lack of eye contact. Babies love to look at faces and should be able to look into your eyes during interactions.
  • Few or no gestures. Babies should be able to point or wave by 14 months old.
  • Lack of expression. Babies should be emotionally expressive. How do they react when something unexpected happens? Do they look in the direction of the sound? Do they laugh? An autistic baby or toddler may be indifferent to an unexpected incident.
  • Lack of joint experience. Joint experiences are moments of interaction between you and your baby—for example, turning the light on and off in the baby’s room. Does your baby watch you and wait to see what you’ll do next? “These experiences should be exciting and magical. For babies under a year old, peek-a-boo can be a joint experience,” says Suzanne Buchanan, PsyD, BCBA-D, clinical director of Autism New Jersey.
  • Unresponsive to name. Most babies with normal development respond to the sound of their name in some way.

Autism symptoms vary greatly from one child to another. Not all the signs may be present in all autistic children, and the presence of some of these signs doesn’t necessarily mean your child has autism. If you have any concerns about your child’s development, consult your pediatrician.

Diagnostic Tools

Professionals may use a variety of screening tools with very young children to confirm a diagnosis of autism. Concerned parents may want to know these tools exist and how they may help. Here are a few of them:

  • The M-CHAT (Modified Checklist for Autism in Toddlers) is a questionnaire for parents that can be used to evaluate children at 16 months of age. Janvier suggests the parent complete the M-CHAT before the 18- and 24-month well-baby check-ups with their pediatrician. Click here for a free copy of the M-CHAT.
  • The CSBS (Communication and Symbolic Behavior Scale) can be used for children at 12 months of age. It measures communication, gaze, emotions, gestures, object use, and understanding.
  • The ADI-R (Autism Diagnostic Interview, Revised) is a parent interview that consists of 93 questions regarding the child’s development, social interactions, language acquisition, and behavior.
  • The ADOS (Autism Diagnostic Observation Schedule) is usually done in conjunction with the ADI-R. A professional observes a child at play to see his reaction in different situations. For instance, the observer might inflate a balloon and let it go to see how the child reacts.

Services & Therapies

There is no cure for autism. However, there are many services and therapies available to a child who is diagnosed with the disorder. The recommendations for therapy are driven by the child’s behavior and symptoms. “The most common therapies are speech and language, physical and/or occupational therapy, and behavioral therapy,” says Teissy Meza, PhD, program director of the Autism Center at St. Joseph’s Children’s Hospital in Paterson.

For parents who suspect their child is not developing at an appropriate pace, the New Jersey Early Intervention System can evaluate your child and develop a plan of action (called an Individualized Family Service Plan) based on the particular treatment needs of your child and the rest of the family.

A diagnosis of autism may address many of your concerns about your child’s development, but is sure to raise others. “It can be a really hard road. You’ll have a lot of questions. The answers may not always be what you want to hear or when you need to hear them. Reach out for support and connect with other parents,” Buchanan says.

Some NJ Autism Resources

Autism New Jersey, 800-4-AUTISM
This nonprofit agency offers services, information, education, and consultation, with lists of NJ providers, support services, workshops, other autism organizations, etc. Staff members are available to answer questions.

New Jersey Early Intervention System, 888-653-4463
This organization works with children birth to age 3. Professionals will come to your house and evaluate your child to see if she is eligible for services. An IFSP (Individualized Family Service Plan) will be developed to meet your family’s needs.

The Autism Center at St. Joseph’s Children’s Hospital, 973-754-3081
Provides diagnosis and support services.

The Autism Program at Children’s Specialized Hospital, 888-CHILDREN
Conducts evaluations, treatment, community education, and research for autism spectrum disorders.

The Autism Center at UMDNJ in Newark, 973-972-8930 for clinical services;
Offers screening, diagnosis, assessment, and an Applied Behavior Analysis (ABA) Parent Training Program.

Parents of Autistic Children (POAC) 732-785-1099
Provides education/training, recreation, and support services.

Autism Parenting Magazine

Autism Society of America

Autism Speaks

Centers for Disease Control and Prevention

National Autism Association

National Autism Center

Natalie Friedrich Kidd is a freelance writer. She has two sons, one of whom has autism.

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