Autism disorders exist along a broad spectrum of highly individualized symptoms. It is categorized as both a neurological disorder and a developmental disorder, and autistic kids do not typically meet all milestones. As the condition is so individualized, it is likely that your child will meet some milestones but not others. In addition, many high-functioning kids with autism do meet most or all milestones, but at a slower rate than their neuro-typical peers. Diagnosis requires complex clinical judgment as well as the symptoms specified in the DSM-V.
What Is Autism?
Until May 2013, autistic spectrum disorders included autistic disorder, Asperger’s syndrome, pervasive development disorder not otherwise specified and childhood disintegrative disorder. With the publication of the new diagnostic manual, the DSM-V, these disorders were merged under the single diagnosis of autism spectrum disorder (ASD). Regardless of label, the condition is hallmarked by social and communication deficits, restricted areas of interest and strong dependence on routines. Symptoms are more severe in some kids and more mild in others.
Normal Developmental Milestones
AutismSpeaks.org provides a checklist of normal developmental milestones. By four months, your child should be aware of the sounds and faces around him. By seven months, he should respond to his name and use his voice to indicate basic emotions. By one year, he should try to imitate sounds, babble with intent and enjoy simple social games. By two years, a typical child will enjoy the company of others, play make believe and communicate in two-word phrases. By three years, most children will communicate in simple phrases, respond to multiple-part commands and openly express emotions. By four years, kids typically speak in clear sentences, tell stories and cooperate with other children. By age five, typical children show some independence, distinguish fantasy from reality and want to be like their friends. A great deal of variation exists between typical children, and not all kids will hit milestones at the same age. Nonetheless, AutismSpeaks.org suggests speaking to your child’s doctor if he does not meet the listed milestones by the appropriate age.
The Centers for Disease Control, or CDC, notes that children with autism spectrum disorder develop symptoms by age three. As many as 90 percent of parents first notice their child’s difficulties by age two. Although a single symptom or even a collection of symptoms does not prove that autism exists, the CDC notes some possible red flags. These include not responding to his name by 12 months, not pointing at objects by 14 months and not playing pretend by 18 months. Other possible red flags include obsessive interests, flapping hands or other unusual motor behavior, avoiding eye contact, preferring to be alone and resisting physical touch.
The CDC recommends that all children receive a basic screening for developmental delays at their 9-, 18- and 24- or 30-month checkups. In addition, kids should be screened specifically for autism spectrum disorders at 18 months and 24 months. If any potential problems are indicated, or the child is at high risk for an autism spectrum disorder, a comprehensive diagnostic examination is appropriate.