Autism is a complex developmental disability that typically appears during the first three years of life. Autism and its associated behaviors have been estimated to occur in as many as 1 in 150 individuals. Autism is four times more prevalent in boys than girls and knows no racial, ethnic or social boundaries. Family income, lifestyle and educational levels do not affect the chance of autism’s occurrence.

Autism impacts the normal development of the brain in the areas of social interaction and communication skills. Children and adults with autism typically have difficulties in verbal and non-verbal communication, social interactions, and leisure or play activities. The disorder makes it hard for them to communicate with others and relate to the outside world. In some cases, aggressive and/or self-injurious behavior may be present. Persons with autism may exhibit repeated body movements (hand flapping, rocking), unusual responses to people or attachments to objects and resistance to changes in routines. Individuals may also experience sensitivities in the five senses of sight, hearing, touch, smell, and taste.

Communication: language develops slowly or not at all; using words without attaching the usual meaning to them; communicating with gestures instead of words; short attention span;

Social Interaction: spending time alone rather than with others; showing little interest in making friends; less responsive to social cues such as eye contact smiles;

Sensory Impairment: may have sensitivities in the areas of sight, hearing, touch, smell and taste to a greater or lesser degree;

Play: lack of spontaneous or imaginative play; not imitating the actions of others; not initiating pretend games;

Behaviors: overactive or very passive; throwing tantrums for no apparent reason; perservating (shows an obsessive interest in a single item, idea, activity or person); apparent lack of common sense; showing aggression to others or self; often having difficulty with changes in routine.

Autism is a spectrum disorder. In other words, the symptoms and characteristics of autism can present themselves in a wide variety of combinations, from mild to severe. Although autism is defined by a certain set of behaviors, children and adults can exhibit any combination of these behaviors in any degree of severity. Two children, both with the same diagnosis, can act very differently from one another and have varying skills.

There is NO known cause or cure for Autism. What is known is that Autism is not a mental illness. Children with autism are not unruly kids who choose not to behave. Autism is not caused by bad parenting.

While no one can predict the future, it is known that some adults with autism live and work independently in the community (drive a car, earn a college degree, get married); some may be fairly independent in the community and only need some support for daily pressures; while others depend on much support from family and professionals.

Evidence shows that early intervention results in dramatically improved outcomes for young children with autism. Because of the spectrum nature of autism and the many behavior combinations which can occur, no one approach is effective in alleviating symptoms of autism in all cases. Various types of therapies are available, including (but not limited to) applied behavior analysis, verbal behavior, auditory integration training, dietary interventions, discrete trial teaching, medications, music therapy, occupational therapy, PECS, physical therapy, sensory integration, speech/language therapy, TEACCH, and vision therapy.

In clinical terms, there are a few “absolute indicators,” often referred to as “red flags,” that indicate that a child should be evaluated. For a parent, these are the “red flags” that your child should be screened to ensure that he/she is on the right developmental path. If your baby shows any of these signs, please ask your pediatrician or family practitioner for an immediate evaluation:

• No big smiles or other warm, joyful expressions by six months or thereafter
• No back-and-forth sharing of sounds, smiles, or other facial expressions by nine months or thereafter
• No babbling by 12 months
• No back-and-forth gestures, such as pointing, showing, reaching, or waving by 12 months
• No words by 16 months
• No two-word meaningful phrases (without imitating or repeating) by 24 months
• Any loss of speech or babbling or social skills at any age

Learn the Signs - Milestones

Milestones enable parents and physicians to monitor a baby's learning, behavior, and development. While each child develops differently, some differences may indicate a slight delay and others may be a cause for greater concern. The following milestones provide important guidelines for tracking healthy development from four months to three years of age.

Before your child's next visit to the physician, please take the time to see if your child has met his/her key milestones. These milestones should not be used in place of a screening, but should be used as discussion points between parents and physicians at each well visit. If a child does not have the skills listed---or if there is a loss of any skill at any age---be sure to let your physician know.

Check to see if your child is achieving these typical milestones at each age level:

By 3-4 months

• Watches faces with interest and follows moving objects
• Recognizes familiar objects and people; smiles at the sound of your voice
• Begins to develop a social smile-
• Turns head toward sounds

By 7 months

• Responds to other people's emotions
• Enjoys face-to-face play; can find partially hidden objects
• Explores with hands and mouth; struggles for out of reach objects
• Responds to own name
• Uses voice to express joy and displeasure; babbles chains of sounds

By 12 Months/1 Year

• Enjoys imitating people; tries to imitate sounds
• Enjoys simple social games, such as “gonna get you!”
• Explores objects; finds hidden objects
• Responds to “no;” uses simple gestures, such as pointing to an object
• Babbles with changes in tone; may use single words (“dada,”“mama,” “Uh-oh!”)
• Turns to person speaking when his/her name is called.

By 24 Months/2 Years

• Imitates behavior of others; is excited about company of other children
• Understands several words
• Finds deeply hidden objects; points to named pictures and objects
• Begins to sort by shapes and colors; begins simple make-believe play
• Recognizes names of familiar people and objects; follows simple instructions
• Combines two words to communicate with others, such as “more cookie?”

By 36Months/3 Years

• Expresses affection openly and has a wide range of emotions
• Makes mechanical toys work; plays make-believe
• Sorts objects by shape and color, matches objects to pictures
• Follows a 2- or 3-part command; uses simple phrases to communicate with others, such as “go outside, swing?”
• Uses pronouns (I, you, me) and some plurals (cars, dogs)

By 48 Months/4 Years

• Cooperates with other children; is increasingly inventive in fantasy play
• Names some colors; understands concepts of counting and time
• Speaks in sentences of five to six words
• Tells stories; speaks clearly enough for strangers to understand
• Follows three-part commands; understands "same" and "different"

By 60 Months/5 Years

• Wants to be like his/her friends; likes to sing, dance, and act
• Is able to distinguish fantasy from reality
• Shows increased independence
• Can count 10 or more objects and correctly name at least four colors

From the parents of a child diagnosed with autism:

• Turn his play truck upside down and spin the wheels.
• Stare at ceiling fans and follow the blades with his eyes.
• Stand in the middle of the floor and spin really fast, but never get dizzy
• Late talker
• Would seem to ignore us sometimes, and would have to call him and call him

This is from the perspective of a mother of a premature child:

• Parents of preemies need to know that they think 1 in 4 babies born severely premature develops autism
• He seemed to have a high tolerance for pain. The traditional spilled that caused kids to cry didn't seem to bother him
• He was a well behaved child happy to sit and be cuddled in our arms while other babies were on the ground putting everything in their mouth and trying to pull things down
• He wanted to be held and cuddled all of the time. Little did I know that he was seeking deep pressure (sensory issues)
• Due to the fact that he was premature that doctors were not worried about the fact that there were some delays in him reaching some of his milestones.
• The fact that he was affectionate, recognized his parents and would engage with his parents misled many people

From the parents of a child diagnosed with autism:

• He was an extremely easy baby. Happy to amuse himself for hours.
• Had frequent ear infections, which seem to be a common thread for children on the spectrum.
• He would sit and play with a toy appropriately but for hours. Not bringing the toy to us to see or seeking out our attention.
• He would push or pull us to what he wanted and guide our hands to what he wanted. He used us as tool to get what he wanted instead of just asking for it.
• Eye contact was not great.
• No pointing (index finger out) to what he wanted
• No joint attention (meaning pointing at things he wanted us to look at or looking in the direction that we were pointing)
• Nearing 12 months we began to suspect he was deaf. He would not respond to his name or to people coming and going from the house. But he came running from three rooms down when he heard the Teletubbies song on the TV. We knew then he was not deaf but for some reason only responding to certain noises.
• Very much in a world of his own.
• Likes to have a long skinny object in each hand
• Would lie on the floor and roll the cars back and forth and look at them out of the corner of his eye
• Picky eater (very common with children on the spectrum)
• But he was very affectionate, not routine at all and was not bothered by loud noises, unfamiliar people or unfamiliar places.
• As a Mother of a child with autism my advice would be, if you think something is not right a Mother’s instinct is normally right. Don’t allow anyone to put you off. Keep pushing until your child is evaluated. You are your child’s best advocate.