How will I know if my child requires an autism evaluation?

How will I know if my child requires an autism evaluation? At one point or another, you may come to question whether your child needs an autism evaluation: either due to behavioral concerns, developmental milestones he or she is not hitting, or a combination of the two.

Many parents endure a phase or two (or five!) spent worrying about their child’s development. After all, it’s natural to compare your child to siblings or playmates and perhaps notice some differences that strike you as concerning. It’s often difficult, however, to determine whether your concerns and the corresponding symptoms/behaviors warrant an evaluation.
Symptom emergence

The characteristics of autism can vary from child to child; some children show clear signs very early on, while others have more subtle symptoms that are easily missed until much later. For example, some children may appear to develop typically and meet all developmental milestones before starting to regress. Others continue to show typical signs of development, but new symptoms—such as sensory sensitivity, rigidity, emotional dysregulation, and social challenges—crop up and become more noticeable by the time they enter school. Some children who do not reach earlier developmental milestones (e.g., babbling, pointing and responding to caregivers) are usually diagnosed before age 2.

It’s important to keep in mind that autism also manifests differently in girls and boys, with the condition often going undiagnosed (or resulting in misdiagnoses) among girls. The abilities and needs of autistic people also vary and can evolve over time; some children reflect uneven skills, with very advanced development in specific areas but delays in others.

For reference, here is a list of symptoms associated with autism and how they manifest across unique developmental stages. Autism is difficult to diagnose—with no medical testing available to do so—meaning clinicians must rely heavily on your own personal observation of your child as well as any additional input from teachers or other caregivers. Thus, as a parent, the best thing you can do is monitor your child’s development, take notes, and capture any behaviors that concern you on video to share with your child’s specialist. If your child is displaying even a few of these symptoms, please reach out for a free consultation to determine whether an evaluation is an appropriate next step for your child. An evaluation will help you understand your child’s strengths and needs while guiding you toward the best possible resources and interventions.

• Difficult to get your child’s attention

• Does not share enjoyment with you

• Does not respond to his/her name

• Uses few to no gestures (e.g., showing or pointing)

• Does not combine gestures, sounds and eye contact to communicate

• Does not imitate simple games or engage in pretend play

• Pulls your hand as a tool to communicate his/her needs

• Does not notice people and is more interested in objects

• Moves his/her fingers, hands, and body in unusual ways (e.g., finger-stiffening, spinning, head-banging, and/or jumping repeatedly)

• Plays by engaging in repetitive actions, filling and emptying, lining up objects, and knocking over and rolling on a continual basis

• Becomes very upset over changes in routine or if stopped from engaging in repetitive behaviors

• Exhibits delayed speech or stops using words he/she used to say

• Produces odd vocalizations and has an unusual tone of voice and/or difficulty modulating his/her voice

• Repeats others’ words and phrases from favorite shows

• Shows intense interest in specific activities or objects (e.g., collecting rocks, sticks, or a long string of cloth)

• Is very sensitive and reactive to sound, light, touch, and texture

• Displays a strong interest in unusual sensory experiences such as licking/smelling objects and/or looking out of the corner of the eyes

• Does not use many facial expressions indicating surprise, happiness, sadness, and/or anger

• Has difficulty expressing feelings and discussing experiences

• Prefers to play alone and has difficulty initiating play and joining other children

• Experiences frequent emotional dysregulation and takes longer to recover than other children

• Exhibits a strong desire for and insistence on consistency with respect to clothing, food, toys, etc.

• Finds it difficult to transition from one activity to another

• Experiences digestive issues, insists on a restricted diet, and engages in stool withholding

• Exhibits exceptionally high skills in specific areas such as early reading, memory, and building blocks

• Finds it difficult to make and maintain friendships

• Unaware of personal space and may get too close during conversations

• Finds it difficult to engage in back-and-forth conversations

• Mainly interested in discussing his or her own interests

• Finds it difficult to shift to a new perspective, becoming stuck on a specific topic

• May not understand sarcasm, humor, and figures of speech

• Becomes easily overwhelmed and distressed in new situations or when facing change

• Resists any change to his/her environment (places, people, objects)

• Typically exhibits a high or low pain tolerance

• Engages in repetitive movements or self-stimulatory behaviors such as hand flipping, finger flicking, or rocking back and forth