I get asked all the time what the first signs of Holden’s autism were. As any parent of a kid on the Spectrum will tell you – it’s always harder to notice the signs in your own child. We change every diaper, give every spoonful of food, are the first to see every new thing they do, and, you get used to the way they are. They seem perfectly normal to you.
I think any parent can say that. We often don’t notice that our child is a bully or a pansy, a peace-maker or a rebel-rouser, quick or slow – until we see them around other kids and really look.
But even when you really look it can difficult to see Autism Spectrum Disorder in your own kid. Some signs are easier to see than others. And keep in mind, many neurotypical kids exhibit some of these. It’s the combination of these that leads to an ASD diagnosis:
Inability to attach to other people – I remember visiting my brother and sister-in-law in San Antonio when Holden was just 17 months old. And it was like he was a completely different person than the one I knew at home. He wouldn’t go to anybody else. He wouldn’t look at or interact with them. My usually very independent baby was suddenly clingy!
The inability to really connect is one of the first signs. Many ASD parents lament that their child doesn’t emotionally connect with them, let alone anyone else.
Avoids making prolonged eye contact – eye contact is one of the ways humans connect with each other. The eyes are called the window to the soul, but eye contact avoidance is a big sign of ASD. It could look like this: you talk to your child and you know your child is listening because their head is turned towards you, but they’re only looking at you peripherally, not right into your eyes.
Holden always made really good eye contact. The only time he doesn’t is when he is getting a “talking-to” – if he’s in trouble, he avoids eye contact. But maybe all kids do…
Delayed Language or Language Cessation – though there are types of ASD where they don’t have language delays and are hyper-verbal, many of them do have trouble speaking. Holden learned words and was on par with other kids his age until about 2 1/2. Other kids were grasping verbal concepts that just seemed way beyond Holden. And he jabbered a LOT without saying distinguishable words. Other signs are when they do speak a lot but suddenly stop talking.
Echolia is another verbal problem that is common with ASD. It’s almost nothing but ASD when it happens. So look for when your child repeats what you are saying verbatim. “Do you want to go to the pool?” and they say “go to the pool” or “want to go to the pool” rather than saying “yea.”
Don’t play with toys “correctly” – at a very early age kids learn to play with their toys, and somehow they just do it correctly. I’m always amazed when I see my 1 year old play with an airplane and he makes propeller noises and flies it above his head. It’s really strange for me, because Holden didn’t do that naturally. Instead, he lined up his toys. Usually in order of size, color, or type. He brilliantly classifies his animal them by land or sea, plain or jungle animal.
But this is something you should look for. Does your child feed a bottle to a pretend baby? Or fly airplanes in the sky, or pretend to be in a car race? Does your kiddo pretend in general? Pretending takes a lot of advanced conceptual skills – and many ASD kids don’t pretend on their own. Does s/he put their action figures in cars/trucks? Or feed imaginary food to a stuffed animal?
Look for a child who does not do these things. But plays differently. Lines up toys, categorizes them rather than plays with them, or sits and spins the wheels on cars rather than pushing them around.
Doesn’t like being touched/hugged – Some kids are just not cuddlers. Holden was one of those kids. I thought he was just independent. But he preferred to sit in his chair and observe – even as a tiny infant – rather than be held. But he didn’t totally reject me when I did hold him, it was just not preferable for him. Some ASD babies/kids can’t handle being touched at all. Watch for the way your child react to your touch. Do they turn away from it, shrug off a hug like it hurt, or pull away their arm when you touch it?
Holden didn’t love being hugged. I taught him how to give kisses and he seemed to prefer that to hugging family members. When he was getting evaluated by the school district, he was upset and annoyed and when they tried to touch him on his arm he screamed “that hurts me!” And it probably did. I will go into theories on why in a different post. But watch for the reaction to these physical touches.
Unusual behavior patterns or “stims” – Stimming is self-stimulation and is really common in ASD. There are so many kinds that I have read about that it would be impossible to list them all. But some very common ones are when a child flaps his hands when he’s excited about something. Or waves the strings on a blanket in front of his face. Rocking is another common stim. There are more serious ones like head banging, or hitting. Staring at the reflection of the sun off of metal – or anything shiny for a long time. Being enamored with the spinny wheels of a toy and watching it spin over and over. Spinning in circles is another common one. Or staring at the fan. Again, a lot of kids do things like this occasionally, but they are more frequent and for longer periods of time with ASD kids.
Stims are easier for other people to notice but hard for parents to see – again because we just get used to it. Especially if your child is difficult, it can be so relieving to have them occupied with something, you may look the other way without realizing it’s a stim. I asked both his Speech Therapist and his Occupational Therapist if Holden had any, because I couldn’t tell. So ask your friends or family members if they notice these about your child. Holden isn’t a real stimmy kid. He’s a sensory-seeker, which we’ll talk about next.
Sensory Seeking/Cycles – Holden burns a lot of calories. Or at least he used to – he’s calmed down quite a bit. But still he moves a lot! For example, when we go to a play room he just can’t stop moving and running around and exploring everything. It’s especially noticeable when you’re with a group of kids. The ASD kid will most likely march to the beat of his/her own drum, not follow the group, and seek out his/her own pattern. ASD can look similar to AD/HD if they are sensory seekers like Holds because they are constantly moving. They would prefer to throw their bodies into a Lovesac over and over and run around the house than sit down and read a book or color.
Holden moves in cycles. Example: when we go to a park, Holden will seek out a pattern – maybe it’s first the slide, then run around the fountain, then go across the bridge, then go up the stairs and back down the slide. Repeat. And repeat again. It’s easy to keep track of him because I learn his pattern and just look for him on that path that I know he’ll stay on.
Fixed Patterns/Unrelenting Behaviors/Tantrums – the toughest behavior to deal with (in my opinion) is the unrelenting patterns and fixed behaviors of an ASD child. I think it’s also the hardest one to observe objectively because you’re knee-deep in dealing with it all the time. They could be simple – like a child who insists they put the right leg into pants first and cannot do it in the wrong order. Or a kid who MUST wear a certain shirt or outfit every day.
Holden likes juice. So does his friend. They could both be over to the fridge asking for juice. I look in the fridge and see that we’re out of juice. “We’re out of juice guys, sorry!” His friend is disappointed and sad, but gets over it when I say we have milk. Holden just freaks out. There’s not alternative for him. There’s no talking him through it. There’s not explaining that the juice just isn’t in the fridge. There’s not reasoning with him. He loses it and just has a huge tantrum until he gets over it or I can transition him to something else.
Holden likes there to be certain things at certain places. At the Dees by our house, they have a floating sign that rotates. When it isn’t rotating, Holden notices and gets anxious about it. When he was younger, he insisted on watching Mary Poppins every time we went to my parents because he did that once. Every time. He would never ask for it until we went there. And Nanny McPhee at my in-law’s house. These were movies that just had to play. And switching him from that movie to another one is very difficult and takes a lot of persuasion.
These are just a few examples, but look for unrelenting behaviors and tantrums that are just way out of control compared to other kids.
Other signs are: not noticing or being interested in other children, not exhibiting empathy, low social skills or not being able to understanding social situations, inability to converse about anything they’re not interested in, laser-focus on certain subjects and no interest in others.
Pediatricians are notorious for not knowing anything about ASD. But they should be screening for it by 18 months and again at 2 years old. My pediatrician handed me the M-Chat test only after I asked him if I should be worried that Holden wasn’t talking very much. Holden was 2 years old. I filled it out, and then he took it and never talked to be about it again. Don’t let this happen to you!
Here is a link to the M-Chat. This test is just a screening to see if a more in-depth evaluation is recommended. I found the test to be a little confusing. I recommend answering NO if you are not sure if your child does something. Because after the initial questions, the online test goes in depth about each one.