Autism Spectrum Disorder: Lack of Eye Contact Isn't the Only Early Sign

Autism spectrum disorder (ASD) is a developmental disability caused by differences in the brain that manifests symptoms in areas regarding a person’s behavior, social relationships, language, and, sometimes, intelligence.

One third to half of the parents of children with autism notice a problem even before their child's first birthday, according to the Centers for Disease Control and Prevention (CDC). And, nearly 90 percent saw issues by the time their child reached 24 months old. 

It’s a “spectrum disorder” because the condition can range from mild to very severe, says the U.S. National Institute of Mental Health, which also means there can be considerable differences between persons diagnosed with it. Though autism does have typical red flags, the combination of symptoms and its severity can vary greatly. 

As listed by CDC, the American Academy of Pediatrics, Autism Speaks, BabyCenter, and developmental pediatrician Dr. Marcelino Reysio-Cruz III, below are the early signs of autism in children. They need not be all present.

6 months

• Does not show interest in faces
• Has limited or does not engage in eye contact
• Does not look in the direction of sounds
• Does not babble
• Does not smile or laugh back in response to a parent’s happy expression

12 months

• Does not use gestures such as pointing and reaching to objects, waving at people, and nodding or shaking the  head to mean yes or no
• Does not respond when his name is called
• Is not interested in social games like peek-a-boo
• Does not try to copy sounds
• Doesn't like being cuddled or touched
• Loses previously acquired speech or social skills

18 months

• Does not use single words
• Does not point to objects to get a parent’s attention
• Walks on toes or does not walk at all
• Loses previously acquired speech or social skills

24 months

• Does not talk in two-word phrases
• Does not follow simple instructions
• Does not play simple “pretend” games (like pretending to “feed” a doll)
• Is withdrawn and does not seem to like the company of other people
• Loses previously acquired speech or social skills

Possible signs of autism at any age:

• Avoids eye contact and prefers to be alone
• Remains nonverbal or has delayed language development
• Repeats words or phrases over and over
• Gets upset by minor changes in routine or surroundings
• Struggles with understanding other people’s feelings
• Has highly restricted interests
• Performs repetitive behaviors such as flapping, rocking or spinning
• Has unusual and often intense reactions to sounds, smells, tastes, textures, lights and/or colors 

Your pediatrician will be looking for delays in developmental milestones that may point to autism at your baby’s 18- and 24-month well-baby checkup, says Dr. Reysio-Cruz, who holds a clinic at Capitol Medical Center in Quezon City and is a diplomate and a fellow of the Philippine Pediatric Society and the Philippine Society for Developmental and Behavioral Pediatrics. 

However, if you have any concerns before then, don’t hesitate to bring it up with the doctor. “Parents may notice the signs early, but then denial sets in. There can also be well-meaning relatives and friends who reassure the parents that there's nothing wrong with their child (with no basis for saying so) leading to late detection and consequently, late intervention,” says Dr. Reysio-Cruz. Remember, you know your child best. 

As with most developmental conditions, early detection is crucial. “Early intervention gives you the opportunity to improve your child’s later outcome. You will not lose anything with early consultation with professionals,” says Dr. Lourdes C. Sumpaico-Tanchanco, a developmental-behavioral pediatrician at The Medical City.