Is My Child Autistic? Surprising Early Signs
I’ve written an all-encompassing article about Emmy’s* (my own daughter’s) journey to an autism diagnosis, but I wanted to share some more focused articles about a few questions that parents on a similar journey might be thinking. Starting with the earliest part of that journey: when you begin questioning if your child might be autistic.
The “Usual” Signs
If you do a Google search for common signs and symptoms of autism in toddlers the top hit might just be delayed language development — not having the “normal” number of words for whatever their age is, not responding to their name, or simply not talking at all. Another term I see a lot is “repetitive or restrictive behaviors.” This can mean anything from preferring lining up toys over engaging in imaginative play, repeating a motion (such as spinning or flapping), or becoming easily upset by changes in their routine.
These are all excellent early indicators, but before you stress out: lots of kids have language delays that don’t have autism. Lots of kids engage in repetitive behaviors, especially when young: no one thinks twice about a baby repeatedly dropping a cup or spoon over the side of their high chair, because very young children are still experimenting with cause and effect. Like the little scientists they are, they repeat actions (and later, questions) over and over again to see if the laws of the universe always hold true. Lots of kids wiggle, flap, and squeal when happy. Lots of kids rock when upset. Lots of kids get upset by changes to their routine. So, please, young parents, don’t stress if your kid is showing some or even all of these behaviors.
Trust Your Parenting Instinct to Gain Valuable Time
That being said, you know your child best. If you even think you want to have your child evaluated for autism, I say get the ball rolling now. According to this article from the National Library of Medicine, most children receive their autism diagnosis after they are four years old, even though the standard criteria for screening can be implemented at two years old, and most parents have their suspicions starting at 12 months old.
While I want to stress it is never too late to start helping your child with autism, getting them diagnosed earlier gets them access to critical early intervention services BEFORE school that can help make the elementary years and beyond so much smoother. In our area, the major medical centers with developmental pediatrics currently have an 18–24 month wait list just for a first appointment. So again, talk to your child’s pediatrician as soon as possible, insist upon a referral if necessary, because even if you start right now there may be a long wait.
We were lucky in the fact that I had a pediatrician who was willing to refer Emmy to a developmental pediatrician before I even asked. We were also very lucky to live in a state with mandated early intervention: this meant all I needed was a “prescription” for it from my regular pediatrician, and Emmy was able to start speech and OT months before even being evaluated for autism. That is not the case everywhere, and I’m thankful every day we didn’t have to wait. Looking back, there were so many indicators that Emmy was autistic. Being my first child, I just thought that’s what babies or toddlers did. But if she had been my second, and my neurotypical daughter, Bee, had been first, I would have known so much sooner. Let’s look at some of those signs together:
Higher interest in mechanical things than human interaction
Emmy loved fans and vents from the time she was an infant. In fact, her first smile and first laugh were both directed at the ceiling fan in her nursery, not at a person. I didn’t think much of it at the time because, well, she was on her back getting a lot of diaper changes so looking up at the ceiling fan seemed just incidental. Emmy was very affectionate with me and my mom (the two people she saw the most), but this love of fans seemed to supercede connecting with others close in her life, including her father and grandfather. Again, I divided the issue: I chalked up her not enjoying the company of the men in her life as the men being awkward with babies, and the fans as just a quirk of her personality. But this love of fans has continued into her childhood. She is now seven, and named all the fans in her school before making friends in her class.
Meeting or exceeding milestones…in unusual ways
Normally you hear about autistic children not meeting milestones, but I think early ability in some areas can be an autism indicator, as well. Emmy could hold her head and shoulders up at just a few weeks old. She was an intensely observant newborn. I cannot find a journal article backing this up as an autistic trait, but I can tell you, anecdotally, that this seems to be a common trait amongst autistic children.
In addition to her early drive to sit up and look around, she met or exceeded many milestones that, in a way, masked her differences or made them easy to ignore. The big one was language: she always had more words than the recommendations for whatever-months-old she was, but they were almost exclusively animal names and sounds. At her eighteen month checkup, it was recommended she have twenty words. I did some mental math and realized she had over fifty. I mentioned to the nurse that they were mostly animal-related, and she said that was fine. When her word count exceeded the 100 words expected at her two-year-old visit but the subject matter hadn’t changed, I mentioned it to her pediatrician and we got the ball rolling on an autism evaluation.
Another unusual milestone was being able to turn paper pages at an extremely young age. Emmy has, in addition to autism, since been diagnosed with hypotonia, which just means low muscle tone, and is a common co-diagnosis. This hypotonia makes her hands weak. At eight months old, this weakness in her hands actually allowed for a more delicate touch than most babies have, and masked this aspect of her disability as a strength.
Emmy also had an intense interest in books, letters, and numbers. By eighteen months old she could identify all of her uppercase and lowercase letters individually from each other. She could count forward to and backwards from twenty. Later, I found out that a large portion of autistic individuals are hyperlexic — or, learn to read early. I thought she was just super smart (I still do), but did not realize this interest in written language and corresponding early ability is a common autistic trait.
Subtle differences in movement
I didn’t learn about midline crossing, retained primitive reflexes, and other gross motor differences until well after Emmy’s diagnosis. Some I noticed but didn’t know the significance of what I was seeing, some I didn’t even notice until her OT pointed them out years later. A big one was her continued preference for a fist grip on a writing utensil, instead of moving to a pincer grip as it became age appropriate. This has more to do with her hypotonia than her autism, but since the two often show up together I thought I’d mention it.
Emmy also had trouble crossing her midline: when making a lowercase “t” for example, she would start at the middle and make four lines going out, instead of an up and down cross. Same for an “x,” and her “s” was a struggle of curved lines. She also would only write on one side of her paper, moving it around to access the page instead of moving her hand or repositioning her body. This reluctance to cross her midline transferred to more gross motor skills as well: she had difficulty transferring things from one hand to another, and had to turn to fully face an object before being able to pick it up (as opposed to reaching and bending to the side to grab something). For whatever reason, gross motor skills, such as midline crossing, seem to be lacking in many autistic kids. If your child seems jerky or uncoordinated beyond the normal awkwardness of whatever age they are at, especially if they seem to favor one side of their body, it may merit taking a closer look.
If any of these signs — usual or less reported — match up to what you are observing in your child I will stress again: start seeking an evaluation now. If you see changes in six months that rule out autism, you can cancel your appointment. But if things continue to concern you, you won’t have wasted any time wondering. In the meantime, there are things you can do with both younger and older children while you wait for that diagnosis, which I will write about next.
*Names have been changed
Annie Newman is a substitute teacher, mom, and aspiring children’s book author raising two children: one neurotypical and one autistic. You can also follow her day-to-day learning on Instagram and on Tiktok.