Autism, particularly in women and non-binary people, has historically been underdiagnosed. Many of us figure out that we’re disabled later in life or have it thrust upon us after a life-changing event. While self-diagnosis is a valid entry point to obtain support, there are some indicators that can help families and care networks identify a child’s disability earlier.
How Early Can Autism Be Detected in Babies?
Autism is a neurodevelopmental disorder. The first definitive signs typically appear between the ages of 1 and 2.5. Dr. Peter J. Chung, medical director of the Center for Autism and Neurodevelopmental Disorders at the University of California, Irvine, says this is largely because of the developmental milestones practitioners look for when making a diagnosis.
“It’s really hard to make a diagnosis of autism before the age of 1 year,” says Chung. “I’ve done that very rarely. Part of that is because some children will actually show typical development up until a year of age or so and then may start to show signs of autism between the first 1 to 2 years of age.”
What Are the Main Signs of Autism in Babies?
There are two main diagnostic areas for autism:1
- Social communication and interaction
- Restricted and repetitive patterns of behavior, interests, or activities.
In young children, this can manifest as a lack of pointing and not reacting when a family member calls their name. Jaime Baquero, MD, a child neurologist, says that parents also often notice skill regression, a lack of babbling, inconsistent eye contact, and a lack of “joint attention.”
“Joint attention is the ability for a child to share an experience,” says Baquero. “For example, if they find something that is fascinating and find some shiny object or some toys, generally, the child is seeing them for the first time and then turns around, will go to the parent, and show them what they just found. And [autistic kids] usually are not showing items, or sharing interests with the parents.”
There are two common diagnostic tools used for autistic kids: the Autism Diagnostic Observation Scale (ADOS) and the Childhood Autism Rating Scale (CARS). Practitioners who spoke to Verywell Mind for this story point out that autistic children are often identified at their regular 18-month screening.
What Causes Autism in Babies?
There is no definitive cause for autism, though some research has found a genetic component.2 It’s commonly understood that if you have a close relative with autism, you are more likely to be autistic.
Sharief Taraman, MD, who works at U.C. Irvine and as an attending physician at Children’s Health of Orange County, recommends that parents and guardians of autistic children focus on how they can support their child rather than worrying about why they are autistic.
“I try not to have parents focus on cause or reason,” Tamaran explains. He notes that his team may look at genetics because it can influence treatments. “And then really, the focus needs to be on, how do you support the best quality of life for the child?”
What Doesn’t Cause Autism?
One debunked theory is that autism stems from vaccines. This theory is based on a flawed ’90s study by physician Andrew Wakefield that suggested that the measles virus triggered inflammatory lesions, which caused autism. This myth was later debunked and discredited for research misconduct and falsehood.3
Chung says that he believes medical misinformation like this may stubbornly persist because of a desire to assign a reason for a jarring diagnosis, combined with the fact that early signs of autism often coincide with the timeline of a typical course of childhood vaccines. He says this distracts from his team’s central focus: getting children with autism the support they need.
“We know that the child has autism,” he says. “It’s better to focus on what to do next because early intervention, especially in the first five or six years of the child’s brain development, can make a lot of differences, especially in the trajectory of the child over time. And the more intensive the services, the better the outcome seems to be.”
One key point Chung and his colleagues make to parents is that they are not the reason for their child being autistic.
“I do stress to the parents that ‘It’s nothing that you did or didn’t do that caused your child to have autism,’” adds Chung. “We think it’s mostly genetic, with maybe some environmental triggers, but we don’t know what that is. And until we have more scientific research to really help us determine, that’s more of a public health question. My concern is really about the child that’s in front of me.”
What Are the Challenges in Diagnosing Autism?
Historically, many marginalized groups—including women—have been under- or misdiagnosed. Taraman says he and his collaborators have repeatedly found that the way the U.S. healthcare system diagnoses autism is “broken.”
“It relied on specialists who were using research tools that had been normalized on predominantly white males with affluent backgrounds,” explains Tamaran. “And so what was happening is kids, females, anyone from a minoritized background, Hispanic, African American, low socioeconomic status, they were getting missed. They were getting misdiagnosed, or if they got diagnosed, it was on average much later than their white male counterparts.”
Recent research suggests that rates of autism diagnoses are on the rise, with 1 in 36 now being diagnosed by age 8.4
Zoe Gross, director of advocacy at the Autism Self Advocacy Network (ASAN), says that medical professionals and parents can learn a lot from autistic adults.
“A lot of times, parents are very frightened when they’re getting an autism diagnosis, and they need to hear things that are not like everything’s rainbows and sunshine, but not like doom and gloom, either,” Gross says. “Like. ‘Your kid can still live a great life.’ That’s a really important message for people to hear.”
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What To Do If a Child You Care for Is Autistic
Practitioners and self-advocates agree that the first step is to find support. Dr. Chung says that there are a myriad of options:
- Options within the legal system, like the Individuals with Disabilities Education Act (IDEA) and the Autism CARES Act, which allow for increased funding and legal provisions for financial support
- Early intervention agencies in each state and schools
- Recreational programs
- University-level resources (for children on an academic path)
- Autistic self-advocates in your area, such as the Autism Self-Advocacy Network or independent living centers throughout the U.S.
One of the most common approaches to supporting those with autism is applied behavioral analysis (ABA), an umbrella term for a set of treatment options. ABA has a complicated history, however, with many self-advocates and autistic adults labeling it a form of torture. Studies also show that it has caused PTSD for many people in the autistic community.5 Some interventions used with autistic children have also been banned.6
Considerations
When searching for support for the autistic person in your life, it’s important to ensure it aligns with their needs and wants. While Taraman isn’t necessarily anti-ABA, he believes that there are ample opportunities for supports, including vital early-stage ones, that focus less on correction and more on comfort and care.
“If the behavior is not harmful—for example, lining up items can be seen as a behavioral feature—if it’s not causing distress to the child, I don’t really care,” Tamaran explains. “If the child isn’t getting upset about the toys being out of line or something, that’s not a thing that you need to necessarily address.”
While the diagnostic journey can be scary, Gross says that one key message to parents is that all is not lost. “It’s difficult to have a disability in this world, but that doesn’t mean that you need to grieve for your child,” says Gross. “Your child is still right there, they’re still the same person they always were; they can still be healthy.”
Support for Parents of Autistic Children
According to the Individuals with Disabilities Education Act (IDEA), autistic children are eligible for certain free or low-cost services to help build skills and manage their needs. These services include physical therapy, occupational therapy, speech therapy, medical evaluations, augmentative and alternative communication (AAC) devices, and other services.
If you suspect your child is autistic or has other developmental challenges but hasn’t gotten a diagnosis, IDEA allows children under 10 to benefit from these services.
