Signs of autism and the road to diagnosis

Signs of autism and the road to diagnosis

Not every child with an autism spectrum disorder (ASD) will rock back and forth, avoid eye contact or line its toys up in a structured row. Every child on the autism spectrum will present with different challenges, some more obvious than others.

Key points

  • Some children don’t present any symptoms of autism, whereas others may display signs of developmental delay
  • The age that a child is diagnosed can vary from child to child 
  • The diagnosis journey generally starts with a GP or health practitioner

Diagnosing autism

Some children are very young when they display strong signs of autism, in others it’s not recognised until they start school or even in adolescence.

No one knows your child better than you and if you have concerns about the development or behaviour of your child you should speak to your doctor.

Your GP or paediatrician will be able to answer any questions you may have about where your child sits compared to general developmental milestones and if the behaviours your child is displaying are normal or should be investigated further.

The path to an autism diagnosis can be quite overwhelming but is essential to ensure your child receives early intervention support as soon as possible.

It is important to understand what is involved in an autism diagnosis so an accurate assessment can be completed and the support journey can begin.

What may I notice in my child?

Some children don’t present any symptoms of autism, whereas others may display signs of developmental delay which could be an indication of autism. It is recommended you seek professional advice if you notice any of the below signs at these ages.

Six months

  • Few or no big smiles or other joyful and engaged expressions

  • Limited or no eye contact

Nine months

  • Little or no sharing sounds, smiles or other facial expressions

Twelve months

  • Little or no babbling

  • Little or no gestures such as pointing, reaching or waving

  • Little or no response to own name

Sixteen months

  • Little or no spoken words

Twenty-four months

  • Very few or no meaningful two-word phrases

Any age

  • Loss of any previous speech, babbling or social skills

  • Avoiding eye contact

  • Difficulty understanding other people’s feelings

  • Repetition of words

  • Resistance to minor changes in routine or surroundings

  • Restricted interests and/or behaviours

  • Unusual and intense reactions to sounds, smells, tastes, textures, lights and colours

  • Preferring to be alone

  • Difficulty picking up on social cues, such as tone of voice or body language, in others

When should my child be tested?

Your child should be screened for developmental delays and disabilities at nine months,18 months and 24 or 30 months, with any additional screenings to be performed if they are at higher risk due to premature birth, low birth weight or relevant family history.

Screening specifically for autism should happen at 18 months and 24 months, with any additional screening for high risk children (for example, if other children in the family have autism).

Your regular doctor can health check your child, but any concerns requiring an assessment will be referred to a specialist or health practitioner with experience in diagnosing neurodevelopmental and behavioural conditions, such as developmental delays and autism.

What are the tests involved in diagnosing autism?

For most people who have concerns about their child’s development or who suspect their child might have autism, their journey starts at their GP or paediatrician.

Firstly, the doctor will ask you, as the parent, some questions about your child. They may also talk to and play with your child to see how he or she speaks, moves, behaves and learns.

Your health practitioner will collect information including your family’s medical history, your child’s medical and health history and will also look into their developmental and functional abilities and can refer you to professionals specialised in autism diagnosis for the next step.

In Australia autism is generally diagnosed by a “specialist multi-disciplinary team” of health professionals.

This is because autism can present in many ways, so a varied breadth of medical knowledge is required for an accurate diagnosis. The diagnosis team will include a paediatrician, psychiatrist, psychologist or speech pathologist and sometimes other professionals such as an occupational therapist, all with relevant experience in diagnosing autism and developmental disorders.  

To get an accurate diagnosis, a Comprehensive Needs Assessment and Diagnostic Evaluation is performed.

Firstly, a Comprehensive Needs Assessment helps to understand your child’s developmental and functional abilities, including cognitive ability, speech and language function and daily living skills.

Your child will then be assessed using the current Diagnostic and Statistical Manual of Mental Disorders (DSM-V), which highlights common language and standard criteria when assessing and diagnosing mental disorders.

A health professional with relevant medical or psychology background will have a look at the information already collected from the Comprehensive Needs Assessment and will have a chat with you and your child. They will assess your child’s cognitive ability, speech and language skills.

Once these tests have been completed you will receive a written report containing the information collected, what this means and where to from here.

What are the levels of autism?

There are different levels of autism, all requiring specific supports. Your child’s level of autism will be indicated when a diagnosis is reached.

Those diagnosed with Level 1 autism require support to improve social communication skills, have difficulty initiating interactions with other people and picking up social cues such as body language, jokes and sarcasm. They also find it difficult switching between activities and present problems with organisation.

People with Level 2 autism require ‘substantial’ support. They experience challenges in verbal and non-verbal social communication skills, social impairments, limited initiation of conversations and social interaction, abnormal responses and difficulty reading social cues, inflexibility of behaviour, restricted or repetitive behaviours and difficulty coping with change.

Those diagnosed with Level 3 autism require ‘very substantial’ support. People with Level 3 autism often have severe challenges in their verbal and non-verbal social communication skills, difficulty coping with change and have restricted or repetitive behaviours.

What is the next step?

If you have a confirmed autism diagnosis, it’s a good idea to contact autism specific organisations in your state. These organisations can provide you with extra information and help you get started by linking you to services and letting you know what kinds of support you can access through the education system and beyond.

Depending on your level of autism and eligibility you may also begin applying for supports through the NDIS.

If your child is under six years of age you may be able to receive early intervention support through NDIS under the Early Childhood Early Intervention program. This program aims to give children the best start to life by identifying the type and level of support they need, promoting inclusion in the community and providing opportunities to learn and grow.

To access supports through the National Disability Insurance Scheme (NDIS) from the age of seven you are required to meet the NDIS eligibility criteria. People with an autism diagnosis are not automatically accepted to the NDIS.

By getting your hands on our DPS Guide to Disability Support you can learn how to navigate the NDIS and find the right support for your family.

What more would you like to know? Tell us in the comment section below.

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