When people ask me "What was the first thing you noticed?"...I often find myself realizing there was no ONE thing I noticed. Autism Spectrum Disorder presents with a constellation of symptoms in early childhood. The big ones to look for are: little to no eye contact, little to no response to their name, and no pointing or following a point. But then again, your child may exhibit all of these symptoms and not be on the spectrum. Usually, a psychologist (who diagnosed my son at 30 months), neurologist or developmental pediatrician looks for a range of symptoms. They will evaluate your child and also heavily rely on the parents' observations. Some parents bluff and make their child look worse on purpose to get a diagnosis (which results in up to 20 hours of free therapy per week, depending on what state you live in). Some parents (such as myself), through a lack of knowledge, fear the diagnosis and may swipe symptoms under the rug.
My advice to all parents is to get a diagnose as early as possible as the first five years are the most formidable years of brain development. It is either an accurate diagnosis or not. Autism is no indication of who your child is, how much you love your child or what the trajectory of your child's life will be. It is just a word to get free help. The sooner you lose your fear of this word, the more appropriate help you will receive and the easier you make your life for your child and yourself. So trust your instinct, stop dodging or denying your fears, and don't listen to anyone (not your parents, not your in laws...only you, the parent who is with the child the most, will know when something doesn't seem right).
Remember, all professionals may not agree on a diagnosis. But it is to your advantage to go with the one who provides you with a label. Because that label can always be removed when they "outgrow" the symptoms or when the therapy is effective enough to get your child off the spectrum. And even if the label never gets removed, you as a parent know you are doing the ultimate best you can for your dear child. And always remember, 1 in 68 children are diagnosed with autism today. The numbers keep climbing. And I don't see 1 in 68 children in this world who are completely disabled. These are mostly high functioning kids who used to be called "quirky" or "nerdy." The label sounds worse than autism actually is in some cases. Of course there is a range in severity, and there is no indication from childhood about where your child will fall on this range as an adult. I am hopeful that within twenty years, Autism Spectrum Disorder will be the new ADHD. It will be a passing line people use to describe themselves (just think when your average inattentive teenager says "I have ADHD") without any negative connotation.
So here are all those first "weird things" I recall seeing in my son during his toddler years...most of which were extremely subtle in nature:
1) Honestly, there wasn't much I noticed that first year. Eye contact was there. Joint attention was there. Responding to his name was there. Dancing when he heard music was there. Playing peekaboo was there. Babbling was there. Below is a video of the first year of his life...where development was completely within range of "neurotypical." The only thing that struck me as both charming and unique was that he would line up toy cars at around nine months. When I was showing off this trait of his at dinner one night, my friend, who is a speech therapist, told me "um, Talia...that's a red flag." I replied "A red flag for what?" "For autism." She told me not to worry because a lot of children who aren't on the spectrum may do this as well. But the seed was planted with those words. From then on, I started scrutinizing my seemingly perfectly developing baby.
First Year of Development
Second Year Development
2) He started walking when he was 10 months old. Which was fantastic because my other son didn't achieve this milestone until he was 16 months. So I thought, "Yes! I'm in the clear of a physical delay...it's just a matter of time before he talks." But as soon as the walking started...he started running. And yes, children run. But something in my gut told me that he was just running too much. And without spacial understand or understanding when he was in harm's way. He would often run into kids on swings (a mother will understand if this is just typical toddler behavior or not). Something in my gut told me this wasn't normal. But I figured "He must have ADHD and not to worry, he is just a wild little boy as most boys are!"
3) Words started coming in around the year mark. But as soon as they came, they went. And inconsistently at that. And he wasn't using words to communicate. Nor was he labelling on demand. He would just sometimes sing the alphabet, or look at books and label what he saw. And the phrases would just come and go for a about a year. So to say that he had words and then regressed is not entirely true. He just never had full command of the vocabulary that was stored in his brain. So it became difficult when it was time to show my family a new skill (parents of typical children take this for granted) and I would ask him to say what I knew he had said the day before only to get no response. This really got me to start worrying....as it is one of the hallmarks of ASD. I also knew that my older son also had a speech delay, but his never made me think something was wrong.
4) He ate baby food just fine. Much better than my first born ever did. He would even mimic my words and say "delicious." But once the solids were introduced, he was no longer interested in ingesting food. From the period of 12 to 24 months, my boy only ate crushed tea biscuits on the floor, dirt he would find on the ground (a disorder called pica that is found in developmentally delayed children), nutri grain bars, and whole milk in a bottle. And a date loaf (yes, a date loaf) from Walbaums. He was an unusually picky eater, not like your average picky toddler (a mom will know the difference). This made him chronically constipated...another kind of red flag for me that something was off. Refer to The Services for more information.
5) He would eat pizza backwards. Like from the crust. Which yes, many children might do. But this was quirky. Eating is social. He had no awareness of how others were eating. He was self-directed (another big hallmark of autism) and would eat how he wanted to. He would also not hug me appropriately. He would just turn around and back up into me and have me hug him whenever I would pick him up from preschool. Now these aren't real red flags, but they were signs of quirkiness. He also had a phase where he would just turn back and look at a person in a funny way, kind of like the "what you talkin bout Willis?" face. Of course, we were utterly charmed by all these quirks. But they were quirks nonetheless.
6) He would laugh out of no where. And my older sister who was very attuned and informed about autism would always indirectly hint to me to change his diet and he might be having a reaction to food (which I always knew parents of children on the spectrum often change their diet to see if they find improvements in their behavior). And I would then google "laughing out of no where" and would be terrified by the stuff I read. This was another big one for me.
7) When he started preschool, I knew he wasn't ready. But there was no choice. He had no diagnosis. He just had a speech delay and autism was ruled out at the 18 months because he was social and would respond to his name and play peekaboo with his brother in front of the evaluator. All he had was speech/feeding therapy twice a week for one month before entering school. And I knew it would be an uphill battle. Once he started school....everything became infinitely obvious. He just was no where close to the other children developmentally. He was receptively and expressively delayed. He wouldn't follow directions. He wouldn't sit down to eat food. (Thank G-d though after two months here he started finally eating meals...one problem solved). It took him four months to detach from me. The transition from preferred to non preferred activities were horrendous. And I was told by the principal that he was "in his own world." Google that. And I remember having heard that about him often from my parents and in laws but never knowing that in today's world, that meant "autism".
8) He would look up at fans on ceilings. Like obsessively.
9) Humming to himself repetitively. Which in retrospect I learned is a "stim", a self stimulatory behavior present in many autistic children.
10) Inconsistent everything. Responding to his name. Eye contact. Following points. Pointing. Playing peekaboo. Being present.
11) Covering and tapping his ears whenever he was sensitive to a particular noise. This was a two week phase in the beginning and continues to come and go into the present day.
12) Stimming: you normally think of hand flapping when you think of autism. But stimming comes in various forms. And in my son's case, it started full force after the diagnosis. Whether it's vocal stimming, jumping up and down, staring at their hands, climbing up and down couches...these are all behaviors that interfere with learning and communication. And they occur when the children are over stimulated, in a new environment, excited, or simply just want to avoid the task at hand. And it often takes over their lives. Probably the biggest battle to date has been against his stim because it competes with learning and focus.