Does My Child Have Autism?

There is no single test that will definitively confirm a diagnosis of Autism. Rather, trained clinicians look for a series of symptoms and behaviors as identified in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). The diagnostic criteria for Autism are separated into three main areas, and a child must demonstrate symptoms from each of the three areas prior to the age of 3 in order to meet the diagnostic criteria of Autism:

1 Social Interaction

The child demonstrates qualitative impairment in social interaction, including at least 2 of the following:

  • Marked impairment in the use of nonverbal behaviors such as eye contact, facial expressions, body postures, and gestures to regulate social interaction.
  • Failure to develop peer relationships appropriate to developmental level
  • A lack of spontaneous seeking to share enjoyment, interests, or achievements with others (for example, the child does not bring things to show his parents)
  • A lack of social or emotional reciprocity (for example, the child does not participate in simple social games, such as “peek-a-boo”)

2 Communication

The child demonstrates qualitative impairments in communication including at least 1 of the following:

  • Delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gestures)
  • In children with adequate speech, there is marked impairment in the ability to initiate or sustain a conversation with others
  • Stereotyped, non-functional, and repetitive use of language (for example, the child may say words or phrases out of context)
  • A lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level

3 Behavior & Interests

Restricted, repetitive, and stereotyped patterns of behavior, interests, and activities, including at least 1 of the following:

  • Preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus (for example, the child may be preoccupied with having all things in a particular color or collecting information about maps, etc.)
  • Apparent inflexible adherence to specific, nonfunctional routines or rituals (as in insisting on following a particular route or drinking from a particular cup)
  • Stereotyped and repetitive motor mannerisms (for example, the child may flap his hands, walk on her toes, or rock her body)
  • Persistent preoccupation with parts of objects

Source:
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington DC: Author.

No single symptom or behavior indicates Autism. Rather, it is the combination of the above three areas.

Behaviors associated with Autism may be apparent as early as 18 months of age, and often become increasingly evident throughout early childhood (24 months to 6 years). See our Research section for further reading.

While there is no one test that can detect Autism, several screening instruments have been developed that are now used in diagnosing Autism. One such screening tool is known as The CHAT: The Checklist for Autism in Toddlers, which was developed to help identify Autism in children as young as 18 months. If you suspect that your child may have Autism, you might consider the following questions, and discuss your answers with your child's pediatrician or a trained clinician.

Yes/No The CHAT – Questions for Parents
Does your child enjoy being swung, bounced on your knee, etc?
Does your child take an interest in other children?
Does your child like climbing on things, such as up / on chairs?
Does your child enjoy playing peek-a-boo / hide & seek?
Does your child ever pretend, for example, to make a cup of tea using a toy cup and teapot, or pretend other things (e.g. pouring juice)? *
Does your child ever use his or her index finger to point, to ask for something?
Does your child ever use his or her index finger to point, to indicate interest in something? *
Does your child play properly with small toys (e.g. cars or blocks) without just mouthing, fiddling, or dropping them?
Does your child ever bring objects over to you (the parent) to show you something?

* Indicates critical questions

Source:
Baird G, Charman T, Baron-Cohen S, Cox A, Swettenham J, Wheelwright S, Drew A. (2000). A screening instrument for autism at 18 months of age: A 6-year follow-up study. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 694-702.

If you suspect Autism, you should immediately speak with your child's pediatrician. It is important that you also have your child evaluated by a clinician with specific training and experience in diagnosing Autism. Be sure to let your pediatrician / clinician know if your child is exhibiting any of the following "red flag" indicators:

  • Does not babble or coo by 12 months of age
  • Does not gesture (point, wave, grasp, etc.) by 12 months of age
  • Does not say single words by 16 months of age
  • Does not say two-word phrases on his or her own (rather than just repeating phrases stated by others)
    by 24 months of age
  • Has any loss of any language or social skill at any age

Having any of these “red flags” does not mean your child has Autism, but could indicate that further evaluation is needed.