Catherine Maurice, in her book Let Me Hear Your Voice (Click to read a summary and/or to order), made the following comments about her daughter (just diagnosed with autism): "Who knows, really, what the first sign was, at what point Anne-Marie began to slip quietly from us. Was it during that first birthday celebration, or after, or before?"
Looking back on life, we can pick out the signs, usually. Unfortunately, this retrospection is usually coupled with regret. "Why didn't we notice?" "Maybe something could have been done." Maybe.
Dr. Stephen Edelson, in his excellent article, Overview of Autism, states: "Many autistic infants are different from birth. Two common characteristics they may exhibit include arching their back away from their caregiver to avoid physical contact and failing to anticipate being picked up (i.e., becoming limp). As infants, they are often described as either passive or overly agitated babies."
The American Academy of Neurology, the Child Neurology Society, and the American Academy of Pediatrics have adopted practice guidelines regarding the screening and diagnosis of autism in children. They stress the importance of early screening for autism and developmental disabilities at every well-child visit to the physician. They specifically indicate an "absolute indication for immediate evaluation" if the child shows any of these symptoms: "No babbling, or pointing or other gesture by 12 months. No single words by 16 months. No 2-word spontaneous (not echolalic) phrases by 24 months. ANY loss of ANY language or social skills at ANY age." These wonderful physicians recommend that a child meeting any of these early criteria should be referred immediately for an autism screening and other developmental tests rather than waiting. To view the guidelines, click the link: Practice parameter: Screening and diagnosis of autism Report of the Quality Standards Subcommittee of the American Academy of Neurology and the Child Neurology Society by Filipek, et.al. You will need Adobe Acrobat Reader.
The value of sharing your story, as Catherine Maurice and many others have done, is that it allows others to benefit from your experience. Perhaps others will not miss the signs. That is the hope of many. May God be with you.
Following is the Checklist for Autism in Toddlers (CHAT), to be used to screen 18-month old children for autism, and information on early signs of autism.
The Checklist for Autism in Toddlers (CHAT) was developed by researchers at the University of Cambridge in the UK. The researchers screened 16,000 18-month old children in the UK using the CHAT. Three items from the CHAT were identified as very accurately predicting a diagnosis of autism: pointing at something in the environment to bring it to the attention of another person (protodeclarative pointing), looking at an object when another person looks and points it out (gaze-monitoring), and pretend play (e.g., “drinking” imaginary tea from a cup). The researchers found that if an 18-month old child consistently failed the three items, there was an 83% chance that the child would be labeled autistic in subsequent testing. Here’s a look at the CHAT:
Note: The CHAT should not be used to diagnose autism. It is designed to be used as a screening instrument by health professionals. Failure of any of the items should alert the parent to the possibility of a developmental delay and should be followed up by a thorough evaluation by an Early Intervention professional.
(*) Indicates critical questions that are most indicative of autistic characteristics.
(*1) - To record YES on this item, ensure the child has not simply looked at your hand, but has actually looked at the object you are pointing at.
(*2) If you can elicit an example of pretending in some other game, score a YES on this item.
(*3) Repeat this with, “Where’s the Teddy Bear?”; or some other unreachable object; if child does not understand the word “light”. To record a YES on this item, the child must have looked up at your face around the time of pointing.
Early recognition of 1-year-old infants with autism spectrum disorder versus mental retardation
A PubMed abstract about a study that analyzed the differences between one year old children later diagnosed with autism, later diagnosed with mental retardation, and normally developing children. Not a diagnostic test but worth a look.
Autism: Recognising the Signs in Young Children by Jennifer Humphries
A very good article on the early detection of autism in youngsters.
FEAT - Checklist for Autism in Toddlers
An expanded version of the CHAT for use by pediatricians and family physicians, etc. (Thanks to the Fargo Moorhead Families for Early Autism Treatment).
DISCLAIMER: This site is intended to provide basic information resources on Autistic Disorder. It is not intended to, nor does it, constitute medical or other advice. The author of the web site is not a medical doctor. Readers are warned not to take any action with regard to medical treatment or otherwise based on the information on this web site or links without first consulting a physician. This web site does not necessarily endorse any of the information obtained from any of the links on this page or links that other pages may lead you to. Neither does this web site promote or recommend any treatment, therapy, institution or health care plan. The information contained in this site is intended to be for your general education and information only and not for use in pursuing any treatment or course of action. Ultimately, the course of action in treating a given patient must be individualized after a thorough discussion with the patient's physician(s) and family.