Every April, communities across the country come together to shine a light on autism spectrum disorder (ASD), a developmental condition that affects how children communicate, interact, and experience the world around them. As parents, you know your child better than anyone, and recognizing the early signs of autism can make a profound difference in their development and future success.
At Wake Forest Pediatrics, we believe that early identification and intervention are key to helping children with autism reach their full potential. This Autism Awareness Month, we want to empower parents with the knowledge to recognize potential signs and understand how we can partner with you on this journey.
Understanding Autism Spectrum Disorder
Autism spectrum disorder is exactly what its name suggests: a spectrum. This means that autism presents differently in every child, with varying degrees of challenges and strengths. Some children may be minimally verbal and require significant support, while others may have exceptional abilities in specific areas but struggle with social interactions.
According to the Centers for Disease Control and Prevention, approximately 1 in 36 children in the United States is diagnosed with autism. Boys are four times more likely to be diagnosed than girls, though emerging research suggests that autism in girls may be underdiagnosed due to different presentation patterns.
The exact causes of autism remain under investigation, but research indicates that genetics and environmental factors both play a role. What we know with certainty is that autism is not caused by vaccines, parenting styles, or anything parents did or didn’t do. It’s a neurodevelopmental difference that begins before birth.
Early Signs to Watch For
While every child develops at their own pace, there are certain developmental milestones and behaviors that, when absent or atypical, may warrant further evaluation. Being aware of these signs doesn’t mean you should panic at every developmental variation, but rather stay observant and communicate openly with your pediatrician.
In Infants and Toddlers (6 months to 2 years)
During the first two years of life, you might notice:
Limited or absent eye contact, even during feeding or play. Babies typically begin making eye contact within the first few months of life, and this connection is an important part of bonding and communication.
Lack of social smiling by six months. Most babies begin smiling in response to their caregivers by this age, and this reciprocal interaction is a key social milestone.
Not responding to their name by 12 months. While babies may not always respond when busy with an activity, they should generally orient toward their name when called.
Minimal babbling or lack of back-and-forth vocalizations. Babies typically engage in vocal play and conversational turn-taking, even before they use actual words.
Limited interest in social games like peek-a-boo or pat-a-cake. These interactive games are usually highly engaging for typically developing infants.
Unusual or repetitive movements such as hand flapping, rocking, or spinning. While all children may occasionally engage in repetitive behaviors, persistent and intense repetition may be noteworthy.
In Preschool Children (2 to 5 years)
As children grow, additional signs may become apparent:
Delayed speech and language development. This might include speaking fewer than 50 words by age 2 or not combining words into phrases by age 3.
Difficulty with pretend play or imaginative activities. Children with autism may struggle with the abstract thinking required for pretend play.
Intense focus on specific interests or topics to the exclusion of other activities. While passionate interests are healthy, an inability to shift attention or discuss other topics may be significant.
Difficulty understanding or expressing emotions. This might look like trouble recognizing when others are happy or sad, or difficulty communicating their own feelings.
Preference for sameness and distress with changes in routine. Many children with autism find comfort in predictability and may become very upset when routines change unexpectedly.
Unusual sensory responses. This could include being overly sensitive to sounds, textures, lights, or tastes, or conversely, seeming under-responsive to pain or temperature.
Difficulty with social interactions, such as not initiating play with peers or preferring solitary activities consistently.
How Your Pediatrician Can Help
Your pediatrician is your partner in monitoring your child’s development and addressing any concerns that arise. At Wake Forest Pediatrics, we take a comprehensive approach to developmental screening and support.
Developmental Screenings
During well-child visits, we conduct age-appropriate developmental screenings. The American Academy of Pediatrics recommends autism-specific screening at 18 and 24 months, in addition to general developmental surveillance at every visit.
These screenings involve questionnaires and observations that help us identify children who may benefit from further evaluation. It’s important to remember that a positive screening doesn’t mean your child has autism, it simply indicates that a more comprehensive evaluation would be beneficial.
Creating a Safe Space for Concerns
We encourage parents to voice any concerns, no matter how small they might seem. You might worry about being “that parent” who worries too much, but we’d rather investigate a concern that turns out to be nothing than miss an opportunity for early intervention.
Bring a list of specific observations or behaviors you’ve noticed. Videos can be particularly helpful, as they allow us to see your child’s behavior in natural settings.
Comprehensive Evaluation and Referrals
If screening suggests the possibility of autism, we’ll guide you through the next steps, which typically include:
Referral to developmental specialists who can conduct a comprehensive diagnostic evaluation. This might include developmental pediatricians, pediatric neurologists, or psychologists specializing in autism.
Hearing and vision tests to rule out sensory impairments that could affect development.
Coordination with early intervention services, which are available in North Carolina for children from birth to age 3 through the state’s early intervention program.
Connection with resources and support groups in the Wake Forest area and beyond.
Ongoing Support and Care Coordination
A diagnosis of autism isn’t the end of our partnership, it’s the beginning of a new phase. We’ll continue to:
Monitor your child’s overall health and development, addressing medical concerns that may co-occur with autism, such as sleep difficulties, gastrointestinal issues, or seizures.
Coordinate care among the various therapists and specialists your child may work with, ensuring everyone is working toward common goals.
Provide guidance on behavioral strategies and support resources for your family.
Advocate for your child’s needs in educational and community settings.
The Power of Early Intervention
Research consistently shows that early intervention makes a significant difference in outcomes for children with autism. When children receive appropriate support during the critical early years of brain development, they often make remarkable progress in communication, social skills, and adaptive behaviors.
Early intervention might include speech and language therapy, occupational therapy to address sensory and motor challenges, applied behavior analysis (ABA) to teach new skills and reduce challenging behaviors, and social skills groups to practice interaction with peers.
The earlier these interventions begin, the more opportunity there is to build on your child’s strengths and support areas of challenge during the most formative years.
You’re Not Alone
Receiving an autism diagnosis for your child can bring a whirlwind of emotions: relief at finally having an explanation, grief for the future you’d imagined, anxiety about what comes next, and hope for the support that’s now available.
All of these feelings are valid, and you don’t have to navigate them alone. Wake Forest and the surrounding area have numerous support resources, including parent support groups, respite care services, and educational advocates who can help you understand your child’s rights.
Moving Forward Together
This Autism Awareness Month, we encourage you to trust your instincts as a parent. If something feels different about your child’s development, don’t hesitate to bring it up. Early conversations lead to early answers, and early answers lead to early support.
At Wake Forest Pediatrics, we’re committed to supporting every child’s unique developmental journey. Whether your child is developing typically or facing challenges, we’re here to provide compassionate, evidence-based care every step of the way.
If you have concerns about your child’s development or would like to discuss autism screening, we’re here to help. Schedule an appointment with our team today, and let’s work together to ensure your child has every opportunity to thrive. Your observations matter, your concerns are valid, and your child deserves the best possible start. Let’s make that happen together.
