How to spot the early warning signs of autism


Autism spectrum disorder is relatively prevalent in South Africa, with The Star Academy, a school for autistic children, receiving an average of 20 phone calls a week from parents of children who have either been diagnosed with autism or who suspect that their child has the disorder. International statistics reveal that as many as one in 88 children are affected by autism.

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What is autism

It is a developmental disorder that causes children to communicate, interact, behave and learn differently from the average child. Autism South Africa’s national director, Sandy Usswald, says the learning, thinking and problem-solving abilities of people with this disorder differ from one child to another. “Some children with autism need a lot of help and intensive intervention, while others need less,” she explains.

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How to spot the signs

Autism is believed to have a genetic component that results in atypical neurological development and functioning. Although there is research being carried out, there are no definitive answers as to the causes of autism. Signs of autism can be detected as early as 12 months, and by 18 months it will be obvious that a child has not reached his milestones and is exhibiting symptoms of the disorder, according to Sandy. “As a parent, you’re in the best position to spot the earliest warning signs of autism, because you know your child better than anyone. Your child’s paediatrician can be a valuable partner, but don’t discount the importance of your own observations and experience. The key is to educate yourself so you know what’s normal and what’s not,” says Sandy.

The following developmental aspects are affected in autistic children:

  • Communication: A child on the autism spectrum may not babble by 11 months or say single words by 16 months. A loss of language at any age is a warning sign.
  • Social: An autistic child will offer limited or no eye contact when interacting with people, and will be more interested in looking at objects than at faces. He will also prefer to play alone at the age of two.
  • Behaviour: Unusual or repetitive ways of moving his fingers may become obvious between 18 and 24 months.
  • Sensory processing: An autistic child will be under- or oversensitive to certain sounds, textures or lights at 12 months.
  • Imaginative play: By 18 months, an autistic child will not engage in imaginative play, such as pretending a wooden block is a car.

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If you notice the following delays in your child’s development, ask for an immediate evaluation by a paediatrician:

  • No big smiles or other warm, joyful expressions by six months.
  • No reciprocal sharing of sounds, smiles or other facial expressions by nine months.
  • No response to his name, no babbling or baby talk and no gestures, such as pointing, showing, reaching, or waving, by one year.
  • No spoken words by 16 months.
  • No meaningful two-word phrases that don’t involve imitating or repeating by 24 months.

Some parents notice that during infancy their child is developing differently to other children, but they only typically express concern by the time their child is two – when he has failed to develop linguistically or there is a regression in the few words that he has learnt (he may stop saying them completely).

Managing the disorder

Jenna White, a family psychologist and applied behaviour analysis (ABA) specialist for The Star Academy, says that because autism manifests in different ways, it needs to be addressed differently for each child.

“For parents, when they hear the word autism, it often means fear, sadness, shock and financial strain. Parents often become physically and emotionally drained. However, if the child receives early intervention in the form of ABA, autism doesn’t need to be a lifelong disability and children can recover,” she explains.

ABA looks at the process of learning and elements that foster learning. “For example, if a child achieves a simple goal or produces a certain action, the behaviour is more likely to be repeated if there is positive reinforcement by some kind of reward (be it verbal acknowledgement or being given the chance to play on the swings outside). This can be beneficial for a child with autism, helping to reinforce behaviours that optimise independence and executive functioning while reducing behaviour that may be harmful or inhibit learning,” Jenna adds.

Sandy agrees. “Behavioural- and developmental-based interventions aim to develop a child’s behaviours by working on his communicative, cognitive and social skills. Existing interventions don’t cure autism, but they do improve its signs and symptoms.”

Parenting an autistic child

Jenna says parents of children with autism will often withdraw from their friends and community, as their child is developmentally delayed and can have terrible tantrums, preventing the family from going out. Autism South Africa shares these tips for raising a child with autism:

  • Educate yourself: The more you know about autism, the better equipped you’ll be to make informed decisions for your child.
  • Start intervention as soon as possible: The earlier children with autism receive help, the greater their chance will be for an independent life.
  • Accept and embrace your child: Don’t compare your child to others. Skills are often uneven in autism, and a child may be good at one thing and weak at another.
  • Join support networks: Find social groups to encourage friendships and interaction.
  • Take note of sensory overload: Your child may be more likely to become stressed or anxious, even feeling pain. A sensory-integration trained occupational therapist can help.
  • Stay positive and don’t give up: Children with autism can’t learn in an environment where they are constantly belittled. When you feel at the end of your tether, try to find time out for yourself, too.
  • Become an expert on your child: Identify the triggers that lead to your child’s difficult behaviours and find out what elicits a positive response.


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