The amount of mis-information about autism which is floating around the internet both saddens and amazes me. It’s no wonder that so many people think that autism is almost impossible to spot in toddlers. More often, the case is that most parents of autistic children will have known something was wrong when their child was a baby or a toddler, and just not known at that time that the ‘something’ was autism. The causes behind the symptoms are quite similar in most autistic children; but they present differently in different children depending on their individual personalities, intelligence and upbringing. Every child is different after all.
An autistic child will demonstrate the ‘triad of impairments’. This means that they will have difficulties with their social communication, social imagination and social interaction. The severity of how each individual is affected in each area will vary drastically, but if a child is autistic then there will be definite impairments in all three of these areas. Whether or not you will be able to spot them in a child during the toddler years is another matter, but there are certainly some behaviours which may highlight the problem early on in a child’s life. It is important to understand at this point that while you as a parent may be able to spot autism in your toddler, it is rare for a child to be officially diagnosed prior to three years of age. Some of the difficulties that stem from autism can also stem from other developmental disorders, as well as from social and environmental factors. Pediatricians need to build up a firm history before making an official diagnosis to ensure that other possible causes behind a child’s difficulties have first been ruled out.
A social imagination is basically the ability to understand the world and see the bigger picture. A child whose social imagination is lacking may respond in an extreme manner to change. A common misinterpretation seems to be that autistic children will scream and cry if you try to upset any aspect of their daily routine, but in fact many autistic children only become distressed when small details within their expected routine are changed. For example an autistic toddler may expect the same bottle at every mealtime and become instantly distressed if given a new one. They may not care about where they are or who is feeding them, but they could be intensely attached to always having one particular bottle.
An autistic toddler learns by being taught and instructed by his carers, or by watching his peers or siblings and copying them; there will be something original and exploratory lacking in his play. Autistic children often engage in repetitive play that goes noticeably beyond that of their peers because of this lack of original and exploratory play. They may insist on shutting all the doors in people’s houses instead of checking out their toy box, or they may prefer repeatedly pressing the same button on electronic toys, instead of trying out the variety of functions that the toy has to offer to see what might happen.
They may insist on lining things up instead of moving characters and cars around when using play sets, or they might continually take toys apart rather than attempt to use them for their real play purpose. The difference in an autistic child’s play at this developmental stage could simply amount to a subtle difference that only those who spend a lot of time with the child will notice. To the outside world, a high functioning autistic child can appear to play in a normal fashion at this age; the lack of originality, purpose and a desire to explore are things that may only be noticed gradually over a period of time.
An autistic child will lack in social communication as a toddler, though this may not yet be very noticeable in contrast with their peer group. The differences are subtle, but they will be there. An autistic child just doesn’t naturally understand the purpose of communication. They may be unable to point things out themselves, and they may not be able to follow your point either. They may not babble or talk, or they may do so in a meaningless fashion. High functioning autistic toddlers may have average or above average speech skills, but will not use that speech to properly communicate with you. They may be perfectly capable of saying “want drink” but will rarely or never say so to you, purely because it doesn’t occur to them to do so. They may appear to assume that you know what they want when they scream and cry, but make no physical or verbal indication as to what it is they want. Autistic children are not all non-verbal, some have amazing speech skills very early on in life; it is a lack of using language to communicate and interact that indicates autism.
Autistic children are well known for being unable to pick up on hints, facial gestures and body language; and this can sometimes be noticed in toddlers. For example when you hold your arms out to embrace your toddler, if they are autistic they may not think to open out their arms to return the embrace, though they will hopefully learn this eventually if you physically guide them and regularly remind them as well. They may not be able to wave without assistance or instruction to do so, and they may may seem to be confusingly unloving at times such as being dropped off in daycare or left with a grandparent; but that’s simply because it doesn’t occur to an autistic child that they might miss their Mum and show this with a wave or a cuddle as their peers might do.
Autistic children have feelings inside the same as their peers do, so sadly you may often notice signs of extreme distress and frustration in an autistic toddler. When they are hurt or in need, they may self-harm by hitting themselves, smashing their head into the floor, or pulling at their hair instead of seeking comfort from a person. They may hit out and cause harm to those around them as well. They may be considerably quicker to scream or cry out in distress than their peers, and over seemingly trivial things too. Autistic toddlers are often very extreme in their general behaviour. They may be placid to the point of being barely responsive, or they may be highly strung and hard to control. Many autistic children will frequently flit between the two behaviours. All toddlers have tantrums and paddies, but an autistic child will take it that one step further. They will have little or no natural awareness of how to process and deal with feelings of distress.
There is something fundamentally different between a toddler being naughty and an autistic toddler losing control. An autistic child may well throw themselves around during a tantrum with no regard for their own safety or the safety of those around them. They may well respond considerably better to being restrained and told firmly to calm down than to being cuddled and spoken to softly. They will throw tantrums easily over things which seem totally inconsequential to everybody except them. You know that the feelings of distress are very real in an autistic child just by feeling their little heart race with adrenaline.
Social interaction should not be confused with social tolerance. An autistic toddler may well be just as able to tolerate others as his peers are, especially if he is good at zoning out from his surroundings or focusing on his own interests. All children will be learning how to share and interact with their peers at this age, so the signs of problems with social interaction will often only be subtle differences at this stage of development. An autistic child may prefer to sit and stare at something or nothing while the children around him run about playing. He may be described as ‘a thinker’ or a ‘serious tot’ by other parents, and he may have a slightly lower tolerance of other children than his peers do, especially if they are noisy.
An autistic child will often be capable of interacting with other people, but largely this will be only on their terms. They will respond to people saying hello when they are interested, and ignore them when they are not. They may remember their favourite people with ease, while not recognising people they’re not so fond of, even if they see them on a daily basis. Autistic children are usually capable of making eye contact, but often have an aversion to doing so. Some find it uncomfortable while others just don’t appear to see the point of doing so. An autistic child may sometimes make no eye contact at all, while at other times he might make a big fuss of studying someone right in the eyes. As a general rule, an autistic child will make noticeably less eye contact than his peers though. He may frequently start talking while looking away from the person he is addressing, and even facing in the wrong direction or while standing in a different room in the house.
Other Autistic Markers
Autism usually includes sensory problems, which you may well spot ahead of signs of the triad of impairments. A child with sensory problems will basically either over-react or under-react to sensory stimulation. Autistic toddlers may either be completely ignorant of loud noises and appear to be deaf at times, or they may over-react and cover their ears and cry when they hear loud noises such as sirens or alarms. They may be extremely funny eaters, or they may have no limits or preferences with their food at all. They may have an aversion to being touched, or a need to have constant physical contact. It’s a common misconception that autistic children do not like to be cuddled, some autistic children crave the sensory stimulation that they get from physical contact and learn that by seeking cuddles they can fulfill this desire. When the cuddles are an excessive demand on your time, and don’t appear to have any actual affection attached to them, that can be a symptom of autism when combined with the triad of impairments.
Autistic children with sensory problems may also be excessively fussy about textures and refuse to play with sand or pick up finger foods. They are often either over or under sensitive to pain, and many autistic toddlers will not react in the slightest at getting a cold or chicken pox or cutting their knee. They might over or under react to strong smells, and they might indulge in self stimulating behaviours such as rocking back and forth, spinning in circles, or flapping their hands like a bird. You may also find that an autistic toddler is extremely physically pliable and almost melts into you at times. You will notice the odd sensory abnormality in most toddlers from time to time; what marks a toddler out as being autistic is the persistent and repeated displays of these abnormalities.
Autistic children may also have an uneven early development. At eighteen months old a high functioning autistic child may be able to operate the TV remote, speak in short sentences, arrange their toys into colour groups and open their own child gate; but they may also not know how to wave, or how to follow a point, or how to ask for something that they need or want. A low functioning autistic child may be able to operate electronic toys that have chunky buttons and flashing lights, yet not even be able to sit up with support.
A lot of people who have autistic children will be able to look back on their child’s toddler years and not be able to believe that they didn’t realise their child was autistic much earlier than they did. The trouble with spotting autism is largely that you have to understand it before you can identify it. Autism is not a codeword for being a late talker, a badly behaved child or a tot who lacks intelligence; it is a condition that affects how a person naturally views the world and functions within it.