Early Signs of ASD

Autism is generally thought to exist in a child from birth, but the behavioral characteristics or symptoms associated with it may not appear right away. Some parents of children with autism describe their children as being “different” soon after birth. They may be very quiet, “easy” babies. Or, at the other end of the spectrum, they may be very fussy. Their language and other skills often lag behind those of their peers.

Other parents report that their children appeared to develop normally until about 18-24 months of age. Then, suddenly, they seemed to stop developing new skills and often lost skills that they had previously mastered. Parents often report that their child stopped talking around this age and no longer seemed interested in playing with them.

You can learn more about typical developmental milestones on this timeline provided by Centers for Disease Control and Prevention (CDC).

If you have concerns about your child’s development, talk to your physician right away. If you want a tool to record and share your observations, download the CDC’s Milestone Tracker App. The earlier you diagnose a developmental delay, the better.

Indicators of ASD include:

  • Not responding to his or her name by 12 months of age
  • Avoiding eye contact and/or preferring to be alone
  • Decreased use of gestures (e.g., pointing and waving) to communicate.
  • Engaging in certain repetitive body movements (e.g., spinning or flapping hands)
  • Not engaging in pretend play (e.g., feeding a doll or petting a stuffed animal) by 18 months of age
  • Decreased babbling or use of language

Prevalence

The CDC estimates that approximately 1 in 44 have been identified with ASD. To learn more about the prevalence of ASD by gender, geography, race/ethnicity and more, take a look at the CDC’s Autism Data Visualization Tool.

You can explore data on the health and wellbeing of children and families with ASD using this portal from the Child and Adolescent Health Measurement Initiative.

At this time, autism is not a reportable health condition in Virginia, so the only data available for the Commonwealth comes from the Virginia Department of Education (VDOE). And while the VDOE has not updated its public statistics in a couple of years, this chart shows that the number of Virginia’s students with ASD has been steadily increasing since 1998.

Source: Virginia Department of Education

Diagnosis

Six. That’s the average age of diagnosis of ASD in the state of Virginia. And that’s a shame. Because professionals can make a reliable diagnosis of ASD in children as young as two. And when it comes to diagnosing ASD, the sooner, the better.

Screening

Since there is no blood test to determine the presence of autism, diagnosing ASD can be difficult. A medical diagnosis begins with screening.

The American Academy of Pediatrics recommends that doctors screen for autism at both the 18-month and 24-month well-child visits. If you are not sure whether your pediatrician screens for ASD, ask. During a screening, the pediatrician observes the child’s behavior and development. The doctor may also ask the child’s caregiver to complete a questionnaire. If the doctor notices atypical or delayed development, he or she may recommend a comprehensive diagnostic assessment.

Medical Diagnosis

The American Psychiatric Association publishes the Diagnostic and Statistical Manual (DSM) to provide healthcare professionals with a common vocabulary and standard criteria for diagnosing mental health conditions such as ASD. The association published the current version of the manual, the DSM-5, in 2013. In this edition, the diagnosis of ASD emphasizes “deficits in social communication and social interaction” and “restricted, repetitive patterns of behavior, interests, or activities.”

The autism spectrum disorder diagnosis now includes three conditions formerly diagnosed separately: autistic disorder, Asperger’s disorder, and pervasive developmental disorder not otherwise specified (PDD-NOS).

Educational Diagnosis

Just because your child receives a medical diagnosis of ASD does not mean he or she will automatically receive the educational disability category of autism. This means your child may not be immediately eligible for special education services through the public school system. We encourage you to contact your local school division’s special education department to request an assessment to obtain an educational diagnosis.

For more information, refer to A Parent’s Guide to Special Education from the Virginia Department of Education (VDOE) and the autism page on the VDOE’s website.

Many parents of children with ASD report that they have behavioral issues at school. Often times, a child “acts out” because they have no other way to communicate. Talk to your child’s educational team about your concerns. A functional behavior assessment (FBA) might help you determine how best to support your child through a behavior intervention plan (BIP). You might also consider contacting a board-certified behavior analyst (BCBA).

Treatment & Intervention

There is currently no cure for autism. However, research shows that numerous interventions can effectively target the core symptoms of ASD.

Research shows that Applied Behavior Analysis (ABA) is an effective treatment, so it is referred to as being “evidence-based.” ABA works for children, adolescents and adults. ABA uses techniques and principles such as reinforcement to address socially important problems and effect meaningful behavior change.

The Importance of Early Intervention

When it comes to intervention, the sooner, the better. In fact, research shows that intervention is most effective in the preschool years, when the brain is developing most rapidly.

The commonwealth of Virginia provides early intervention services for children until they are three years old. Sadly, many families miss out on these services because they are reluctant to seek a diagnosis when concerns first arise. If you suspect a developmental delay, ask your doctor for an assessment. It’s better to be safe than sorry.

It’s also important to remember that intervention at any age can still help. In fact, according to the National Autism Center, many educational and behavioral interventions have been proven effective for people up to the age of 22.

Avoiding Misinformation

It’s important to note that there is a lot of misinformation about ASD on the internet and elsewhere. At best, this misinformation is confusing. At worst, it may be harmful. We recommend the following resources to anyone interested in learning more about evidence-based treatments and interventions:

Our blog is another great source of information regarding treatment and intervention.

The Cost of Treatment

In Virginia, there are several ways to pay for treatment and services:

  • Public funding: Early intervention, FAPE (Free Appropriate Public Education)
  • Private insurance: As of January 2020, Virginia law mandates that state-regulated large group plans cover medically necessary care for people with autism, regardless of age
  • Medicaid or a Medicaid waiver
  • 529 ABLE (529A) accounts
  • Out of pocket

Your Rights

Individuals with Disabilities Education Act (IDEA)

The Individuals with Disabilities Education Act (IDEA) is a federal law that ensures services to children with disabilities. IDEA governs how states and public agencies provide early intervention services (for ages birth to three) and special education and related services (for ages 3-21).

Free, Appropriate Public Education (FAPE)

Remember, just because your child has a medical diagnosis of ASD does not mean they’ll automatically receive the educational disability category of autism. If your child does receive an educational diagnosis of ASD, their Individualized Education Plan (IEP) team decides whether your local school division can provide FAPE. If it can’t, the state will pay for out-of-school placement. For more information regarding placement decisions, read A Parent’s Guide to Special Education from the Virginia Department of Education (VDOE).

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