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Writer's pictureHeather Gotthelf

Autism Spectrum Disorder: The importance of red flags and early intervention

Updated: Aug 15, 2019



AUTISM…a word that scares many, rightfully so. It can be a difficult diagnosis to cope with and there is still so much unknown in research. In earlier days, autism was not recognized as a treatable condition, so most of those affected were placed in institutions. Today, however, there has been ongoing extensive research to help determine possible causes, appropriate treatment, and counseling tactics to help families living with this widespread diagnosis.


I am a parent of two typical children so I cannot personally relate to those parents who have children on the spectrum. I truly can’t fathom what the lifestyle is like on a daily, or even hourly, timeframe. Although I have years of experience treating many children with ASD, I get to see each child from a different perspective than the caregivers. I will never forget the first time I worked with children on the spectrum. I was a senior in high school, completing an internship course with children who have special needs. My first encounter was intimidating since I had no experience with them, but I quickly learned of the amazing potential these children possess! With mutual respect, intervention, understanding, and love, these children can thrive and develop skills in their own way. The progress is incredibly rewarding, and it makes my heart swell with joy to witness a moment or day of breakthrough in development. The internship taught me much, but the most important thing I took away was these children are not “disabled” …they just have different abilities. The term “disability” doesn’t describe it properly in my opinion. It’s simply a difference.



"These children are not 'disabled'....they just have different abilities."



Autism Spectrum Disorder (ASD) can range from highly functioning (Asperger’s) to a more severe, nonverbal diagnosis. One of the most important things to consider is early intervention is VITAL for optimal success! Parents, educators, therapists, and pediatricians should be able to recognize red flags that point towards a potential diagnosis of ASD. If there is any question or doubt as a parent, always go with your instinct and seek professional advice. Although only certain professionals are qualified to diagnosis ASD, the process and wait lists are typically long…so be proactive and take action as early as possible.


Some red flags are more obvious than others. The more known signs include hand flapping, rocking, spinning objects, and poor or lack of eye contact. The less obvious signs are frequently overlooked and can create confusion when the diagnosis is mentioned later in the child’s life because the parent has believed the child to be typical up until that point. For example, a child with relatively appropriate eye contact or one performing well academically may not be considered as someone on the spectrum. But this is not always the case. There are other less obvious symptoms that can contribute to the diagnosis (i.e., poor social skills, focus/obsession on specific topics, difficulty with changes in routine, difficulty tolerating various textures). The cases of higher functioning ASD can be more difficult to diagnosis since the symptoms are not as easy to identify.


Here are some intriguing statistics and facts about ASD according to the Centers for Disease Control and Prevention (CDC):

- “About 1 in 59 children has been identified with autism spectrum disorder”

- “ASD is about 4 times more common among boys than among girls”.

- “Almost half (44%) of children identified with ASD has average to above average intellectual ability”.

- “Children born to older parents are at a higher risk for having ASD”.

- “Even though ASD can be diagnosed as early as age 2 years, most children are not diagnosed with ASD until after age 4 years”.


If a parent, grandparent, teacher, therapist, or caregiver has any thoughts or concerns about a child being on the spectrum, there is a screening that can be completed to determine if the child is at risk. It’s called the Modified Checklist for Autism in Toddlers (M-CHAT). Click on the link, answer the 20 questions and submit your answers. Many pediatricians and therapists utilize this tool for guidance to initiate early intervention as needed. Pediatricians are a vital component regarding a child’s general health and well-being. When questioned by a pediatrician about a child’s development, the caregivers need to be clear AND understood. Children are often referred to a Speech-Language Pathologist for a developmental delay and it is typically the therapist who discovers tendencies related to ASD due to the level of interaction with the child. It is important to recognize the red flags for ASD. According to www.autismspeaks.org:


"The following may indicate your child is at risk for an autism spectrum disorder. If your child exhibits any of the following, ask your pediatrician or family doctor for an evaluation right away.

By 6 months: few or no big smiles or other warm, joyful and engaging expressions; limited or no eye contact


By 9 months: little or no back-and-forth sharing of sounds, smiles or other facial expressions


By 12 months: little or no babbling; little or no back-and-forth gestures such as pointing, showing, reaching or waving; little or no response to name


By 16 months:very few or no words


By 24 months: very few or no meaningful, two-word phrases (not including imitating or repeating)


At any age: loss of previously acquired speech, babbling or social skills; avoidance of eye contact; persistent preference for solitude; difficulty understanding other people’s feelings; delayed language development; persistent repetition of words or phrases (echolalia); resistance to minor changes in routine or surroundings; restricted interests; repetitive behaviors (flapping, rocking, spinning, etc.)Unusual and intense reactions to sounds, smells, tastes, textures, lights and/or colors"


Although the initial understanding of an ASD diagnosis can be shocking and upsetting, early intervention is key and these children can learn to adapt when provided with the appropriate therapeutic services. There are many well-known people who have sustained successful lives with an ASD diagnosis. A few of those icons include Dan Aykroyd (actor), Albert Einstein (Scientist and Mathematician), Steve Jobs (Former CEO of Apple), Temple Grandin (Animal Scientist), and Tim Burton (Movie Director).


April is National Autism Awareness Month! We need to spread awareness, support, and serve as the voice for those who are unable to speak for themselves. Auburn TLC’s therapists are knowledgeable and equipped to work with ASD. Our Speech-Language Pathologists and Occupational Therapists work together as a team with the family to ensure appropriate and functional goals, as well as develop home programs to encourage carryover. EARLY INTERVENTION IS VITAL! So, trust your parental instincts, complete a screening, talk to your pediatrician, seek a referral, and take action. It’s best to avoid the “wait and see” approach that many choose regarding their child’s development. The time lost while waiting could have been applied to therapeutic services that help the child. Auburn TLC is here, and we want to help and provide support for those with ASD!


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