April International Autism Awareness Month: FAQ about children on the Autism Spectrum |15 April 2021
As a parent how did you first know?
“He didn't respond to his name being called. He showed no interest in toys, he only played with this one car that he would spin the wheels. He seemed to be stuck in his own world, meaning no interest or response to his surroundings or even other children. He also engaged in repetitive movements like going back and forth while looking at objects sideways,” says Ethan's mum when looking back at the first signs.
For Mattias’ mother it was “Mother's instinct, then I started noticing that he was concentrating mostly on spinning objects, wasn’t responding to his name, went from an active little guy to a very quiet one, from my sweet little boy who was actually saying a few words to saying nothing”.
In Josh's case, the fact that he was lagging behind was picked up by a nurse at a milestones check visit.
It was “intuition combined with visible signs such as regression and eventually loss of language, lack of eye contact, not responding to his name, not interested in others and playing with parts of his toys instead of the whole toy. He would always be spinning the wheels of his cars/trucks” that alerted Sébastien's mum that something wasn't quite right.
Four of our children. Four of our families. Four of our stories.
Autism characteristics can present in a variety of ways and can change as the child gets older. The red flags as they are frequently referred to, might be easy to see in one child, and be barely noticeable in another, especially in girls who tend to mask (ie they learn and mimick neurotypical behaviours) better. In general terms though, children with autism may seem different, especially when compared (yes, “comparison is the thief of joy” and generally speaking we shouldn't compare children as they are all different, but sometimes that comparison can lead to realisations) to those their own age. In some cases, children may develop normally until about 18 months or even their third year before they start showing the traits commonly associated with autism.
Although recent international research shows that children as young as 6 months can begin to exhibit symptoms of autism, doctors are reluctant to diagnose that early and it can take a long time to get an official diagnosis. In Seychelles, the ADOS, that is the standardised diagnostic test for Autism Spectrum Disorder, is only administered on children 3 years and above.
Parents are often in the best position to spot the earliest warning signs of autism.
It is important therefore that parents and other guardians educate themselves on important developmental milestones and observe their child, so as to notice anything out of the ordinary and to share any concerns or observations with their nurse at a wellness check (apwentman peze) or a doctor.
It is also important for grandparents, child minders, early childhood educators and community health workers to be aware.
So what should you be looking out for?
Early indicators of autism:
- no babbling or pointing by age 1
- no single words by 16 months
- no 2-word phrases by age 2
- no response to name
- loss of language or social skills previously acquired
- inconsistent eye contact
- excessive lining up of toys or objects
- no smiling or response to social interactions
- hand flapping, jumping, walking on tip toes
- may prefer to play alone and in the same way all the time (eg. lining up toys, spinning wheels)
- may be sensitive to loud noises and/or crowds
- may appear to be a “picky” eater
Later indicators include:
- impaired ability to make friends
- impaired ability to initiate or sustain a conversation with others
- absence of imaginative and social play
- repetitive or unusual use of language (e.g scripting i.e reciting lines from movies, series, TV adverts)
- abnormally intense or focused interest
- preoccupation with certain objects or subjects
- inflexible adherence to specific routines
This is by no means an exhaustive checklist nor does it mean if your child exhibits one or two of the traits, he/she is on the Autism Spectrum. However, if you think your child is showing signs, please get your child evaluated.
An early evaluation can open the door to early interventions, which though limited in the Seychelles context, is very important as it is proven to improve future outcomes for the child, whether or not he or she is eventually formally diagnosed.
I am a parent, I see the signs, what do I do?
Don't panic. Seek professional help. Contact the Early Childhood Intervention Centre at the English River health centre. (Incidentally, but in an exciting new development, assessment and diagnosis is now being offered by a service provider privately, so more options).
But remember that no person knows your child better than you do, and it is important that you advocate for your child at a time when it is perhaps not possible for them to advocate for themselves.
I am not a parent, how can I help?
Listen and be supportive. Resist the temptation to minimise concerns. Save the “you are worrying too much, he/she is fine, so and so also didn't speak until he/she was five” comments. Advocate for more resources for early assessment, diagnosis and interventions. We need it.