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Signs of autism spectrum disorders can be seen as early as 18 months

Autism is typically diagnosed in children around the ages of 3 and 4, but research now shows that signs of autism spectrum disorders can be seen as early as 18 months.

Young Child

Research now indicates that signs of autism spectrum disorders can be detected in children as early as 18 months.

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Critical signs, however, are usually apparent in younger children making it possible -- and important -- to identify autism earlier, said Hannah Schertz, now an assistant professor at the University of Northern Colorado. She conducted research involving autism while a doctoral student at the Indiana University Bloomington School of Education. Schertz said children can show greater gains when intervention begins early because of the malleability of the young brain.

Schertz and other researchers are beginning to find ways to intervene more effectively with children who have been identified with an autism spectrum disorder before age 3. Schertz found that a relationship-based approach that builds on the parent-child relationship is effective in promoting crucial joint attention in toddlers. Joint attention is a milestone that is evident when a child shares attention with another person about an object or event. It is a precursor to verbal language, which is a core difficulty for children with ASD.

Schertz's "joint attention mediated learning" model builds competency with joint attention through a sequence of focusing on facing, turn-taking, responding to joint attention and initiating joint attention. Schertz said researchers have found subtle social differences in retrospective videotapes of children with and without autism across cultures.

One difference -- at about age 1 -- is that the group with a later diagnosis of autism does not spend as much time looking at others' faces. An even more reliable sign can be seen in toddlers who do not show signs of joint attention by age 18 months. Here are some characteristics of joint attention:

  • The child may respond to a parent showing an object by exchanging looks between the object and the parent or by visually following a parent's point.
  • The child may initiate a joint attention encounter by holding out, or pointing to, an object while shifting gaze between the object and the parent.
  • Studies have found that verbal language follows very quickly on the heels of joint attention in typical development.
  • Toddlers with ASD have less difficulty communicating non-verbally about an object for the purpose of requesting than for purely social reasons. They are relatively able to make their wants and needs known even without the benefit of verbal language. However, they have difficulty with socially-oriented nonverbal communication that is for the purpose of sharing enjoyment or excitement about objects or events.