The boy in the picture is Quinn, an 18 month-old boy with autism. He is shown obsessively stacking cans. While repetitive behavior like this is a common symptom of autism, there are other signs of the disease that appear earlier.
The Earliest Signs of Autism
According are recent article in the journal of the American Academy of Family Physician (AAFP) titled, Primary Care for Children With Autism, the earliest signs of autism in children is the delayed attainment of social skill milestones. Here are some of the diagnostic criteria offered by the AAFP for physicians.
- a. Marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction
- b. Failure to develop peer relationships appropriate to developmental level
- c. A lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest)
- d. Lack of social or emotional reciprocity
Language impairment is a common, but less specific, sign of autism. Repetitive behaviors and restricted interests may not be noted until after social skill and communication impairments are exhibited. Physicians should perform developmental surveillance at all well-child visits, and the American Academy of Pediatrics recommends administering an autism-specific screening tool at the 18- and 24-month visits.
The goals of long-term management are to maximize functional independence and community engagement, minimize maladaptive behaviors, and provide family and caregiver support. Physicians play an important role in coordinating care through an interdisciplinary team; referring families for specialized services; and treating children's associated conditions, including sleep disturbances, gastrointestinal problems, anxiety, and hyperactivity. Autism is a lifelong condition, but early recognition, diagnosis, and treatment can improve the prognosis, whereas associated medical conditions, psychiatric conditions, and intellectual disability can worsen the prognosis.