What are early signs and symptoms that your toddler may have autism (clinically refered to as autism spectrum disorder)? Read on to find out.

What is autism (autism spectrum disorder)?

Autistic spectrum disorder (ASD) is a complex disorder of the central nervous system, which often first appears as delayed speech in children around 18 months of age. The disorder exists at birth and can usually be reliably diagnosed by the time the child is three years old.

Autism is one type of ASD that appears in early childhood — usually before age three. About 15 to 20 children in every 10,000 children are autistic. Boys are up to four times more likely to develop autism than girls. Autism is characterised by impaired communication and social interaction, as well as behavioural problems.

Prof Ho Lai Yun, Emeritus Consultant from the Department of Neonatal and Developmental Medicine at Singapore General Hospital (SGH), a member of the SingHealth group, explains: “Autism is one of several disorders – including Asperger syndrome and Rett syndrome – that are classified under autism spectrum disorder (ASD).”

Children with ASD develop normally into adults. However, they continue to have impaired social communication, interaction and fondness for repetitive actions. How the child turns out is usually determined by his or her cognitive and social abilities.

Up to 70% of children with ASD experience learning difficulties, with many requiring supervision at home and work. They enjoy a normal life expectancy, although some will have residual psychological problems (anxiety and depression) or seizures.

Autism may improve with appropriate education and therapy or as the child matures. Some eventually lead normal or near-normal lives, although they continue to show some social awkwardness.

Autism awareness in Singapore

Autism (autism spectrum disorder) continues to be on the rise in Singapore. But this could simply be due to a growing awareness and systematic screening of developmental problems. Professor Ho shares, “Previously, a whole lot of children with mild or moderate developmental problems were not picked up or were wrongly diagnosed as mentally retarded.”

These days, parents and medical professionals are more aware. While children typically get diagnosed between the age of four and six, parents usually notice something is wrong by 18 months.

Signs and symptoms of autism

A child with autism (autism spectrum disorder) displays certain behavioural characteristics over a period of time, include:

Impairment of social communication

  • Delayed speech and language development

  • Difficulty expressing oneself or understanding others’ feelings or thoughts

  • Have difficulty using and reading gestures, facial expressions and body language

Impairment of social interaction/imagination

  • Tends to ignore people Most would show simple attachment to parents or caregivers

  • Often active although socially odd

  • Some may initiate contact but in an odd, awkward or inappropriate way

  • Unable to play imaginatively with objects or toys or with other children and adults

  • Display limited range of imaginative activities. Play tends to be copied, repetitive and stereotypic

Often likes repetitive and stereotypic activities

  • Simple stereotypic activities like flicking fingers, spinning themselves or car wheels, watching running electronic displays, rocking or head banging

  • Complex stereotypic activities: lining things, repeated replays of CDs, using fixed routes and fixation with particular topics

Other symptoms

  • Intolerance to noise or certain textures, apparent insensitivity or over-response to pain, heat or cold

  • Uneven patterns of intellectual functioning: may have unique skills, for example in music, numbers and letters but overall developmental delay or mental retardation

“If the child is not meeting developmental milestones like babbling or gesturing by one year of age, a visit to the doctor is a must,” advises Professor Ho. “Early diagnosis can help to improve the long-term outcomes for developmental disorders like autism.”

Read the next page for treatments and tips to care for a child with autism​​​​​.

Ref: N18

Check out other articles on autism:

Diet Tips for Children with Autism (Autism Spectrum Disorder)

Tips to Overcome Caregiver Burnout and Where to Get Help

Early Sibling Screening for Children with Autism (Autism Spectrum Disorder)