Understanding Autism Spectrum Disorder in Young Children

Discovering that your child might have autism can be overwhelming for parents. Like any medical condition, it means your family may have to deal with special challenges. Sumit Sen, MD, a pediatrician at Stanford Medicine Children’s Health — Pediatrics in Alameda, offers some strategies that families can use to help set their child up for success. Dr. Sen also discusses this topic in a HealthTalks podcast.

What is autism?

Autism spectrum disorder (ASD) is a condition that occurs in the brain and affects how a person communicates and interacts with others. Children with autism might have a hard time expressing themselves or making friends with other kids. They might also have routines they prefer to follow, repeating the same activities again and again.

The importance of early diagnosis

According to Dr. Sen, early intervention is crucial for children with autism. That is why it’s important to keep an eye out for any developmental red flags and share them with your pediatrician.

“The American Academy of Pediatrics recommends that ideally a child be diagnosed by 24 months of age for optimal treatment outcome,” he said. “Here at Stanford, we have instituted a checklist at every well-child visit starting from birth. The parents are very aware of what we’re looking for at each visit, and if there are any red flags, we’re able to bring it up and discuss. Within our system, I do not believe we miss a single kid.”

The earlier a child is diagnosed, the better the outcome, Dr. Sen explained. “If we diagnose very early, we are not that much off track. With therapy, we can get your child on track and move forward,” he said. “Whereas if your child is undiagnosed for several years, by this time, a child is so far behind on their developmental trajectory that it’s like doing several years of homework in one month, which is impossible to do. And therefore, the child never catches up and becomes permanently delayed.”

Signs your child may have autism

There are several common signs that may indicate your child is on the spectrum. Dr. Sen encourages parents to watch for any of the following:

Not responding when someone calls their name by the time they’re 1 year old.

Not pointing or showing interest in things like airplanes flying by when they’re around 14 months old.

Not playing with toys, like feeding a doll, by the time they’re 18 months old.

Getting really upset over small changes in their routine.

Having very intense interests in certain things.

Doing things like flapping their hands, rocking back and forth, or spinning around.

Reacting in unusual ways to things like sounds, smells, tastes, or how things feel.

Preferring to spend time alone rather than with others.

Finding it hard to understand what other people are saying.

Repeating words or phrases over and over (called echolalia).

Not being very good at social skills, like making friends or talking to people.

Having trouble with language skills, like not knowing many words by the time they’re 18 months old.

Not looking at someone’s eyes while they’re talking to them.

Having lots of tantrums or finding it really difficult when things change.

What to expect if your child is diagnosed with autism

If your pediatrician confirms that your child has autism, they will work with you to create an individualized plan for your child. This typically involves a range of different therapies (like speech therapy, occupational therapy, and behavioral therapy) that are designed to help with your child’s specific needs.

While your child’s therapists will play a big role in supporting your child, Dr. Sen explained, parental involvement is key.

“A child does best if the parent participates intensively in the intervention. A parent is a child’s best therapist,” he said. “When I counsel parents, I always say that therapy is not sitting the child in a chair and teaching them skills; it is all done through fun, playful, interactive activities that are enjoyable to the parents, too.”

He encourages parents to use play to help connect with their child and reinforce the lessons learned in therapy. “Be silly, animated, and playful, and that’s when the child is really going to be engaged. Practice in front of the mirror,” he shared. “When you adopt that fun persona with your child, it holds their attention and helps you become a more effective parent.”

You can also join support groups and connect with other families who are going through similar experiences. Having autism doesn’t have to stop your child from living their best life.

“It’s a journey that I will walk with the parents for the next several years,” said Dr. Sen. “With all the appropriate therapies and the parents fully engaged, a lot of my patients start elementary school at the same level as their peers. And by their late elementary school years, they do not have the diagnosis anymore. It’s like a huge team—parents, therapists, doctors—we are all working together to do the right thing with the kids.”

To learn more about ASD in children, read “Autism Spectrum Disorder in Children” or “Family Support for Autism Spectrum Disorder.”