What to Do if Your Child Shows Signs of Autism 

Autism spectrum disorder is often talked about, but recognizing and diagnosing it in young children isn’t always straightforward. For families who are unsure what symptoms to look for—or what to do next—understanding the specifics may ease some of the worry.

“Parents can feel nervous about the possibility of an autism diagnosis,” says Columbia developmental behavioral pediatrician Lauren Nolte, MD. “It’s okay to share any fears with your pediatrician openly.” 

Autism spectrum disorder is a neurodevelopmental condition that people are born with that affects how they communicate, interact with others, and experience the world around them. Because people with autism spectrum disorder typically develop symptoms during early childhood, early diagnosis can provide children with the support and services they need to succeed throughout their lives.

Dr. Nolte and fellow Columbia developmental behavioral pediatrician Gabriella Paskin, MD, explain what the condition could look like in children, how to seek a diagnosis, and the resources available to children and families.

What is autism spectrum disorder?

Autism spectrum disorder may be caused by genetic and environmental factors that affect a child’s brain development. Vaccines do not cause autism. The disorder can be challenging to diagnose—there’s no single test for it, and no one way people with autism look or act. “It’s a spectrum because individuals with this diagnosis can have a wide range of symptoms, cognitive abilities, language abilities, and behaviors,” says Dr. Nolte.

Symptoms may appear and change over time, but can begin as early as 15-18 months. Common signs may include:

• Not responding to their name or making eye contact
• Delays in language or social skills
• Lack of gestures like pointing or showing
• Making repetitive movements or sounds
• Strong reactions to certain textures, sounds, foods, or other sensory input

As children get older, they may also have difficulty learning in school, playing with others, or adapting to changes in routines. “These things alone can be seen in many kids,” says Dr. Nolte. “But it’s really a pattern of behavior that we’re looking for.”

For some children, these patterns may be obvious. But for others, symptoms may not be recognized for years; this happens more often with girls, who tend to show fewer stereotypical autistic behaviors, hide their symptoms, and imitate others to fit in.

How are children diagnosed with autism spectrum disorder?

Because autism spectrum disorder is complex, diagnosis involves two stages: screening and evaluation.

Screenings are typically part of a child’s routine checkup with their pediatrician. They are first performed at 18 months, then again between 24 and 30 months. They consist of checklists that parents fill out about their child’s behavior and indicate some concerns or common symptoms seen in children with autism. Some behaviors may become apparent earlier or later in life, though. Hence, it’s important to mention any signs of autism you may notice to your pediatrician, no matter how old your child is.

Dr. Paskin notes that a positive result from a screening doesn’t necessarily mean your child has autism. “It screens for autism, but it’s also good at screening for other delays, like language delay.” On the other hand, a child who doesn’t screen positive may still show symptoms and behaviors that could be due to autism.

The next step is to have an autism-specific evaluation from a specialist in child development, neurology, or behavior to narrow the possibilities.

Evaluations vary based on the situation and provider. “A provider could observe the child in the office or use a more structured observation or assessment,” says Dr. Paskin. Evaluations can be conducted at a doctor’s office or through the nationwide Early Intervention Program. After the evaluation, the specialist will make the diagnosis (if appropriate) or recommend additional assessments if another condition could be causing the symptoms.

What treatments for autism spectrum disorder are available?

Because each child with autism spectrum disorder is unique, many different resources can help children and families cope and thrive. As awareness and research around autism spectrum disorder grow, services are expanding and becoming easier to access.

Depending on a child’s needs, speech therapy, special education, occupational therapy, and applied behavior analysis (ABA) can teach important language, social, and physical skills. At the same time, counseling can help families manage symptoms at home. Early treatment is critical for setting children up for success.

Ultimately, a diagnosis is just that—a diagnosis. Talking with your pediatrician is the best way to develop the right plan for your family.

“Nothing has actually changed about your child,” says Dr. Paskin. “We just want to help families access the best services for their kids and help kids do their best.” 

Lauren Nolte, MD, MA, is an assistant professor of pediatrics at Columbia.

Gabriella Paskin, MD, is an assistant professor of pediatrics at Columbia.