Deciding to objectively look at your child for signs of autism is hard. Thinking about your child possibly needing alternate care or schooling when that child is still a baby was not what you signed up for. But detecting early signs of Autism Spectrum Disorder (ASD) and seeking a professional diagnosis is the best way to make sure your child lives a productive and happy life.
Early signs of ASD are not easy to detect and you should always seek a professional opinion with your observations and concerns. It is not possible to diagnose your own child with ASD from reading online tests, blogs, or watching videos. The purpose of this blog is what to look for that could potentially be a valid concern for your child.
Many early signs of ASD can be confused with normal developmental behavior. All children develop at different rates. There are some behaviors that may be valid reasons for raising concern. Let’s take a look at what to look for (and what not to look for) when it comes to your infant or young child and ASD.
What are the Warning Signs of ASD in Young Children and Infants?
There are several marker behaviors that parents should take into account when observing their infant or young child developing. Again, note that none of these behaviors means your child has ASD. These are simply behaviors that are commonly associated with ASD if they persist.
The behaviors listed are from the CDC and Autism Awareness Center.
Infant Behavior Markers (up to 12 months)
- Does not make or maintain eye contact
- Lack of facial expressions (never smiles or frowns)
- Does not respond to their name by 9 months
- Uses few or no gestures
- Does not respond to verbal cues or ‘games’
- Lack of attempts at verbal communication
Young Child Behavior Markers (up to 24 months)
- Does not share interests, such as found objects or toys by 15 months
- No pointing to indicate things by 18 months
- Lack of empathy (recognizing others are happy or sad) by 24 months
- Delayed language, motor, or cognitive skills
- Interested primarily in objects and not people
- Gets upset by minor changes
- Has unusual or extreme reactions to sensory experiences (touch, taste, smell)
Other Potential Early ASD Markers
The CDC lists the following as other marker behaviors commonly exhibited by those with ASD:
- Preterm births or low birth weight
- Environmental exposure to hazards like lead paint
- Hyperactive, impulsive, and/or inattentive behavior
- Epilepsy or seizure disorder
- Unusual eating and sleeping habits
- Gastrointestinal issues (e.g., constipation)
- Unusual mood or emotional reactions
- Anxiety, stress, or excessive worry
- Lack of fear or more fear than expected
Remember, all of the above behaviors and characteristics are just general markers. Some children who get diagnosed with ASD won’t exhibit any of the signs listed above. Always speak to a medical professional when you are unsure of what to be concerned about.
When do the Signs of ASD Start to Show?
Autism Spectrum Disorder is hard to diagnose, as there are no medical tests that reveal it. Diagnoses are made from testing conducted by medical professionals based on behaviors, developmental milestones, and other specific criteria.
With that said, warning signs of ASD can begin to manifest as early as 9 months of age. These are warning signs, not a diagnosis, however, and need to be monitored. Keeping an eye on specific behaviors and conferring with a professional is the first step if you notice one or more marker behaviors that don’t go away as the child gets older.
The CDC notes that “ASD can sometimes be detected by 18 months or younger,” but that 24 months is the age where “a diagnosis by an experienced professional can be considered very reliable.”
When Should I Seek a Professional Opinion?
The best way to seek a professional opinion is by getting one directly from your child’s pediatrician. Pediatricians can help with screening and recommendations. Sometimes developmental disorders and signs of ASD are part of a regular wellness visit for your child. Talk to your pediatrician about specifics if you have questions or concerns.
ASD screening is recommended by many pediatricians at specific developmental intervals. If your child’s pediatrician doesn’t mention an ASD screening at a wellness visit and you have concerns, ask them about it.
The American Academy of Pediatrics (AAP) recommends developmental screening for all children at doctor wellness visits at 9 months, 18 months, and 36 months of age. The AAP also strongly recommends screening specifically for signs of ASD at 18 months and 24 months.
If your child’s pediatrician believes that your child is at risk for ASD, there are two paths you can take for a formal diagnosis and care plan: private evaluations & interventions and state-sponsored early intervention programs.
What is a Private Evaluation?
Private simply refers to private pay i.e. paid for out-of-pocket or covered by an insurance company. These evaluations allow parents to select a care program of their choice to help evaluate their child.
Private evaluations are in-depth looks at a child’s development. These evaluations are handled by a licensed medical professional like a child psychologist, speech-language pathologist, occupational therapist, developmental pediatrician, or another specialized professional
These evaluations screen your child, analyze the data, determine whether or not the child needs specialized care, and then help develop a course of action. Keep in mind that private-pay evaluations may not be covered by your insurance and can cost lots of money out-of-pocket.
If you don’t have insurance or can’t afford out-of-pocket expenses for a private ASD screening/evaluation, you should look at your state’s Early Intervention program.
What is an ASD Early Intervention?
For those who cannot take on the financial burden or private ASD testing and screening, Early Intervention (EI) programs are available from individual states. These programs help families with children under 3 years of age get screened and will create a care plan if necessary. States are required by the federal government to provide several services free of charge.
If a screening or concern from your child’s pediatrician notes several at-risk behaviors, you may be encouraged to start an EI. Early intervention screenings do not require a formal diagnosis and are conducted by federal EI specialists.
The EI specialists will determine whether or not your child requires more comprehensive care. EI specialists will recommend the type of care they believe will be the most beneficial for your child.
What Should I Do If My Young Child is Diagnosed with ASD?
Both of the paths to getting a legitimate ADS screening or evaluation listed above will provide you with a care plan. Following this care plan will get you started on helping your child get the services they need to flourish.
After an ASD diagnosis, children are commonly referred to work with one of the following types of professionals:
- Behavioral Analysts
- Developmental Therapists
- Social Workers
- Speech Therapists
- Occupational Therapists
- Physical Therapists
This is not a comprehensive list, it is simply to give you an idea of where your child may start in their developmental journey.
On top of your child receiving special care you, as a parent, will need to learn how to best help your child grow and develop. Talk to your child’s healthcare professional to learn what you can do to best provide the things they need most to grow.
Being active and supportive in your child’s development will help greatly in their development. Therapy for ASD shouldn’t stop when a clinic or class ends–parents should be aware of their child’s interests, behaviors, and moods to help them develop all the time.
Asking your child’s healthcare provider for information on how to learn more is the best next step you, as a parent, can take. Learn, teach, and do what you can to make sure your child grows up in a loving environment.
ABA Therapy from IABA Consultants
If you have questions regarding autism treatment with ABA therapy, we are here for you! Our goal is to make sure no family is turned away due to financial constraints. Our therapy team would love to talk to you. Find the location closest to you and give us a call. We’re here for you.
CDC Signs & Symptoms of Autism Spectrum Disorders
It’s been a little over a year since I started blogging. I was asked to start blogging by my marketing team to bring relevant information to our families. I was secretly waiting for this invitation because I’ve always wanted to be a writer and felt ashamed while thinking about “proper writing.” The invitation to write for you all quickly became therapy for me. The perfectionism that was holding me back was put down and writing has quickly become my favorite part of every week (outside of basement snuggles and coffee…).
When I began writing the blog I was focused on the services provided by Instructional ABA Consultants to support families of children with autism. I also wrote as a mama of two young children and one adopted teenager to let all mamas (and papas) out there know they are not alone. That even someone like me, an experienced clinician and CEO, has struggled with motherhood, tiny humans, and teenagers. Raising other humans is no easy feat and it takes a village of support and love. My hope was that my writing created a space of belonging for parents of both neurotypical children and children with autism.
Finding Myself During the COVID-19 Pandemic
As the pandemic hit in early 2020, I was not only burdened with running a company through a pandemic. I was also burdened with sheltering in place, taking care of my children, domestic violence, and the end of my marriage. I’ve alluded to the fact that I am a survivor of domestic violence. What I have not told you, however, is that I am one of the too many women who were (or are) not safe at home.
For a long while, I did not want to write this because I was ashamed. It’s not easy to identify domestic violence, let alone leave it behind. I was also fearful that anything and everything I wrote or said would be used in court against me. That by speaking up about my situation I would damage myself. There is much I will not say until I am ready, but please know this: I was not safe in my marriage. Neither were my children. I hold no ill will toward my ex-husband, but I absolutely believe abuse deserves accountability and that we all deserve to be safe. Writing about healing, alongside a community of support, helped show me the way out. I hope someday my writing will be a candle for others.
Shifting into a mindset where I can speak up (after 6 months of trauma-based therapy and more love than anyone can ask for) showed me that my current focus is shifting away from the original focus of my writing. I want to be able to continue to explore my own writing while not forgetting the part of my tribe who need online support for their children with autism and parenting. In a gentle way, I found it to be true that the content surrounding autism and parenting should be given to a writer who is currently more aligned with this topic. I also wanted to continue writing personally as a way to heal from trauma and live a life built in joy.
How did I decide what to do?
New Writings and Blogs
As usual, when I don’t know what to do, I went first to my gut, then to my team (tribe at home) and asked what to do.
This month my company will be splitting the blog section into two tabs. The first section will be for autism-related topics and family support. The second will be my writing, wherever that takes us. It is my hope that both blogs serve each community that receives them by being relevant to their respective topics.
Professionally, I continue as the CEO and owner of Instructional ABA Consultants serving children and adults with disabilities regardless of funding source. We have a clear mission and a badass team. Personally, I’m embracing the author I’ve always wanted to be and hoping my words bring peace, hope, joy, and connection to others.
May we all be happy, healthy, safe, and free.
As fall comes to an end I’m sitting on the farm surrounded by freshly fallen snow. It’s as though the universe is painting a visual for this season of life. These past few months have been extremely difficult for me. In the middle of a growing pandemic and the pressing matter of racial inequality, I know I’m not alone. Collectively as a nation and world, we’ve had to adapt overnight to changes in our culture, find ways to address what seems like trauma after trauma, and somehow keep putting one foot in front of the other. Yet life is still around us, no matter the valley we’re in.
As a business owner of a company that makes my heart swell with pride, there are so many things I want to tell you. I want to tell you about the years before Instructional ABA Consultants was born–what it was like to hold the hands of mothers whose children were being institutionalized. I want to tell you how Applied Behavior Analysis changed everything for each and every client I worked with. Of my deep love of a man named David, my favorite client of all times.
I want to explain how through tears, sweat, heartache, brilliance, vulnerability, and grit my company was shaped; this came from me and the employees who built it. I want to create resource after resource for children with autism, families of these young children, and each person in the world who feels like their voice doesn’t matter. All of these things burn inside my heart.
Yet today, my win was that I got up without crying. Was this anyone else’s win?
Taking Time After Trauma
In the middle of trauma or in coming out of trauma it’s easy to expect ourselves to quickly go “back to normal.” I remember this vividly when I was awakening from postpartum depression after Henry was born. I was so joyful to feel like myself again. I wanted to pack my days with everything “Jessie” I could think of. Doing this, while very tempting, would have flattened me. In coming out of a depression I had to honor what my body and mind had been through. To choose wisely what I would add to each day.
So what is normal and how do we choose what to add? Today we’re all so indicated by social media and marketing telling us what our lives should look like. On top of that, we’re socially conditioned to be a certain way or want certain things based on our gender, race, sex, and age. There are so many opinions swirling around us on who we should be and how we should behave. Trauma, like the COVID-19 pandemic, threatens this unnatural order.
Many of us were on autopilot prior to COVID-19. Then we were forced to stop. I believe this is true with any trauma or major life event. It could be a cancer diagnosis, the loss of a loved one, an injustice toward a loved one, a divorce, your own mental health taking an unexpected turn, financial upset–the list goes on and on. Trauma is part of our lives and it’s the part of our lives we don’t talk about enough.
The scariest part? If a person does speak up about their own personal traumas, the systems supporting us or the people around us often bring shame. Shame to keep us small and silent. If you feel pain, scared, or threatened don’t ever let anyone tell you to stay quiet. Speak up every single time regardless of what others say around you.
What We Can Do to Recover
So what can we do? What can I do as 2020 comes to a close and the pandemic we thought would be over by June continues? Wasn’t it just yesterday I was laughing about toilet paper and schools closing over margaritas with friends? We honor the season then get the hell out when it’s time to get out. That’s what we do.
Winter comes every year and our busy-ness becomes harder to keep. COVID took much of that busy-ness already. Personally, I hope it never comes back. This season of stillness is a natural order of things. We as humans are not meant to be on high speed every second of every day. We are also not built to impress and conform. We’re built to breathe freely, live freely, and love fully.
To do this we must honor where we are in life and love ourselves just as much when we’re crying on the bathroom floor as we do when we’ve achieved a goal. Grief comes for all of us. When we can offer ourselves compassion and grace the season is honored. On the other side of winter is spring where the flowers grow. Yet if we spend our lives wishing for beautiful flowers we’ll miss the cold beauty of a bare tree.
A new season is coming. Sit here darling ones. Hold your heart if you’re crying and take a moment to breathe the sweet winter air.
If you’re a mom of young children like me I’m sure you’ve had the thought of going to the zoo once or twice. It goes something like this:
The local zoo announces a baby. Let’s say an elephant is born so of course, you go rushing! You get to the zoo (pre-COVID, maybe) and see the beautiful baby elephant, just days old, walking behind their mama. In a short moment, you think back to your child’s infanthood and think, “baby boy(or girl) you had fewer skills than an elephant.” Infant humans, while incredibly squishy, cute, and forever smelling of Dreft and lavender, come into the world with no survival skills.
There are thousands of articles on the importance of early intervention. I spent my bachelor’s degree diving into many of them, followed by stocking my brain with new findings for the past decade. This is in part because I am a researcher by trade. The other part is because I am a nerd for human development. It fills my bucket. In my blog today I’m going to try and give you a snapshot of why development from infancy through kindergarten is so vital. I’m also going to talk about why it’s important for children with autism and our amazing clinics at Instructional ABA Consultants.
Focusing on Child Development Early
OK, let’s get started by going deep. Human infants are born without any skills because their brains need more time to develop than all other mammals. If babies grew into functional toddlers in the womb they could not come out of the birth canal. Women’s bodies are incredible but they aren’t magic; there is a limit to the size of what we can birth (yes, I’m grimacing as I’m writing this because medication-free birth with a newborn is magical, but birthing a toddler? Um…).
So we get these tiny humans, who are desperately in need of being cared for–it’s almost like they are in the womb for an extra three months after delivery. Then they begin to wake up. I remember when both Henry & Declan found their toes and fingers in amazement around three months old.
During this first year of life, thousands upon thousands of neuroconnections are made. Babies are quickly developing their brainpower, motor skills, and language through these high-speed connections. To do this babies need a few simple things. Infants need to be nurtured, to know that when they have a need their parent responds. This creates a secure connection and lets baby know the world is safe. Babies need food and lots of sleep. Once these basics are covered we move into the two most important things; environment and socialization.
Early Socializing & Environments
I like to think of babies, toddlers, and children as little scientists learning through cause and effect. The environment is a huge blank canvas for our children to discover how their world works. Socialization is the tool children need to survive in our culture.
In their early childhood years, these two pieces are so incredibly important because of the rate children can learn. From infancy to year five, children will learn more than any other time in their lives. “What about college,” you say? Nope. These foundational years are the years where connections are made in the brain that last a lifetime.
As a professional, I love looking at how all this heavy lifting helps to shape the outcome of children’s lives. As a mama, I drove myself crazy after Declan was born and I realized I was basically running a school in my home for Henry. This wouldn’t be possible with two kids under two.
This was insanity in hindsight. This was also when I was personally able to take a deep breath and remember what I knew. The two most important things are environment and socialization. It’s not about how “cute” my day is with my boys. It’s about how often they are able to explore and engage. These days you won’t really find me teaching at a table much. Instead, you’ll see a “yes” environment set up (more on this later but basically a safe space to learn), technology out of reach (no TV/no Tablets on the regular as these devices delay both language development & socialization), and lots of talking.
Henry and Declan get to flex their learning muscles through exploration and language. I get to flex my relaxation muscle by not trying to do it all. I’m lucky in that way because my children do not need intervention. If they did I would not be able to sit back because these experiences would need to be contrived. That’s why ABA is so helpful for young children with autism. Here’s why.
The Importance of ABA Therapy for Autism
When a child has autism the neural pathways or roads in the brain that tell that child how to communicate and process information are not forming, either naturally or as quickly as a neurotypical child. The connections are still there to be made but without intervention, a child with autism can’t connect the dots. What this looks like in each child with autism is different but always results in some form of socialization or communication developmental delays. This leaves the child with autism lost in their social world and wondering how to connect.
In applied behavior analysis (ABA), behavioral scientists (BCBAs) are able to assess the language and communication skills missing in early childhood based on developmental milestones. Children with autism are gifted learners but they learn differently because their neural pathways are routed differently. Through assessment, BCBAs are then able to figure out how our little students learn, what skills are missing, and how to connect those missing dots. This happens in three really key ways.
The first is one on one therapy (think personal trainer at the gym) to really teach to the student. The next is to help the child with autism apply what they are learning with their peers. Remember, socialization is hard but children who are neurotypical learn from other children. To strengthen the socialization neuropathway, children with autism need to practice these skills with kids their own age. The last is transferring learned skills back to mama and papa. If a child with autism is in therapy and can do all these skills at a treatment clinic but not at home, the neural pathway is not fully formed.
Therapy at ABA Consultants
Instructional ABA Consultants runs autism clinics for children ages 2 ½ to 6 years old (in addition to our home-based therapy for older children). Our clinics (Naperville & Oak Lawn IL, Castle Rock CO, and coming soon Northside Chicago) have a Preschool Instructor designing the socialization component of our students’ days and BCBAs designing the individualized instruction. Parents are at the core of treatment goals and together we’re helping their precious children make connections in their early development.
Whether you’re a parent of a neurotypical child or a child with autism know that your child’s early years are precious. While we all can dream of our children functioning like that baby elephant walking around fully skilled, the reality is human babies and children need shaping. We’re a social species.
So set down the tablet today, pack up all the toys the marketing teams said you needed, and let your children explore and enjoy. If your child isn’t exploring, jump in and help. If you need help teaching these skills because your child has autism (or this is a new way to parent for you) reach out. We’re all in this crazy world of parenthood together.
Okay, okay I hear you. That title! It’s a loaded one. I thought I’d just have a little fun this week with wrapping up our series about functions of behavior. I’ll explain the title in a bit.
Over the past month, IABA has republished my series on functions of behavior because it’s such an important part of working with children. It deserves an annual highlight! As a BCBA, owner of an Applied Behavior Analysis company, and boy mama this little piece of scientific knowledge guides so much of life.
Functions of behavior give us the framework for why a behavior continues to happen and lets us breathe easier knowing that all behaviors have a reason. We can start building our plan of action to address whatever it is we’re interested in changing once that behavior is identified.
Learning About Functions of Behavior
Let me back up a little and tell you why learning about functions of behavior was so life-changing for me. In doing so I’m going to go ahead and date myself. Thirteen years ago I was working as a line therapist with adolescent boys with autism who engaged in high levels of aggressive behavior. At the time there was little regulation in the applied field and while I was supervised by a BCaBA. I was not using function-based intervention because she wasn’t designing her treatment following this principle. As a new undergraduate, I knew I didn’t want to continue to work with children with autism if I couldn’t be effective. I was so frustrated for the children that our interventions weren’t working. I then decided to apply for my master’s degree with a goal to better understand behavior. I’ve been enjoying this gift for 12 years now.
One of the first things I learned in my master’s program was that behavior is maintained by the four key functions I’ve reshared this past month; escape, attention, access to tangibles, and automatically maintained behaviors. When a problem behavior occurs you want to make sure not to reinforce the behavior with what the learner is seeking.
My beautiful clients from back home? We were directed to put them in time out every time they engaged in aggression and their behaviors were maintained by escape functions. This meant each time they engaged in aggression, putting them in time out told them we were saying, “yes! That’s what I want you to do.” What should have been done instead is follow through with demands and teaching the boys how to tell us they needed a break. Their lives could have been changed using our science properly. This is a large piece of why I love ABA so much; lives change.
Using Functions of Behavior at Home
Fast forward to today and the wrap of our series. Learning about functions of behavior can be overwhelming. To think that all human behavior can be categorized into four sections and then studied from there is work by itself! This is the work we love at Instructional ABA Consultants but let me tell you this first hand as a mama, that shit is hard at home.
Raising Henry has been one of the greatest blessings of my life (Dametrius and Declan are the other two). Henry, as I’ve written, is a strong-willed child with a great big heart. Henry feels and responds to things the moment his feet hit the ground. This brings me to the title.
About a year ago I was transitioning Henry to a booster seat from his high chair. It’s a value of mine that my boys eat at the table and don’t wander around eating or zone out eating in front of a screen. I love food and want us to enjoy it together as a family. Henry? Henry had wanted no part in this family value.
I knew the function of his daily battling was escape from the table and followed him through each time for sitting. He would not back down. Frazzled, I went to my team saying I was now six months in and I still had to use strict follow-through at every meal to get Henry to sit and the end was nowhere in sight. One of our BCBAs (now supervisor & PhD!) Allaina Douglas said, “Jessie you have to pick your mountain to die on.”
What she meant was if this was an important value to my family that I would need to let go of other demands through the day that were less important and literally buckle into sitting at the table. So that’s what I did. I sat down and thought about what was really important for me with Henry so that when I made any demands, including sitting, I knew I had to be ready to follow through. This allowed me to lighten up on what wasn’t a value (PJs all day? Sure! Tv all day? No way) and hone in on what I did want to see out Henry.
Henry responded beautifully to this regarding the sitting. We then of course entered the 8-month potty training saga but hey, you win some, you lose some, but I digress. In the end, I understood that as a mama and clinician I couldn’t be function-based all day every day. That shit is exhausting. I could pick my values so that I could decide which behaviors will be allowed in my home and which ones won’t be. As my children grow up this will provide them their own moral compass to follow. I parent Dametrius way differently than Declan and Henry (as he is older) but our values are still the same.
Functions of Behavior and Being a Mom
This leads me to the second “purely mama” part of this. When you are choosing to live in a home where you are the leader and not your children it takes an incredible amount of energy. It would be super relaxing and wonderful if we could all say yes to popsicles for breakfast and binging Netflix every day. For most of this, we have different values than that for our kids (zero judgment here if these are your values!).
Being a leader in the family means you will have to implement rules and therefore boundaries. This is work! In order to do this, we as parents have to learn how to rest, reflect, and take care of ourselves so we can implement our values in the home. When we don’t we risk either giving in or blowing up. While this happens to the best of us, I know personally that I want this to be the exception to my parenting, not the rule.
In order to do the meaningful work of choosing what goes in your home and standing on that mountain, we as parents have to be at home with ourselves. That means spending time with our own thoughts, deciding our own values, and creating a self-care plan. The time with your thoughts and deciding values provides a compass for your home. Remember, attacking every single behavior and function in your family home would be exhausting! Picking your mountain means picking what’s important to you.
The self-care plan is included because, let’s be honest, as a mama or papa shit gets real fast. At any given moment our children are doing the next “please don’t do that thing.” We can navigate through our days with intention (most of the time!) when we’re rested and healthy. For me, this looks like morning meditation, evening journaling, and drinking more tea than wine these days. It also looks like saying I’m sorry when I do slip up and yell or holding myself accountable if I gave in when I didn’t want to.
Last night Henry had a high-emotion night because it had snowed and he really wanted to go outside to play at bedtime. I had to say no, it was bedtime. But I sure as shit could say yes when he asked me for a cool down bath with his swimsuit on. Rock on Henry, rock on Mama! We followed our values and I sat on my mountain. I hope this helps you find yours.