Earliest Autism Red Flags Requiring Intervention

There are a variety of reports about the early warning signs and symptoms of autism. It’s complicated, and ‘researching’ the literature does not confer a degree in childhood development. So, parents are left to question whether pediatricians are correct when they announce, “Well, let’s wait six months and see what develops. It’s probably nothing, and your child will be OK.”

Rather than merely list the ‘Top Ten Warning Signs,’ I have assembled a matrix to assist families. This is based on the clinical presentations of more than 1,000 patients, since being part of the autism clinic at the  Child’s Diagnostic & Treatment Center, in 2007.

Requires intervention:   Requires further evaluation:
Poor suck, frequent formula changes. Later, not chewing.
Loss of eye contact, socialization, language
Gastro-esophageal reflux
Unusual, late, or no crawling
Family history of auto-immune conditions, plus S&L delays. Previously affected sibling.
The lack of joint attention, including pointing
Frequent antibiotic usage
Repetitive or unusual movements, incl. clenching, facial ‘tics’, or purposeless gestures of the arms and hands
Immune symptoms such as asthma, eczema, frequent infections
Restricted interests – only playing with one object, especially if it isn’t a toy
Motor delays, especially low core tone, including late sitting or walking
Not consistently turning to voices after 6 months
No babbling by 6 months, or no words by 14 months
Rarely smiling after 3 months
Persistent diarrhea or constipationMales with undescended testicles or other urinary malformation

In the left column are behaviors that, by themselves, should encourage pediatricians to explore the possibility of ASD, and suggest useful interventions. It is simply not sufficient for doctors to placate parents about such atypical maturation.

In the right column are conditions that, when combined with other findings, should alarm parents and professionals alike to the fact that the child could be succumbing to the childhood epidemic of the 21st century. Underlying signs and symptoms, such as GERD, need to be explored – not merely ‘treated’ with B12-depleting PPIs – and dealt with to their successful resolution. Behaviors, such as infants not turning to their name, should be documented with audiology testing. Effective, proven interventions, such as OT and S&L therapy, should be initiated at the earliest time.

Importantly, any combination of symptoms in the first column plus others in the second, mandates evaluation and appropriate intervention at the soonest opportunity. Early recognition and therapy is paramount. For children presenting prior to age 5, The Child Development Center has been successful, over 90% of the time, in improving the conditions that are described as ASD, in selected patients. Children who respond to treatment can enter a neuro-typical 1st-to-3rd grade classroom.

The CDC reports an incidence of 1/88 children and 1/54 boys. This is 2014, these are not merely ‘soft signs’, and this list is meant to get the parent’s and pediatrician’s attention.

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