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Early Signs of Autism

This video from the Kennedy Krieger Institute, in Baltimore, features three children who show early signs of autism spectrum disorder playing with toys and interacting and communicating with others. It compares the footage on each of these children to that of typical children in the same situations. “It helps parents to articulate to their pediatrician any behaviors that concern them,” says Rebecca Landa, Ph.D., director of the Center for Autism and Related Disorders.

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-I'm Rebecca Landa, Director of the Center for Autism and Related Disorders at Kennedy Krieger Institute. You are about to watch a brief tutorial illustrating the early signs of autism spectrum disorders or ASD. You will see 3 pairs of videos of 1-year-olds. Within each pair, you will first see a child with neurotypical development followed by a child who shows early signs of ASD. The developmental features indicative of ASD shown within these videos fall into 3 main categories. These include effective communication and sharing enjoyment, making social connections and the one with which we will begin seeing social opportunity through playing. This 19-month-old child does not show signs of ASD. He has chosen to play with the balls. He quickly integrates the lady into his play. He pretends that the balls are food and offers a bite to the lady. -He pretends a lot stuff is food and he always wants to know and offers it to him. -Okay. -Uhm, they're making some yummy food. -He understands that food, spoons, plates, and eating go together. -[unk] -As he creates the pretend play activity, he remains aware of the people nearby. He enjoys incorporating social interaction into his play and offers the lady a bite. -Thank you. That's yours. Take this. -He is able to pay attention to the lady, the doll and the pretend food all at once. He shares his excitement about the toys with the lady looking at her and smiling. -That's-- -After the lady comments that the food is hot, he links his play and language to her idea. -That's okay. Now, it's cool. It's nice and cool now. -Here, he imitates the lady's action with the pretend lipstick. -Oh, my lips is-- my lipstick on. Oh, it is the cover. -This helps him to learn new play skills, and at the same time, synchronize his actions with the actions of others. -Yeah. She has lipstick on. Oh, just like mommy wears. You look so pretty. Thank you. -This 19-month-old child shows signs of ASD. He has an intense interest in the toy phone. -Toys are-- -He does not share his enjoyment of the phone with others. He does not look toward others and smile. -It shows, yeah, the signs are very apparent. -Uh huh. Here, he has this addiction to telephones like [unk]. It's okay that kid was [unk] on to sounds. There's probably like 10 telephones here in my house because he walks around carrying one, sits him down and he goes on to the next one. -Although he puts the phone to his ear, he does not show creative play with the phone. When his name is called, he does not respond. -Ellioth? Eli? Eli? Ellioth? -He does not offer the phone to others so that they can have it turned. -While he was very entertained and pervasively he's not. -Eli-- -His mother tries to distract his attention away from the phone. -The mom will see the phone. The will see it. The mom is with the phone. -There you are. -She began to tickle him. Although he seems to enjoy the tickling, he does not look at his mother or make a social connection with her. He does not try to communicate with his mom to keep the social game going. This 14-month-old child has a mild motor delay, but does not show signs of ASD. As he explores the new toy, he remains aware of the people nearby. He checks in with his mother behind him to ensure that she also sees the toy. Next, he shows that he understands the social communicative meaning of the woman's pointing gesture by immediately looking at the sticker. Then, he looks over at another sticker she had pointed out before. He continues the woman's topic of communication as he points to the tiger sticker. He shows the motivation to maintain social engagement with others and the ability to communicate using coordinated gaze, vocalization and gesture. This 14-month-old shows signs of ASD. First, he claps his hands while and during the bubbles. He does not share enjoyment by looking at the man. He does not respond to his name. -Ben? Ben? Ben? -Although he looks at the man's pointed finger, he does not follow the direction of the man's gesture to locate the object to the man's attention. This 14-month-old does not show signs of ASD. While she enjoys look at and exploring the toy, she stays engaged with the people nearby. She tries to share her enjoyment with her mother as she turns to show the toy to her. Then, she shares her enjoyment with the lady across from her by directing her gaze and smile toward the lady. Also, she recognizes that the lady is a source of help. Her request for help is clear and effective. Coordinating eye contact, gesture, and vocalization for purposeful communication is a sign of healthy social and communication development. This 14-month-old child shows signs of ASD. Notice how his attention is so focused on the toy that he does not interact with the people nearby. He does not share his attention with others. His exploration of the toy is also unusual. He drops the toy onto the table and watches it move. When the toy stops moving, he does not use eye contact, vocalization or gesture to ask for help. He also tenses his body and mouth in an unusual way. -Let's do again. -Even though the lady is talking to him, he shows no interest in her. He does not seem to understand that her gesture is an offer to help him. He does not check in with the lady or his mother to see whether they are paying attention to the toy that he is enjoying. ASD is a neurodevelopmental disorder affecting multiple aspects of development especially social and communication skills. Children with ASD often show unusually intense interest in certain objects or sensory experiences. They may repeat certain behaviors over and over again. The signs of ASD are not transient, but rather persist over time. The earliest signs of ASD are often subtle and become clearer in the second and third year of life. A diagnosis of ASD should be made by one or more experts who gather a third developmental history, directly assess the child's developmental abilities and conduct a medical exam. For more information about ASD early detection and intervention or to sign up to receive our newsletter, please visit autism.kennedykrieger.org/card.