signs of autism in a toddler

Signs of Autism in My Toddler: 5 Steps for Worried Parents

Dona Matthews

Dona Matthews, PhD, has been working with children, adolescents, families, and schools since 1990, and has written dozens of articles and several books about children and adolescents. She writes a twice-weekly advice column for Parents Space, 'Ask Dr Dona.' Please send your questions to her at the e-address below. She'll do her best to answer your question as quickly as possible.

Question: My 18-month-old is showing no signs of talking. Not ‘Mama,’ not anything. Christopher has always been impatient, but over the past few months, his temper has been getting worse. He has major temper tantrums, total meltdowns—screaming, kicking, enraged—several times a day. Based on these early signs of autism, should we be worried?

Answer:

It’s too soon for the autism label. However, it’s not too soon to pay attention to possible signs of autism. What’s most important at this stage is to look at the possible signs of autism—delayed speech and temper tantrums—in the context of Christopher’s general development.

(As an aside, I try to stay away from labels that put people in categories—‘autistic,’ ‘gifted,’ ‘learning disabled’—as much as possible. Categorizing kids can actually prevent them from getting the kind of attention or treatment they need. When labels are necessary for the appropriate treatment, I use them to describe behaviour rather than persons—‘a child showing signs of autism,’ ‘a child with [certain kinds of] gifted learning needs,’ ‘a child with[certain kinds of] learning problems’.)

1. Get Christopher’s hearing checked.

Hearing problems can be responsible for both the signs of autism you mention—late talking and terrible frustration leading to temper tantrums. It won’t hurt to get his hearing checked if that’s not the problem. If there’s a problem with it, though, it’s essential to attend to that sooner rather than later.

2. Make sure Christopher is getting lots of loving attention.

No matter what the reason is for Christopher’s delayed speech and temper tantrums, he will benefit from lots of patient, loving, one-on-one time. Whether or not there are signs of autism, a toddler needs lots of time each day with an adult who listens, echoes his sounds, helps him communicate, and sings with him. Does he have someone who takes pleasure in his attempts at communication? Someone who’s enthusiastic about his learning and exploring?

3. Be patient.

Both the signs of autism you describe are within the normal range. It’s not uncommon for toddlers not to be talking at 18 months (especially boys), and temper tantrums are common at that age, especially in children who can’t yet communicate. (More information on temper tantrums in the links below.)

4. Know the signs of autism.

Autism affects two main aspects of a child’s development—communication and social interaction. Other signs of autism include repetitive behaviours, lack of responsivity to normal social cues like greetings, and a disinterest in pretend play.

It isn’t usually diagnosed before the age of 3, but here are some early signs of autism to pay attention to in the meantime:

As an infant, did Christopher show joy in interacting with you and others? Did he babble and coo when he was happy, and cry when he was unhappy?
Around 9 months of age, did he start making faces and sounds in reaction to your funny faces and noises?
Does he enjoy social games like peek-a-boo?
Does he use gestures to get your attention? Does he let you know (before going into a tantrum) that his needs are not being met?
Does he communicate in nonverbal ways to let you know what he wants?
Does he engage in pretend play?

5. Consult an expert.

If you sense that something isn’t right about the way Christopher expresses himself, or if he seems to lose skills he once had, it’s time to consult an expert. A good place to start is with your paediatrician or family doctor. Ask for a routine developmental screening. Be prepared to provide specific examples of behaviours that concern you as possible signs of autism (as listed above, and in some of the websites below).