Hello to all the parents and caregivers out there! Between caring for ever-surprising bundles of joy and navigating the expected and unexpected, there’s little downtime to make sure our little ones are on track during the stretches in-between doctor’s appointments. Whether you’re a new parent to an adorable infant or a busy parent following around an equally busy two-year-old, children of all ages have appropriate developmental milestones to gauge how the child is developing. Sometimes our kiddos are right on track, other times they may be a little behind; some even surpass milestones for their age group! Every child is different, and development may look different depending on what category is being measured. Still, when a child is displaying deficits in an age appropriate milestone, it can be concerning or even scary for some parents. Fortunately, knowing what signs to look for and seeking professional help greatly supports your child’s development if they’re diagnosed with a developmental disorder such as Autism Spectrum Disorder (ASD).
Perhaps you’ve heard of terms such as stimming, or hand flap, or Asperger’s, and thought to yourself, what does it all mean? These are terms sometimes used within the context of ASD, and may be viewed as dated or perfectly okay depending on who you ask! Considered a developmental disorder, Autism Spectrum Disorder (ASD) is characterized by deficits in social skills, communication skills, as well as repetitive and rigid behaviors. Though ASD is generally diagnosed around age three and older, children as young as two can be diagnosed and will often exhibit signs and symptoms. The following is a list of signs for when to seek professional advice about Autism Spectrum Disorder (ASD).
Have you ever looked at a close friend and instantly understood what they were communicating? Those moments of synchronicity that solidify bonds between people are achieved through simple eye contact. There is so much communicated in a glance, especially if eye contact is a primary form of communication. Nonverbal communication such as eye contact is one of the most basic forms of communication because it takes so little effort. Eye contact is a skill babies exhibit as early as six months! If your two-year-old plays semi-permanent peek-a-boo with her gaze, this could be a sign of ASD. Sometimes removing distracting or competing stimuli in the room helps our little ones focus on us more. But if you’ve locked you and your baby in a completely sterile room, and their hand waving back and forth is somehow still more interesting, informing the doctor couldn’t hurt.
Facial expressions, vocalizations, words
By two years of age, children are quite the mastered wordsmiths. Some children may be of few words, uttering only what’s necessary to get their point across. Other two-year-old toddlers may speak in impassioned monologues that you roughly catch half off. And why shouldn’t they? After spending so long observing and trying to communicate their findings to no avail, children realize they’re finally able to capture our attention and bring us into their world. One thing most experts agree on is that verbal language should be well within the early toddler’s grasp by this age. If you’re talking and emoting to your two-year-old and feeling like chopped liver when you don’t receive a smile, glance, or back and forth communication of any kind, then it may be time to schedule an appointment with the doctor. This extends to lack of gesturing such as pointing or reaching for preferred or desired objects, as well as not responding to their name being called.
People who dedicate their careers to diagnosing and treating ASD work in the field of psychology called Applied Behavior Analysis (ABA). One symptom of ASD they have observed children engaging in are behaviors that are repetitive and lack functionality in context. These repetitive behaviors are sometimes referred to as stimming. Common repetitive behaviors to look out for around two years of age include hands flapping up and down or back and forth, body rocking back and forth, spinning in circles, and many others. These behaviors are described as repetitive because it is a behavior the child engages in often, seemingly unprompted, and inappropriate in time and setting. These behaviors may also be described as restrictive because there are not many settings in which the behavior would be appropriate, such as spinning in place and rocking back and forth. Disrupting repetitive behaviors to engage with our little ones may be difficult as these behaviors are likely to be reinforcing or pleasing to them.
Mocking can range from a cute joke to an annoyance. If you have a toddler whose mocking you, it may amuse you to go back and forth repeating the same word. If this is pervasive for your toddler, they could be exhibiting a symptom called echolalia. A fancy ABA term, echolalia simply means the child repeats a word or phrase they’ve heard before. Echolalia may be immediate, such as a child repeating “dog,” when you say to them, “This is a dog.” Or it may be delayed, such as repeating a word or phrase out of context hours, days, or weeks later. It should be noted that echolalia is categorized by its pervasiveness. Repetition of words or sounds in an of itself may not be a toddler exhibiting echolalia.
Lack of Play
We all have fun in our own ways. What may be a great time for someone may not be of interest to someone else, and vice versa. However, there should be some interest in something. If you’ve bought out Toys R Us’ going out of business sale to put a smile on your child’s face and they still don’t glance at the pile of fun you’ve purchased, this may be a sign of ASD. Children with ASD sometimes see the world differently from very early on. Age appropriate toys likely won’t interest them. Sometimes an aspect of a toy or game that is otherwise unserviceable outside of the context of the toy may be the best plaything for an atypical two-year-old. This newfound toy may even be incorporated into repetitive behaviors, such as flapping the toy up and down or even beating the toy against their chest. It may seem alarming at first, but that’s okay! That’s your child playing! At this stage, speaking with a professional about how to increase the functionality and appropriateness of play would be ideal.
Think of your least favorite meal, then imagine having to eat it. Now imagine having several least favorite or non-preferred meals, limiting your choices of what to eat. Many parents of children who have ASD express frustration with getting their kids to eat fairly non-offending foods such as bananas, cheese, or even a bag of plain, salted chips. If you’re finding it hard to feed your early toddler, this is certainly a time to seek a medical professional. This over-sensitivity to taste may extend to the other four senses. A child may be averse to certain forms of touch, smells, sounds, or may even be easily overstimulated visually. Does your child shrug away from your hugs? Children aversive to touch may shrug away when you reach for them, hold their hand, or hug them. Children who find sound or sight aversive may cover their ears often or close their eyes a lot. Altering the environment such as reducing the volume of music or the TV, and dimming the light may help children adjust to their surroundings.
No Give and Take
Face it, it can often feel like we’re just talking to ourselves when we coo and discuss mundane adult topics with our toddler who comprehends little to nothing but our smiles, frowns, inflections, and eye contact. Even though they don’t understand, our little ones may smile back, whine if our tone gets a little too sharp, or hold our gaze for as long as they dare. This kind of reciprocal communication keeps parents coming back to bare their souls at their toddler’s feet who accepts them with hugs and slobbery kisses. Perhaps aversion to touch is the reason some toddlers may not initiate or reciprocate physical contact. Maybe our little ones don’t smile a lot or make much eye contact as age appropriate toys collect dust in a corner of their bedroom. Often it is a combination of these signs and many more that parents share with the doctor.
It can be daunting, scary, and maybe even a little embarrassing when our kiddos aren’t meeting necessary developmental milestones. It’s okay. Refer to this list if you ever question your two-year-old’s development, then seek the advice of a professional to put the puzzle pieces together. Regardless of the outcome, know that there are tons of resources to support parents of children diagnosed with ASD or children with undiagnosed developmental delays. Studies have shown that early intervention greatly diminishes deficits over time to place your child on an appropriate developmental track sooner rather than later. The important thing is that your child is otherwise happy and healthy!
The Juncture Mag Staff