How Early Can You Test for Autism?

Because early interventions make such a difference in the lives of children with autism spectrum disorder (ASD) and their families, most pediatricians now screen for autism when toddlers reach the 18-month mark. From there, they’ll continue to screen for signs of ASD at their 24-month and 30-month appointments.

However, some children may not show any definitive signs of ASD until three, four, or even five years old because everyone is different. That said, early screening, testing, and access to research-driven interventions, such as ABA therapy, for children with autism improve their quality of life at home, in the classroom, and in their social circles. And, of course, it also allows parents, caregivers, and siblings to learn more about the types of support, tools, and strategies for a less stressful household and lifestyle.

What Is Autism Testing & What You Can Expect

First of all, it’s important to note that autism is not a disease that can be tested for via blood, urine, or other standard medical tests. Autism spectrum disorder is a neurodivergent diagnosis, meaning that a person’s brain and nervous system are “wired differently” than those of us who are considered neurotypical. Other examples of neurodivergent diagnoses are ADD/ADHD, dyslexia, dyscalculia (a disorder that inhibits the ability to learn math), and dyspraxia (a coordination disorder).

So, rather than a specific test, pediatricians, neurologists, and behavioral specialists/therapists use a range of screening “tests” as well as information from a child’s primary caregivers to determine whether or not the child has ASD. This includes a series of evaluations and developmental monitoring that assess:

• Observing whether physical and mental skills/abilities meet standard developmental milestones.
• A child’s ability to read emotion in primary caregivers.
• The ability to express their emotions (with words if they have achieved standard verbal milestones).
• Social interactions and relationships (playing, sharing, responding to songs/clapping games, etc.)
• Hypersensitivity to sensory input (lights, sound, external stimulus, etc.)

All of these things paint a picture about whether a child may be on the ASD spectrum. Keep in mind that “high-functioning” children may escape diagnosis longer than their lower-functioning peers. Also, it’s essential to note that girls are vastly underdiagnosed largely due to their inherent ability to mimic others to try to fit in.

Early Signs of Autism & When to Test

Always remember that if you’ve met one person with autism, you’ve met one person with autism. Everyone is unique in their own way. So, while there are some similar signs and symptoms that may indicate a child has ASD, not all children will have all of the indicators listed below - and some symptoms may not be as limiting or negatively impactful as others. Also, many children may have a trait or two that sounds similar to ASD, but typically, children with autism have several of them in common, and with an intensity that is more than that of the average child their age.

The more you understand about autism and how it shows up in babies, toddlers, and early childhood, the more likely you’ll be to seek early autism testing and diagnosis for your child. 

Some common indicators of autism between six months & two years old

Pay attention to your baby and toddler during your interactions with them, and their interactions with others. Let your pediatrician know if you notice any of the following ASD indicators.

• By six months: Limited eye contact and little to no smiles.
• Between six & nine months: Still minimal to no real eye contact, few to no smiles or changes in facial expression, little to no sharing of sounds through back-and-forth play (the typical baby's “cooing” in response to vocalizations from caregivers).
• By one year: Still minimal vocalizations or babbling, doesn’t repeat common gestures like waving, pointing, or reaching for things. May not respond to their name or respond to it very rarely.
• Between 12 and 16 months: Little to no words (however, many neurotypical children are late talkers, so if your child is smiling, interactive, responds to emotions, etc., this may not be such a significant red flag).
• By two years old. Most two-year-olds should be able to speak one or two-word phrases to communicate and express needs. This does not include repeating or imitating, which may be a sign of echolalia (a symptom of ASD where children continually repeat words spoken to them).

If you have concerns about your baby or toddler, we recommend taking Autism Speak’s Modified Checklist for Autism in Toddlers, Revised (MCHAT-R) screening questionnaire. Then discuss the results with your pediatrician. 

General signs or indicators of ASD at any age

The older your child gets, the more certain signs stand out, especially when compared to other children their age. These signs include things like:

• Continued difficulty making eye contact or matching face expressions to emotions.
• Hypersensitivity to stimuli that results in extreme reactions when something is uncomfortable, too loud, too bright, etc.
• Difficulty or completely unable to relate to, interact with, or play with peers.
• Remaining completely or largely non-verbal.
• Obsessive qualities around specific subjects or objects.
• Trouble understanding other people’s emotions/inability to read facial expressions, verbal, and body language cues.
• Trouble potty training or establishing a sleep routine.
• Restrictive behaviors, which include not understanding how to “play with toys,” (like they may just line up their cars but never make them “drive” or make motor sounds).
• Difficulty using imagination to play pretend or create their own stories.
• Taking things literally - even into older childhood and adolescence.
• Having meltdowns for seemingly inconsequential things like shifts in routine, not having the right food available, not winning a game, or being forced to share, etc.
• Uncontrollable stimming (repetitive motions like hand flapping, spinning, etc.) when nervous or excited.

If your child exhibits more than one of the above bullet points, contact your pediatrician to check in. While they can provide a customary general screening, it will take a more formal evaluation process to reach a definitive conclusion. From there, your doctors can help you get the support and resources you need to help your child succeed in their home, school, and social environments. 

The Autism Response Team Uses ABA Successfully To Improve Lives

Applied Behavior Analysis or ABA therapy is one of the most successful interventions for children with autism. The earlier there is a diagnosis, the sooner we can begin helping your child learn essential skills like emotional regulation and social play while also giving them customized tools that support their physical, mental, and emotional growth.

The Autism Response Team has been working with parents and caregivers just like you to learn to adjust to their new autism diagnosis. We understand that it’s not an easy diagnosis to receive, but there is so much light ahead when you have access to the right therapies, resources, tools, and support. Contact us to schedule a full-spectrum assessment and learn more about how we can help.