Singapore Women's & Children's Medical Group

Early Signs of Autism and How It Can Affect Your Child

early signs of autism
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Autism spectrum disorder is a condition associated with brain development that influences how an individual perceives and socialises. The disorder also includes restricted and repeated patterns of behaviour. The term “spectrum” in autism spectrum disorder represents a broad scale of symptoms and conditions such as:

  • Autism
  • Asperger’s Syndrome
  • Childhood Disintegrative Disorder
  • Pervasive Developmental Disorder (Unspecified)

Autism spectrum disorder starts early on during childhood and results in problems when adapting to society. Often symptoms show within the first year. A minority of children seem to develop normally in the first year, and then go through a period of regression between 18 and 24 months, showing symptoms of autism. While there is currently no cure for the disorder, early diagnosis and intensive treatment can make a huge impact.

Symptoms of Autism Spectrum Disorder

Some children show symptoms early infancy, while others may behave normal for the first few years of life, but abruptly become hostile or lose language skills. Symptoms usually are shown within the first 2 years. Every child with autism spectrum disorder is prone to have a unique behavioural pattern as well as a low/high functioning severity level.

Some children with autism spectrum disorder have trouble learning and have lower IQ. Others may have average or high intelligence. They learn fast but have difficulty with social interactions and applying knowledge to everyday life. Because of the differing mix of symptoms, it can be challenging to identify the severity levels, which is generally based off the degree of impairments and its impact on the child’s functionality.

Common Social Signs of Autism Spectrum Disorder

  • Failing to respond to his or her name
  • Rejects cuddling or any physical contact with strong preference to play alone
  • Limited eye contact and lacks emotional expression
  • Restricted or delayed speech, or loses capability to speak
  • Unable to start or keep a conversation going
  • Speaks robot-like, or in a singsong voice, or unusual tone
  • Repeats words or phrases verbatim without understanding its meaning
  • Unable to comprehend simple questions or directions
  • Doesn’t point to or bring objects to communicate interest
  • Approaches social interaction in a passive, aggressive or disruptive demeanour
  • Trouble identifying nonverbal cues, such as interpreting other’s facial expressions, emotions, body postures or tone

Behavioural Patterns of Autism Spectrum Disorder

  • Displays repetitive movements, such as swaying or hand flapping
  • Performs activities that could cause self-harm, such as head-banging
  • Follows certain routine daily and gets upset or unable to adapt to changes
  • Difficulty coordinating or has abnormal behavioural patterns, such as clumsiness or exaggerated body language
  • Intrigued and fixated by details of an object, but does not understand its purpose or function, such as the wheels of a toy car
  • Especially susceptible to light, noise, or touch, yet indifferent to pain or temperature
  • Avoids imitative or make-believe play
  • Specific food preferences

Some children with autism spectrum disorder can eventually grow to be more sociable with less behavioural disruption. Generally, those with the least serious problem may be able lead normal lives. Others, however, continue to be socially challenged.

Prevention and Causes of Autism Spectrum Disorder

There is no known cause for autism spectrum disorder. Given the complexity of the disorder and the variation of symptoms and severity, there are many probable causes. Studies suggest that genetics and environment may play a role.

  • Genetics: Several genes appear to be involved in autism spectrum disorder, such as Rett syndrome or fragile X syndrome. Genetic changes (mutations) may also increase the risk of autism spectrum disorder. Other genes may affect brain development or the way that brain cells communicate, or they may determine the severity of symptoms. Some genetic mutations seem to be inherited, while others occur spontaneously.
  • Environmental factors: Scientists are studying if factors such as viral infections, medications or complications during pregnancy, or air pollutants contribute to triggering autism spectrum disorder.

One of the biggest controversies in autism spectrum disorder centers on vaccines. Despite extensive research, no reliable study has shown links between autism spectrum disorder and vaccines. Moreover, the initial theory that started the debate have been retracted due to flawed design and research methods.

Refusing childhood vaccinations can put your child at risk of catching serious diseases, including whooping cough (pertussis), measles or mumps.

There is no given way to prevent autism spectrum disorder, however, there are treatment options. Early diagnosis and intervention are most helpful and can improve behavior, skills and language development. However, intervention is helpful at any age. Though children usually don’t outgrow autism spectrum disorder symptoms, they may learn to function well.

Risk Factors of Autism Spectrum Disorder

Statistics of children with autism spectrum disorder is on the rise. It’s not proven if it is due to improved detection or an actual increase in the number of cases, or both. Autism spectrum disorder affects children of all races and nationalities, but certain factors increase a child’s risk, these include:

  • Boys are about four times more likely to have autism spectrum disorder.
  • Family history. Families who have a child with autism spectrum disorder have an increased risk of having another child with the disorder. It’s also not uncommon for parents or relatives of a child with autism spectrum disorder to have minor problems with social or communication skills themselves or to engage in certain behaviours typical of the disorder.
  • Other disorders. Some children with medical conditions have a higher risk of autism spectrum disorder or autism-like symptoms. Examples include fragile X syndrome, sclerosis, and Rett syndrome.
  • Preterm babies. Babies birthed before 26 weeks of gestation may have a greater risk of autism spectrum disorder.
  • Parents’ ages. There is a possible link between children born to older parents and autism spectrum disorder, but more research is required to establish this connection.

When to see a doctor for Autism Spectrum Disorder

Babies develop at their own pace, and most don’t follow timelines stated in parenting books. However, children with autism spectrum disorder generally display obvious signs of late development by 2 years.

If you suspect that your child has autism spectrum disorder, speak with your paediatrician. Various signs linked to the disorder could be associated with other disorders. 

Reviewed by Dr Janice Wong on 17 June 2022. 
Click here to make an online appointment.

Dr Janice Wong Tzen Yuen
Paediatric Neurologist 

Dr Janice Paediatric Centre
A wholly owned subsidiary of   Singapore Women’s & Children’s Medical Group
101 Irrawaddy Road
#14-07 Royal Square
Singapore 329565
Tel: +65 65138633

Dr Janice Wong is experienced in the management of new born and children disease, paediatric neurology, childhood behavioural and developmental disorders such as global developmental delay, speech delay, autistic spectrum disorder and ADHD. She is also trained to manage children with cerebral palsy and other neuro-disabilities. Dr Wong is also one of the few trained paediatricians who performs botulinum toxin therapy for spasticity.

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