Dr Jozelle Miller
February 8, 2022
Could my child be Autistic?

Something seems wrong with my child. This is a statement often made by parents with sheer terror on their faces as they seek to get answers about what they deem to be strange behaviours with their child. Catching autism early makes a huge difference. By recognising the early signs and symptoms, you can get your child the help they need to learn, grow, and thrive.

What is Autism?

According to the Autism Awareness Association in Australia (2015), Autism spectrum disorder, commonly known as ASD, affects how people communicate and interact with others. It affects how they make sense of the world.

Autism is a developmental condition that is typically lifelong. People with autism experience difficulties with communication, social interaction and restricted/repetitive interests and behaviours. These are often accompanied by sensory issues, such an over-sensitivity or under-sensitivity to sounds, smells or touch. All these difficulties may lead to behavioural challenges in some individuals.

The term “spectrum” is used to emphasise that autism presents differently in every single person. People with autism have a wide range of challenges as well as abilities.

The signs and symptoms of autism vary widely, as do its effects. Some children with autism have only mild impairments, while others have more obstacles to overcome. However, every child on the autism spectrum has problems, at least to some degree, in the following three areas:

  • Communicating verbally and non-verbally.
  • Relating to others and the world around them.
  • Thinking and behaving flexibly.

There are different opinions among doctors, parents, and experts about what causes autism and how best to treat it. There is one fact, however, that everyone agrees on: early and intensive intervention helps. For children at risk and children who show early signs, it can make all the difference. But no matter your child’s age, don’t lose hope. Treatment can reduce the disorder’s effects and help your child thrive in life.

Causes of Autism Spectrum Disorder

Autism is a diagnosis based on the observation of behaviours; currently, we have no reliable biological test for autism.

Eventually, we may discover that autism is not a single disorder but a group of disorders with many different causes, which would help explain how it varies so much in symptoms and severity.

The cause of Autism is still unclear, but research suggests it’s a combination of developmental, genetic, and environmental factors. What we do know quite clearly is what does not cause autism.

Autism is strongly genetic

  • Families with one child with autism have an increased risk of having another child with autism when compared with the general population. The risk of having another affected child is estimated to be around 1 in 5.
  • Family members of a person with autism also tend to have higher rates of autistic traits.
  • Twin studies demonstrate that when one identical (monozygotic) twin is affected by autism, there’s a very high chance the other twin will be affected too (77% in one large study). With fraternal (dizygotic) twins, who have a different genetic makeup to each other, the risk is much less.

Google ‘autism and genes’ and you’ll find it’s a thriving area of autism research. Unfortunately, about the only thing that’s clear at the moment is that the genetics of autism are extremely complex, with hundreds of different possible ‘risk genes’ and pathways identified, some involving multiple genes in combination with environmental factors.

Older parents may be a factor

There is growing evidence that older fathers and mothers (over 45 years) are at increased risk of having a child with autism. Older parents, as a rule, are more likely to have children with developmental and other disorders. While the cause is most likely genetic, older mothers are also at higher risk of pregnancy and birth complications.

Pregnancy and birth

Pregnancy and, to a lesser extent, early infancy appear to be crucial periods when brain development may be affected. Bacterial or viral infections in the mother during pregnancy have been found to slightly increase the risk of autism, however this is only a minor factor.

Other factors in the mother that could be related to offspring autism include a folic acid deficiency, gestational diabetes, and the use of certain antidepressants during pregnancy, but no conclusive evidence exists for any of these links.
Conversely, taking prenatal vitamins seems to decrease the risk.

Environmental causes

In the past decade there has been increased research into the aspects of our environment that may also contribute to autism. However, despite substantial research, no one environmental factor has yet been found to be a definite cause of autism.

How parents can spot the warning signs

As a parent, you’re in the best position to spot the earliest warning signs of autism. You know your child better than anyone and observe behaviours and quirks that a paediatrician, in a quick 15-minute visit, might not have the chance to see. Your child’s paediatrician can be a valuable partner, but don’t discount the importance of your own observations and experience. The key is to educate yourself, so you know what’s typical and what’s not. The following are a few suggestions for your consideration:

1. Monitor your child’s development. Autism involves a variety of developmental delays, so keeping a close eye on when—or if—your child is hitting the key social, emotional, and cognitive milestones is an effective way to spot the problem early on. While developmental delays don’t automatically point to autism, they may indicate a heightened risk.

2. Act if you’re concerned. Every child develops at a different pace, so you don’t need to panic if your child is a little late to talk or walk. When it comes to healthy development, there’s a wide range of “typical.” But if your child is not meeting the milestones for his or her age, or you suspect a problem, share your concerns with your child’s doctor immediately. Don’t wait.

3. Don’t accept a wait-and-see approach. Many concerned parents are told, “Don’t worry” or “Wait and see.” But waiting is the worst thing you can do. You risk losing valuable time at an age where your child has the best chance for improvement.

Furthermore, whether the delay is caused by autism or some other factor, developmentally delayed kids are unlikely to simply “grow out of” their problems. To develop skills in an area of delay, your child needs extra help and targeted treatment.

4. Trust your instincts. Ideally, your child’s doctor should take your concerns seriously and perform a thorough evaluation for autism or other developmental delays. But sometimes, even well-meaning doctors miss red flags or underestimate problems. Listen to your gut if it’s telling you something is wrong and be persistent. Schedule a follow-up appointment with the doctor, seek a second opinion, or ask for a referral where necessary.

We’ll continue this topic next week