What To Look For...

Most pediatricians will screen children at the age of 2 using the M-CHAT screening tool, but, you can also refer to this yourself using this site.

If you don't have a pediatrician, you can request developmental screening through your state. This is NOT the same as a full evaluation that will lead to a diagnosis.

The points of the M-CHAT are here (with full credit to firstsigns.org):

1. Does your child enjoy being swung, bounced on your knee, etc.?
2. Does your child take an interest in other children?
3. Does your child like climbing on things, such as up stairs?
4. Does your child enjoy playing peek-a-boo/hide-and-seek?
5. Does your child ever pretend, for example, to talk on the phone or take care of a doll or
pretend other things?
6. Does your child ever use his/her index finger to point, to ask for something?
7. Does your child ever use his/her index finger to point, to indicate interest in something?
8. Can your child play properly with small toys (e.g. cars or blocks) without just
mouthing, fiddling, or dropping them?
9. Does your child ever bring objects over to you (parent) to show you something?
10. Does your child look you in the eye for more than a second or two?
11. Does your child ever seem oversensitive to noise? (e.g., plugging ears)
12. Does your child smile in response to your face or your smile?
13. Does your child imitate you? (e.g., you make a face-will your child imitate it?)
14. Does your child respond to his/her name when you call?
15. If you point at a toy across the room, does your child look at it?
16. Does your child walk?
17. Does your child look at things you are looking at?
18. Does your child make unusual finger movements near his/her face?
19. Does your child try to attract your attention to his/her own activity?
20. Have you ever wondered if your child is deaf?
21. Does your child understand what people say?
22. Does your child sometimes stare at nothing or wander with no purpose?
23. Does your child look at your face to check your reaction when faced with
something unfamiliar?

Your child only needs to have 3 of these items to be abnormal to trigger more investigation.
Let's look at some of the main red flags, namely 6, 7, 10, 14, 5

6 and 7 were big ones for us. Our son used his hand, not an index finger.
10 is a classic indicator of autism, ie, lack of eye contact, but, it can also be a cultural issue, so be mindful of the cultures your child is exposed to with this one. There is also quite interesting research that says we shouldn't put so much stock in the concept of eye contact and that for some it is more of a distraction to what the person is saying or communicating verbally. RDI refers to it as 'facial gazing', but more on that front in another post. Our son had eye contact, then lost it.
14 is another one that our son did at around 9 months, but it had disappeared by 24 months. Again, classic regression, or loss of skills.
5 also formed part of the DSM-IV  (Diagnostic and Statistical Manual of Mental Disorders) autism diagnosis criteria  -a lack of pretend play skills. Our son did have some of these skills.

If your child has any of these signs, it is best to seek out more advice as soon as possible. Trust your gut - you know if things don't feel right. If you already have a child on the Autism Spectrum, you will probably recognize signs even earlier than the 2 year point they recommend this questionnaire be completed.

The main weakness of autism diagnosis is the fact that it is diagnosed and recognized by clinical observation, in other words, does a child have certain behaviour. There is no blood test. There are no biomarkers. Therefore the diagnosis procedure is somewhat subjective. Children respond better to some adults than others, especially if unfamiliar with them. One clinician will readily diagnose a child, another might not be so certain. I'll cover the DSM diagnosis criteria in another post, but, it's something to keep in mind at this point.

I would add these items to the list though, given our experience with co-morbid conditions.

a - Did the child have reflux or colic?
b - Does the child have eczema or asthma?
c - Does the child have a larger head than normal, or did they experience a period of rapid head size growth, even if the proportions are now correct?
d - Does the child have trouble sleeping?
e - Does the child have a history of gastrointestinal problems, whether diarrhea or constipation?
f - Does the child self-limit foods to just a few?
g - Has the child ever lost skills after mastering them (ie used to respond to name, but now doesn't, did have certain sounds or words and no longer uses them)?
h - Does the child seem to have lots of ear infections or other illnesses?

If your child has a few of the M-CHAT and more than a couple of my little supplemental list, you should take your concerns to your child's doctor immediately. If there is a problem, the earlier you intervene, the better the result.