“Autism is not new, nor is it something to be feared. Autistic adults and children deserve acceptance, understanding and support. At their core, autistic rights are human rights. There’s room for all different kinds of minds. Love always, not fear.” – Courtney Alison

Autism spectrum disorder or ASD is a neurodevelopmental condition – the endpoint of several medical causes that manifest on a behavioural level. It impacts the developing brain and affects various areas including behavioural, psychological, social, communicative and, occasionally, physical. A transdisciplinary approach is needed to address the full range of needs of those with autism and early diagnosis and intervention is crucial.

While ASD symptoms typically present between the ages of two and three years, symptoms may be evident earlier. Making a diagnosis requires taking a comprehensive history focusing on developmental milestones and inquiring about core behaviours, along with observations in several settings. Play-based assessments that elicit core deficit areas are often used.

There is no objective medical way – such as blood tests or scans – that can be used to diagnose autism. It is characterised by qualitative impairments in social communication, social interaction and social imagination with a restricted range of interests and, often, repetitive behaviours and mannerisms. Sensory hypo- and hyper-sensitivities to the environment are common.

Early Childhood

In the first year of life, there are usually few clear features of autism. However, a parent should be concerned if they observe the following:

  • lack of appropriate facial expressions and social smiling, poor attention and impaired social interaction
  • ignoring people, a preference for being alone and a lack of eye contact, appropriate gestures and emotional expression along with less looking at others, pointing or showing objects.

Two to three years

Concerns about the following verbal and non-verbal communication milestones may indicate autism:

  • Deficits in understanding language
  • Unusual use of language
  • Poor response to own name
  • Lack of pointing
  • Difficulty in following a point
  • Lack of reciprocal social smiling during interactions

Social Impairments

Social impairments associated with ASD include:

  • Limited or complete lack of imitative actions such as clapping
  • Lack of demonstration with toys and other objects
  • Lack of interest in or an unusual approach to other children
  • Minimal recognition of and responsiveness to other people’s happiness or distress
  • Limited variety of imaginative play or pretence, especially social imagination (i.e. not joining with others in shared imaginary games)
  • Failure to initiate simple play with others or participate in early social games
  • Preference for solitary play activities
  • Odd relationships with adults (overly friendly or ignores them)

Impairment of Interests, Activities and other Behaviours

Other indicators can include:

  • Hypersensitivity to touch or sound
  • Irregular motor mannerisms
  • Biting or hitting of or aggression towards peers
  • Oppositional towards adults
  • Preference for sameness or inability to cope with change especially in unstructured settings
  • Repetitive play with toys such as lining up objects
  • Turning light switches on or off

Absolute Indicators

Children exhibiting the below indicators should be referred for diagnosis of ASD:

  • No babbling, pointing or other gestures by 12 months
  • No single words by 18 months
  • No two-word spontaneous (non-echoed) phrases by 24 months
  • Any loss of language or social skills at any age

Autism and Vaccination

There is no scientific evidence linking vaccination with the causation or development of ASD. Public anxiety about the link between the MMR (measles, mumps and rubella) vaccine and autism is based on a flawed and completely discredited “study” by a former British doctor who was subsequently banned from ever practising medicine in the United Kingdom. There is strong reassurance from both our own Department of Health and the Royal College of Paediatrics and Child Health in the United Kingdom about the safety of the MMR vaccine. To read more about this, please visit:

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