Parents hope, when they bring a child into the world, that the child will be healthy, develop normally, and thrive. If this is their first child, it can be hard for parents to gauge whether theirchild is developing typically and meeting their childhood milestones. Unfortunately, the concerns of new parents are often downplayed, with the parents dismissed as ‘nervous’ and ‘too worried’.

The early signs and symptoms of ASD,including gastrointestinal problems, tantrums, and other adverse behaviours vary widely. Some children with ASD have mild symptoms and impairments, whilst others have severe gut and behavioural issues. If you suspect that your child has ASD, make an appointment with achild psychologist at BNC, or call reception for further advice.

Below is a list of some of the symptoms of ASD, albeit not exhaustive.

Please note, many of these behaviours are also common for typically developing children. The difference is that a childwith ASD will display some (not all) of these behaviours in excess:

• Hand flapping, repeated finger movements, called stimming (self-stimulation).
• Toe walking or an awkward gait.
• Head banging
• Rocking back and forth.
• Humping toys and furniture (usually to ease gut discomfort or pain).
• Fussy eating (e.g., prefers white foods containing refined wheat and dairy).
• Sensory hypersensitivity or hyposensitivity i.e.,responding too much, or too little, to certain physical sensations.
• Sensory overload (e.g., to signs, or sounds) leading to tantrums.
• Not responding to their name, and a lack of responsiveness to other people.
• No pointing at objects.
• Not waving to say ‘hello’ or ‘goodbye’.
• Difficulty following objects and/ior people with their eyes (‘eye tracking’).
• Poor eye-contact in social interactions.
• No reciprocal social smiling or imitation of actions.
• Does not reach out to hold the person when being picked up.
• Does not like to give or receive cuddles.
• Does not call to their parents or make basic requests.
• Does not share enjoyment or toys.
• Does not speak or does not have age-appropriate use of language (it is delayed).
• Repetitive and/or obsessive behaviours.
• Gets very distressed if their activities are interrupted.
• Inflexibility to changes in routine or personal/external environment.
• Lines up cars or toys instead of playing with them appropriately (e.g., using cars as vehicles).
• Is aggressive towards other children.
• Repeating words (echolalia)or nonsensical phrases.

SYMPTOMS OF AUTISM SPECTRUM DISORDER:

Whilst every child with ASD has behavioural problems to some degree, a formal assessment will specify the degree of severity and any co-morbidities.Symptoms fall in three key areas:

• Quality of reciprocal social interaction (e.g., emotional sharing, offering and seeking comfort, social smiling and responding to other children);
• Communication and language (e.g., stereotyped utterances, pronoun reversal, social usage of language); and
• Repetitive, restricted, and stereotyped interests and behaviour (e.g., unusual preoccupations, hand and finger mannerisms, unusual sensory interests).

EARLY DETECTION OF AUTISM SYMPTOMS

Parents are usually the first to pick up on their child’s ASD, since theyspend the most time with them and know them well. Parents often observe behaviours that are easily missed by apediatrician, who may not have time in a brief consultation.

If you think that your child’s ASD behaviours were missed by a pediatrician,it is worthwhile to seek a second opinionby our expert team at BNC.

Pediatriciansarevaluable resourcea, but do not discount your own observations and knowledge of your child. It is important that parents educate themselves to differentiate between typical, and atypical, behaviours. Keep monitoringyour child’s development and behaviours, act swiftly if you have concerns, trust your instincts,and seek advice from an ASD professional. Early intervention is the best kind of intervention. The biggest barrier to effective treatment is acting too late, and unfortunately this is often the case when pediatricians miss the ASD. In any case, regardless of whether your child has ASD, a developmental disorder, or is slow to develop, your child can benefit from early intervention.

INTENSIVE EARLY INTERVENTION

The rate at which a child develops varies greatly, and parents and healthcare professionals often hope that the child will eventually catch up. If a midwife, nurse, childcare worker, or kindergarten teacher raises concerns about your child’s development, this might come as a shock. If you had some pre-existing concerns yourself, you may feel guilty for not acting sooner. Allparents react differently to a suggestion of ASD. Some parents spring into action, seeking information andadvice, whilst others refuse to accept the permanency of the disorder and do nothing. Some parentsfeel guilty or ashamed and may hide their concerns from family members and friends.

When it comes to ASD, intensive early intervention is vital. If therapies are started soon, ideally by the age of 18 months, yourchild will have a greater chance of behavioural change.

However, at whatever age, there are therapies to reduce the behavioural symptoms of ASD.

GASTROINTESTINAL DYSFUNCTION AND AUTISM

Stomach pains, diarrhea, constipation, bloating, flatulence, and humping are all signs of intestinal disorders. In 2010, a multidisciplinary panel of experts reviewed the medical literature on these physical symptoms in children with the aim of generating evidence-based recommendations (see[LINK]). The panel came to the consensus that (a) gastrointestinal disorders and associated symptoms are commonly reported in ASD and (b) care providers should be aware that problematic behaviours in patients with ASD may be a primary symptom of underlying gastrointestinal disorders.

Thus, it is imperative that all children have gastrointestinal concerns thoroughly assessed.

AUTISM AND TANTRUMS

Screaming and tantrums are often seen in children with ASD. However, these tantrums can be associated with gastrointestinal disorders, and are not necessarily the result of ASD.

Gastrointestinal disorders are often related to nutrient deficiencies, food sensitivities, and reactions to food colourings, additives, and preservatives that some people cannot process.

The difference is the pervasive nature of the tantrums in childrenwith ASD.

REGRESSIVE AUTISM

It is important to know that the earliest signs of ASDare not necessarily abnormal behaviours, but rather the lack/absence of normal behaviours. A baby or infant with ASD may seem quiet and ‘easy’ due to their lack of activity.

Many children with ASD start to develop communication skills, respond socially, and play appropriately, beforeregressing between the ages of 12-24 months. At this age many withdraw, become socially and emotionally isolated, and lose some (or all) of the language that they had previously acquired. Developmental regression of this nature can be a sign of regressive autism. The regressive nature of this ASD suggests that there is a mechanism at play that causesdamage to the developing brain. If ASD is diagnosed,and therapies are started early, there is high chance that developmental regression will be halted.