Most often however they have seemingly subtle but atypical features to their language development. Young children who have largely met language milestones (e.g., obtained phrase speech by 30 months) may seemingly appear to be on target developmentally because they have the ability to speak. In addition to considering context, it is also important to consider moderators such as language level.Ī child’s language skills will affect symptom presentation. Similarly, it is common for young children with autism to direct positive social communication behaviors (e.g., pointing, eye contact, vocalization) towards an adult in a situation where the child is highly motivated to get something (e.g., snack, toy) but less so during pragmatic contexts that are solely related to shared interest (e.g., showing or giving toys to others). For example, a young child might initiate eye contact more frequently with a parent than a teacher. When considering an ASD diagnosis it is important to understand how a child’s social and communication impairments manifest within a broader developmental picture and how impairments vary across settings. Children with ASD show deficits in their ability to use verbal and nonverbal communication behaviors when regulating social interactions and simultaneously often have difficulty understanding social relationships at the level anticipated for their age. Impairments in Social Communication and Social Interaction – Deficits in social communication and social interaction are core features of an ASD diagnosis, with subcategories including: (1) impairment in social response, (2) deficits in nonverbal communication, and (3) difficulty with or understanding relationships (American Psychiatric Association, 2013). Symptom level can be heavily moderated by a child’s age, language level (Gotham, Pickles, & Lord, 2012), cognitive abilities (Bishop, Richler, & Lord, 2006 Matson & Shoemaker, 2009), and whether or not they have comorbid psychological or medical conditions (Grzadzinski, Huerta, & Lord, 2013). Although all children with an ASD diagnosis have deficits in social communication and social interaction as well as restricted, repetitive behavior, each child can potentially have a very different manifestation of those particular symptoms. Illustrative examples of symptoms are provided within the DSM-5. The DSM-5 specifies that an individual must have deficits in social communication and social interaction as well as present with restricted and repetitive behavior, either currently or by history. Symptoms of Autism Spectrum DisorderĪSD is diagnosed using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) (American Psychiatric Association, 2013). By detecting ASD early and also providing subsequent early intervention we can help a child make substantial progress in language skills, cognitive abilities, and adaptive skills, all of which improves long-term prognosis (Dawson et al., 2010 Estes et al., 2015 Pickles et al., 2016 Rogers et al., 2012). Early detection of ASD leads to early intervention. When using standardized evaluation tools in combination with clinical judgment, children under 24 months old are most often accurately identified (Guthrie, Swineford, Nottke, & Wetherby, 2013 Kleinman et al., 2008). Symptoms of ASD generally emerge between a child’s first and second birthday (Landa, Holman, & Garrett-Mayer, 2007). Bethany Vibert, PsyD, So Hyun Kim, PhD, and Cynthia Martin, PsyD
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