If you are a parent or a preschool teacher, you know that your child or student’s development is at the forefront of your mind all. the. time. Of course children develop at different paces, but with the rate of autism now at 1 in 44 in the U.S., it’s sure to be something you think about. If you have a child who is not meeting developmental milestones or you have some sort of feeling in your gut, you may be looking for some signs of autism in preschoolers if, for nothing else, to put your mind at ease.
There are many different reasons a child may develop at a different pace than the “masses.” Most of the time, it’s just they need a little extra time. That’s OK! Maybe they have had health concerns or traumatic events in their short lives that is affecting their development. Or, maybe there really is any one (or several) of a number of disabilities.
First of all, I want to say, that having a disability is not a death sentence! It’s just a different journey! Some weaves and waves, sure, but it will give your family or classroom an interesting life!
Even though I do not see any disability as a poo-poo moment, I do know that they bring unique challenges, and one of the best things you can do is identify it early enough in life that you can plan and plot your course ahead with as much time as possible to gain a sure footing for the journey.
So with that…
What are the signs of autism in preschoolers
You can find the actual autism diagnosis on the CDC website, and I recommend you start there, first. Just read it through. It’s short but a little dry. But I think it’s important to keep that in mind, keep it in the frame, as you read anyone’s list of symptoms or signs. That official diagnosis is really the one to come back to.
I thought I’d use that as the framework for some things you can look for in your young, maybe 2- to 4- year old child or student. Read What is Autism for a more general description.
Lack of social-emotional reciprocity
- May not respond to own name
- Doesn’t seek or enjoy social games typical for age
- Doesn’t respond to someone else’s emotional state (e.g., when someone is upset, doesn’t seek to comfort)
- May not imitate
- May not engage in pretend play
- Unusual or limited eye contact or doesn't look at someone’s facial expressions to gather information
- May give too much or too little personal space
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This is Linus the Lanky Leopard Learns to Lose. Readers get to choose what Linus does in three different losing situations. Students learn what the “hidden rules” are for being a good sport when you lose.
- May have a delay in speaking language
- May not make small talk, answer simple questions, or reciprocate questions
- May say inappropriate things or not know when to say/not say things
- May not understand sarcasm or humor (at age-appropriate level)
- May not use gestures to communicate (e.g., nod/shake head, point, wave)
- May not be able to tell you about their day (either in interest to share or not being able to generate the language)
- May have a unique cadence in speech, may have a sing-song sound or monotone or dysfluencies (e.g., kind of “tripping” over words)
- May not engage in parallel play (sitting near a peer while doing a similar activity)
- May not engage in “crossing boundaries” (e.g., give/take from a peer)
- May not engage in shared imagination
- May not participate in group games
- May not pick up on the cues to a social situation or game without explicit instructions
- Prefers to be alone
B. Restricted and repetitive patterns of behavior
Stereotyped or repetitive motor movements, routines, or speech
- May repeat what others say (e.g., says “cookie” when you asked, “Do you want a cookie?”)
- May repeat phrases from favorite shows or other phrases and may do it repetitively
- May engage in repetitively motor movements like hand flapping, hand wringing, toe walking, jumping up and down, or vocal sounds like humming, squealing, or grunting
- May not play with toys the way they are intended
- May do ritualistic things with toys like line them up or spin the wheels to watch them go
- Repeatedly watches the same shows or parts of shows
- May get very upset if something changes
- May be difficult to soothe when upset
- May get upset for an unidentified reason
- May overly focus on one thing to the exclusion of everything else around them
- May have a difficult time with transitions
Restricted or abnormal interests
- May have interests that are typically for older/younger children
- May be hyper-focused on a topic of interest
- May have an unusual topic of interest (e.g., vacuum bags, fans, plugs – all interests I’ve seen!)
- May know EVERYTHING you can think of about a certain topic
- Very frequent interests: dinosaurs, cars, planets, states, flags, Pokémon
- May want to carry an object from a favorite interest with them at all times
- May be unusually good at letters, numbers, and other concrete learning tasks like memorization
This is the bundle of 6 resources to complete Functional Behavior Assessment and Behavior Intervention Plan with background developmental history including trauma-informed care considerations, behavior referrals, behavior data sheets, observation forms, and more!
These IEP goals are customizable and written to help with progress monitoring, particularly for teachers of students with autism and related disabilities and in early childhood special education and ABA classrooms.
- Strong preferences to food, temperature, clothing textures, sounds, lighting, etc.
- May show strong aversions to environments that may seem “normal” to everyone else
- May have unusual volume in speech
- May seem to have an over- or under-developed sense of pain
- May seem to get overwhelmed in a large space or a space with a lot of people
- May have delayed motor skills
C. Must present in early development
The diagnosis is not intended to include a child who was developing normally for the first many years, and then a traumatic event happened, and, as a result of that trauma, they developed similar symptoms. There are, however, many cases of toddlers losing speech or retreating socially which are common markers for autism in preschoolers, but these loss of skills can’t be pinpointed to a certain event.
D. Cause clinical significant impairments
- Don’t know where else to put this, but may engage in self-injurious behavior like head banging or hitting or scratching or nail picking or a bunch of other things, and these behaviors could come from a variety of reasons from over-stimulation to not being able to communicate a need to just enjoying the feeling!
- Also common to have gut issues (e.g., chronic diarrhea or constipation or a combination) and sleep issues (usually NOT sleeping!)
E. Not better explained by something else
Many of these symptoms in the criteria can also be observed in other disabilities or differences. For example, a toddler who is hearing-impaired may not respond to their name consistently, but that isn’t a marker for autism in preschoolers, it’s the result of the hearing impairment. A preschooler with a traumatic brain injury may not respond to social overtures by peers not as a result of autism but as a result of the brain injury. So other explanations for the symptoms observed need to be looked at through those lenses.
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Levels of Support
Finally, the criteria asks for “severity level.” The diagnosis gives the Level of Severity on a scale from 1 to 3 with 3 being the most impacted, needing the most intensive supports and 1 being the most independent with fewest supports needed. Severity is based on social communication impairments and restricted, repetitive patterns of behavior (a level is given to both of those areas; they can be different!).
Level 1 Requiring support
- Without supports, social communication causes noticeable impairments
- Difficulty initiating social interactions
- Atypical or unsuccessful responses to social overtures from others
- Appear to have decreased interest in social interactions
- Inflexibility of behavior interferes with functioning
- Difficulty switching between activities
- Problems with organization
Level 2 Requiring substantial support
- Marked deficits in verbal and nonverbal social communication skills
- social impairments apparent even with supports in place
- limited initiation of social interactions
- reduced or abnormal responses to social overtures
- Inflexibility of behavior, difficulty coping with change, or other restricted/repetitive behaviors appear frequently enough to be obvious to the casual observer and interfere with functioning in a variety of contexts
- Distress and/or difficulty changing focus or action
Level 3 Requiring very substantial support
- Severe deficits in verbal and nonverbal social communication skills cause severe impairments in functioning
- very limited initiation of social interactions
- minimal response to social overtures from others
- Inflexibility of behavior, extreme difficulty coping with change, or other restricted/repetitive behaviors markedly interfere with functioning in all spheres
- Great distress/difficulty changing focus or action
Autism in preschool checklist
Lastly, my favorite quick checklist…
The M-CHAT-R™ is an excellent quick screening you or your pediatrician can use if you are worried about your kiddo. You can either do it, yourself, and take it in to your pediatrician to discuss, or ask them to fill it out.
Using this quick screener is probably the BEST way to get a pediatrician or other provider to listen to your concerns or to get a parent to see the concerns from a teacher if they haven't been ready to hear (they get grace for that!).
Keep an eye on this blog for future posts on what to do if you think your preschooler may be on the autism spectrum, where to get a diagnosis, and treat options for autism! Or if you're a parent of a newly diagnosed, you can my 10 tips to coping !