Diagnosis: Autism

The most common mistake is missing a child whose symptoms of autism are so mild that they're overlooked. In addition, sometimes children develop difficulties with communication and socialization before they begin to show repetitive behaviors or restricted interests, so they are not initially diagnosed as having autism but get the diagnosis later. Some have even hypothesized that the restricted interests and repetitive behaviors of autism are caused by the lack of social communication, but whatever the reason, if something is not right with your child's development, even if it's just communication and social skills, it needs to be addressed immediately.

Finally, sometimes people will suggest that your child has been misdiagnosed, even if he hasn't been. This usually happens when a child is showing considerable improvement. That is, some children who receive intervention at a very young age can get over some of the symptoms early on, and may appear to look more like they have a communication delay, Atypical Autism, or Asperger's syndrome. Which is still another reason to get intervention as early as possible – children can improve tremendously when they're little.

Could It Be Something Else?
The doctor who diagnoses your child will first need to rule out other possible underlying problems. How do we differentiate Autism Spectrum Disorders from other childhood disabilities that don't have a genetic cause? It can be tricky. For example, children with hearing impairments can exhibit similar symptoms to autism. My daughter did when she had severe and chronic middle ear infections. She didn't socialize, didn't respond, and spent the bulk of her time engaging in self-stimulatory behaviors. I've seen others like that too – it's rare, but it does happen. But many children with autism will respond to some sounds, like a candy wrapper opening or a favorite video, whereas children with hearing impairments won't respond to anything below their threshold of impairment. A good audiologist or ear, nose, and throat specialist will be able to help you rule out hearing difficulties as a possibility.

Another possibility is a language delay. If a child has a language delay, he will most likely have some difficulty interacting socially at the same level as his peers, but usually he won't avoid social interaction, like a child with autism. In addition, a child with a language delay doesn't generally have the limited interests we see in children with autism.

A lot of parents ask me whether their children may just be "late talkers," as Einstein was supposed to have been. Well, it is true that some children do learn to talk a little late, but it's rare that a child who has a significant language delay (even if it isn't autism) will overcome it without intervention. This only happens with a very, very small subgroup, and we really don't know what variables account for children who catch up without intervention. I wouldn't leave it up to chance. The right intervention won't hurt, and it will help, so waiting and hoping for another Einstein may be a waste of time and result in your child's falling further behind.

Finally, there are many other types of developmental delays. Usually children with developmental delays have somewhat flat functioning across the board. Children with autism tend to have strengths in nonverbal areas. They may be good at puzzles and nonverbal activities, and may even line up items in some order.