What Are Autism Symptoms? What Are Autism Symptoms in Babies?

Autism is a neurodevelopmental condition that begins in the early periods of life. However, the age at which the diagnosis is noticed is not the same in every child. The child's developmental level, language skills, social environment, and how pronounced the symptoms are can affect when autism is noticed. While symptoms attract attention in the first years of life in some children, they may become more evident in some children, especially in the preschool or school period when social expectations increase.

What Is Autism?

Autism is a neurodevelopmental condition that can affect the style of social communication and social interaction, behavior patterns, interests, and the processing of sensory stimuli. In medical sources, it is also referred to as autism spectrum disorder. The concept of "spectrum" expresses that autism does not appear the same way in every individual and that symptoms can show significant differences from person to person. While differences in communication and language development are noticed earlier in some children, repetitive behaviors, adherence to routines, or difficulties in social interaction may be more prominent in others.
When evaluating autism, looking at only a single behavior is not sufficient. The child's developmental history, social communication, interaction with peers, play style, repetitive behaviors, interests, and sensory characteristics should be evaluated together. For this reason, symptom comparisons made over the internet are not sufficient to make a diagnosis.

What Are Autism Symptoms?

Autism symptoms are fundamentally evaluated around differences in social communication and social interaction, repetitive behaviors, restricted or intense interests, and difficulty adapting to changes. While delay in speech development may be seen in some children, the language skills of some children may be appropriate for their age. For this reason, having developed speech alone does not rule out autism.
Autism spectrum disorder is a neurodevelopmental difference that manifests itself with distinct characteristics in individuals' communication, social interaction, and behavior patterns. Individuals affected by this condition may exhibit various developmental presentations at different stages of life and at different severity levels.
Accurate developmental monitoring in early childhood is extremely critical. While most parents seek the answer to the question "At what age do autism symptoms begin?", initial developmental differences often become evident within the first two years of life. Indeed, when the early signs of autism are noticed, the chance for early intervention increases significantly. In this process, the developmental clues to pay attention to according to age groups are as follows:

• Autism symptoms in a newborn: It is not correct to speak of symptoms specific to autism in the newborn period. Observations related to eye contact or gaze alone cannot be evaluated in terms of autism.
• Autism symptoms in a 6-month-old baby: Features such as limited social smiling or reacting differently than expected to social interaction can be considered in the evaluation.1-year-old autism symptoms: It may be seen as limited gestures such as pointing, differences in social interaction, and joint attention skills being 
• different from what is expected according to the developmental level.
• Autism symptoms in babies: In some babies, different reactions to sensory stimuli or differences in social interaction may be seen.
  Autism symptoms in children: As age progresses, it becomes evident with an inability to establish play with peers, excessive interest in spinning objects, and repetitive (stereotypical) movements.
• 4-year-old autism symptoms: It may appear as delay in language and speech development, inability to engage in imaginary/symbolic play, and showing excessive reaction to disruption of routines.
• 5-year-old autism symptoms: It manifests itself with difficulty in social communication, inability to express emotions, inability to adapt to rule-based games, and special interests concentrated in a narrow area.

Autism is not a uniform picture; it can be divided into different subgroups or clinical definitions according to the severity and type of symptoms:

• Mild autism symptoms: Covers situations in which the individual can maintain daily life but has mild difficulty understanding social cues and thinking flexibly.
• Severe autism symptoms: It is a clinical picture in which receptive and expressive language skills are mostly absent, and intense tantrums and self-harming repetitive behaviors are seen.
• Atypical autism symptoms: It is observed in situations that do not fully meet all the diagnostic criteria for autism but in which there are significant difficulties in the areas of social interaction and communication.
• Pseudo-autism symptoms: It is used to describe pictures resembling autism due to reasons such as screen exposure or lack of exposure to heavy environmental stimuli (stimulus deprivation).
• Temporary autism symptoms: It is a misconception, and although there is no condition in the medical literature that permanently disappears on its own, it is used in popular culture to describe the regression of symptoms with correct intervention and therapy.
• Atypical autism improvement symptoms: It emerges as an increase in the child's social adaptation, development of language skills, and eye contact gaining continuity with intensive and continuous special education support.

As age progresses and in different genders, the clinical appearance of autism may vary:

• Autism symptoms in adolescents: It may manifest itself as adaptation problems in peer relationships, social anxiety, difficulty understanding abstract concepts, and excessive adherence to routines.
• Autism symptoms in adults: Difficulty in social communication and mutual interaction, strong adherence to routines, sensory differences, and difficulty understanding social cues may be seen.
• Autism symptoms in women: In some studies, it has been reported that camouflaging or compensating for social characteristics may be more common in women, and this may contribute to the diagnosis being overlooked.

Differences in Social Communication

Differences in social communication are one of the fundamental characteristics that can be seen in autism spectrum disorder. These differences can manifest in the way a person initiates, maintains, and mutually shares communication. Especially in children, differences may be seen in areas such as establishing eye contact, responding to their name, pointing to show something, sharing their interest or happiness with others, and participating in mutual interaction.

Although some children have learned to speak, they may have difficulty maintaining a conversation mutually, understanding the context of the conversation, or inferring the other person's emotions and intentions from non-verbal cues. Differences may also be seen in the use of gestures, facial expressions, and body language. However, it is not expected that the same communication characteristics be present in every autistic child; therefore, evaluation should be made by considering the child's general developmental characteristics and communication skills together.

Not Responding to Name

It may be seen as the child not looking when their name is called, not turning toward the caller, or their response being significantly limited compared to peers. Since this situation may not only be related to communication skills, other possible causes such as hearing should also be evaluated.
Not responding to name alone does not mean an autism diagnosis. It should be evaluated together with the child's eye contact, joint attention skills, use of gestures and facial expressions, social interaction, language development, and other behavioral characteristics. Especially if this situation is persistent and affects the child's social communication, it is important to obtain a developmental evaluation from a healthcare professional.

Difference in the Use of Gestures and Facial Expressions

It may manifest as the child using hand, arm, and facial movements in a limited way during communication, not pointing to show an object, not using social gestures such as waving, or their facial expressions being more limited compared to the situation the person is in.
In some children, difficulty may also be seen in understanding the gestures and facial expressions of the person opposite them or in evaluating the social meaning these expressions carry. However, differences in the use of gestures and facial expressions alone are not an indicator of autism. It should be evaluated together with the child's general social communication skills, language development, and other developmental characteristics.

Difficulty in Peer Relationships

It may manifest as the child having difficulty initiating communication with peers, establishing a shared game, following the rules of the game, or maintaining mutual interaction. Although some children are present with their peers, they may prefer to play alone instead of interacting with them.
This situation does not mean that the child does not want to make friends. Difficulties experienced in making sense of social cues, understanding how to maintain mutual communication, or making sense of others' perspectives can affect peer relationships. Difficulties in peer relationships alone do not lead to an autism diagnosis. It should be evaluated together with the child's social communication skills, play behaviors, and general developmental characteristics.

Differences in Speech and Language Development

In some children, speech may begin later than peers, vocabulary may be limited, or previously acquired speech skills may regress. In some children, although speech development progresses appropriately for their age, difficulty may be experienced in using language for the purpose of establishing mutual communication.
Differences may also be seen in the intonation of speech, the rhythm of the voice, and the style of emphasis. The child repeating the words or sentences they hear, using certain expressions in a way that is not appropriate to the context, or continuing speech only in line with their own interests rather than as mutual communication may also attract attention. However, delay or difference in language development alone does not mean an autism diagnosis. Together with the child's social communication skills and general developmental characteristics,
it should be evaluated together.

Repetitive Movements

In autism spectrum disorder, it may be seen in some children that certain movements are made frequently and repetitively. Hand flapping, rocking, playing with fingers, spinning around oneself, or repeating certain body movements can be given as examples of these behaviors. Some children, on the other hand, may tend to spin objects, place toys in a certain order, or repeat the same movement for a long time. Seeing these behaviors alone does not mean an autism diagnosis; it should be evaluated together with social communication and otherdevelopmental characteristics.

Repetitive Speech

Repetitive speech can manifest as the child repeating words or sentences they hear either immediately or later. These repetitions, called echolalia, can be seen especially in certain periods of language development and can be a part of the child's way of communicating. In addition, the child frequently using certain words or expressions independently of the context of the conversation, or bringing up the same topic over and over again, may also be seen. In the evaluation of repetitive speech, the purpose for which the child uses language and their skills in establishing mutual communication should also be taken into account.

Excessive Adherence to Routines

Some autistic children may feel a strong need to preserve the order they are accustomed to in daily life. Wanting daily activities to be carried out in a certain order, reacting to a change in the usual route, or experiencing significant restlessness when encountering an unplanned activity can be among the examples of this situation. The level of reaction given to changes in routines varies from child to child. Therefore, the conditions under which the behavior occurs and the child'sextent to which it affects daily life should be evaluated.

Restricted and Intense Interests

In autism spectrum disorder, some children may show quite intense interest in a particular subject, object, or activity compared to peers. The child may want to learn detailed information about the subject they are interested in or may be occupied with the same activity for a long time. The distinctive feature of these interests is not only that the child likes something, but that the intensity of the interest and its place in daily life are significant. If the interest significantly limits the child's social interactions or participation in different activities,expert evaluation may be required.

Using Objects in Unusual Ways

Some autistic children may use toys or everyday objects in ways different from their usual purpose of use. For example, instead of driving a toy car, spinning its wheels for a long time, arranging objects in a certain order, or focusing intensely on only a certain part of an object may be seen. These behaviors may be important in terms of evaluation, especially when they occur together with repetitive movements and other social communication differences. However, using a toyin a different way alone should not be accepted as an autism symptom.

Different Reactions to Sensory Stimuli

In autism, reactions given to sensory stimuli such as sound, light, smell, taste, touch, or movement may be different from other children. While some children may show intense sensitivity to loud noise, bright light, the texture of certain clothes, or physical contact, some may react less than expected to the same stimuli. Sensory differences can affect the child's daily life, nutrition, sleep, educational life, or social participation. In the evaluation of these characteristics, which stimuli the child reacts to and how, and to what extent these reactions affect their life, should be taken into account.

Difficulty Adapting to Changes

Some autistic children may feel a strong need to preserve the daily order they are accustomed to and may have difficulty adapting to unexpected changes. A change in the daily schedule, going to a different place, not being able to do a usual activity, or a small change occurring within the routine can lead to reactions such as intense restlessness, crying, or anger. This situation may be related to the child's inability to make sense of the change or needing more time to prepare for the new situation.
Explaining changes in advance and making them as predictable as possible can make it easier for some children to adapt to new situations.

Difficulty in Mutual Play

In autistic children, difficulty may be seen in establishing mutual play and sharing the game with another person. The child may prefer to play alone, have difficulty joining the games of peers, or have difficulty understanding the aspects of the game that need to be maintained mutually. Limited imaginary or symbolic play, or focusing on specific features of a toy rather than its functional use, may also attract attention. However, preferring to play alone does not always
mean autism. Play behavior should be evaluated together with the child's age, developmental level, and other social communication characteristics.

Regression in Developmental Skills

In some children, a decrease or loss over time in previously acquired language, social communication, or other developmental skills may be seen. For example, no longer using words they previously used, a decrease in their response to their name, or a significant change in eye contact or social interaction may be noteworthy for parents. Regression in developmental skills, especially in early childhood, is a situation that should be evaluated without delay. When such achange is noticed, it is important not to associate it only with autism and to have the child's general health and developmental status comprehensively evaluated by an appropriate healthcare professional.

How Is Autism Treated?

Since autism is a lifelong neurodevelopmental condition, when it comes to autism treatment, there is no mention of a single treatment that completely eliminates autism. The aim of the support approach is to support the communication, learning, daily life, and independence skills of the child or adult as much as possible and to improve their quality of life.
The support program is not applied in the same way for every individual. A personalized plan is created by evaluating the child's developmental level, communication skills, learning characteristics, behaviors, and difficulties encountered in daily life. Language and communication support, educational practices, and behavioral approaches can be used according to need. If there are accompanying anxiety, sleep problems, epilepsy, or other health problems with autism, their treatment is also planned separately.
It is important to evaluate developmental differences noticed in the early period.
Early support can enable the child's needs to be identified earlier and directed to appropriate developmental and educational services. The aim here is not to fit the child into a certain mold, but to help them develop the skills they have and become more independent in daily life.

What Is the Most Prominent Feature of Autism?

Autism does not have a single feature. The main reason for this is that autism is a spectrum and symptoms vary from person to person. However, differences that show continuity in social communication and social interaction, and repetitive behavior and interest patterns, constitute the main areas of autism evaluation.
In some children, differences in social communication may attract attention earlier. For example, the child not initiating mutual interaction, not responding to their name, not sharing their interest with others, or limited participation in social games may require evaluation. In another child, a pronounced need for routine, repetitive movements, or intense interests may attract more attention.
For this reason, an autism diagnosis should not be considered based on a child merely not making eye contact, flapping their hands, having delayed speech, or being intensely interested in a certain object. Symptoms should be evaluated together and associated with the developmental history.

What Are 0-2 Year Autism Symptoms?

Characteristics that may be related to autism in the 0-2 year period can be noticed through social communication, eye contact, joint attention, use of gestures, response to being called, and changes in developmental skills. For example, the baby showing limited interest in social interaction, eye contact and mutual smiling being different than expected, or their behaviors aimed at attracting the attention of people around them being limited may be important in terms of evaluation.
In the following months, characteristics such as not responding to their name, not using gestures to point or show an object, not sharing their interest with others, limited participation in mutual games, and repeating certain movements may be seen. In some children, regression in developmentally acquired language or social skills may also be observed.
However, there are natural differences between children's developmental rates in the 0-2 year period. For this reason, the presence or absence of a single behavior does not mean autism. Especially if there is a distinct and persistent difference in more than one developmental area, it would be appropriate to have an evaluation made by a pediatrician or a healthcare professional specialized in developmental evaluation.

At What Age Does Autism Become Apparent?

Developmental characteristics related to autism can emerge in the early periods of life and can be noticed within the first two years in some children. However, it is not expected to become evident at the same age in all children. While developmental differences are seen more clearly in the early period in some children, symptoms may become more visible in periods when social expectations increase in others.
Autism may be noticed later, especially in children whose language skills are well developed or who can adapt by observing social behaviors around them.
In the preschool period, the gaining of importance of skills such as mutual play with peers, conversation, group activities, and adaptation to changing social rules may cause some differences that did not attract attention before to emerge. For this reason, it is not correct to give a specific age limit such as "autism definitely becomes apparent at this age." If the child's development is not progressing appropriately for their age or if regression in developmental skills is noticed, there is no need to wait for a specific age for evaluation.

What Is the First Sign of Autism?

There is no single first sign of autism seen in all children. The first characteristic noticed may vary according to the child's developmental structure. While differences in social communication come to the fore in some children, differences in language development or repetitive behaviors may attract attention earlier in others.
For example, the baby's eye contact and mutual social interaction being limited, not responding to their name, or their behaviors of pointing or sharing interest being different than expected may cause evaluation in the early period. In some children, on the other hand, the loss of previously acquired words or social skills can be considered an important developmental finding.
What is important here is to follow the whole of the child's development rather than accepting a specific behavior as the "first sign." In the event that parents notice a distinct difference in their child's development, applying to a healthcare professional ensures a more detailed evaluation of the symptoms.

What Are the Obsessions of Autistic Children?

Some behaviors expressed as "obsessions" in everyday language can often manifest as intense and restricted interests, strong adherence to routines, or repeating certain behaviors. The child may be interested in a particular subject, object, or activity much more intensely compared to peers, and this interest may constitute a significant part of their daily activities.
Some children may use toys in ways different from their functions, place objects in a certain order, or want to perform the same activity over and over again. Showing a distinct reaction to changes occurring in the daily routine may also be seen. For example, changing an activity done in the same order every day may cause intense restlessness in the child.
Some repetitive behaviors may help the child make their environment predictable or regulate themselves sensory-wise. Understanding the reason for the behavior is important in terms of creating an appropriate support plan.

When Do Autism Symptoms Begin?

Developmental characteristics related to autism begin in early childhood. While symptoms can be seen distinctly in the first years of life in some children, they can be noticed in later periods in others. The reason for this is that symptoms do not emerge with the same intensity in every child and the child's developmental characteristics differ.
In some children, differences in the area of social communication and interaction attract attention in the early period. In some children, on the other hand, after development progresses relatively typically in the initial periods, distinct differences in social communication, language, or behavior areas can be noticed. Observing regression in acquired skills is a situation that especially needs to be evaluated.

What Are Early Autism Symptoms?

Among early autism symptoms, there may be limitedness in social interaction, differences in eye contact and mutual communication, not responding to name, limited use of gestures and pointing, not sharing interest with others, and difficulty in participating in mutual games.
In addition, behavioral characteristics such as repetitive movements, unusually intense interest in certain objects or subjects, adherence to routines, and distinct reaction to changes may be seen. Unusual reactions to sensory stimuli such as sound, light, touch, smell, or taste can also be noticed in the early period in some children.
These symptoms alone do not lead to an autism diagnosis. While evaluating the child's development, developmental milestones appropriate for their age, acquired skills, social communication, and behavioral characteristics should be considered as a whole.

What Are Signs of Improvement in Autism?

When evaluating developmental progress in autism, it is not correct to look only at the disappearance of a specific behavior. After developmental support, signs of improvement in autism; progress seen in the child's capacity to communicate, express their needs, participate in social interaction, use daily life skills, and adapt to changes around them can be evaluated as positive developments.
Since autism is a lifelong neurodevelopmental condition, making a definitive assessment such as "symptoms have completely disappeared and autism has ended" is not correct. Developmental progress should be followed in line with the child's individual characteristics and needs.

How Does Hitting Behavior Occur in Autism?

Hitting behavior can be seen in some autistic children, but it is not a behavior specific to autism or expected in all autistic children. The child may show hitting behavior toward themselves, others, or objects around them. The way this behavior emerges and its reason varies from child to child.
In some cases, hitting behavior may be related to the child having difficulty expressing themselves, intense stress, sensory overload, a change in routine, or not being able to reach a situation they want. In some children, there may be other developmental, psychological, or psychiatric factors contributing to the emergence of the behavior.
When hitting behavior is seen, it is important to determine the conditions under which the behavior occurs, rather than focusing only on suppressing the behavior. An appropriate approach can be determined by evaluating what happened before the behavior, what the child is trying to express, and what is experienced after the behavior. If there is a risk of harming oneself or others, professional evaluation should not be delayed.

What Are Autistic Children Afraid Of?

There is no specific object, situation, or stimulus that all autistic children are afraid of. However, in some children, sensory sensitivities or intense reactions given to environmental changes can manifest themselves with fear or avoidance behaviors. Loud noise, intense light, crowded environments, certain smells, or unexpected physical contact may be disturbing for some children.
Some children may also experience intense anxiety about the disruption of the usual routine or situations where they cannot predict what will happen. This situation may not always manifest as "fear"; it may be seen as crying, avoidance, anger, restlessness, or an increase in repetitive behaviors.
Observing the situations in which the child is uncomfortable and making environmental conditions as predictable as possible can be helpful. If distinct anxiety or fear affects daily life, expert evaluation is required.

Does Autism Become Apparent in the Womb?

Autism is not a condition that can be directly diagnosed during pregnancy through routine ultrasonography or standard pregnancy tests. Today, it is not possible to definitively determine whether a baby will be autistic through routine examinations performed in the womb.
It is thought that genetic factors play an important role in the development of autism, and various factors related to the pregnancy period are also being examined in scientific research. However, detecting a specific finding during pregnancy does not definitively show that the baby will receive an autism diagnosis in the future.
An autism diagnosis is made by evaluating the child's developmental characteristics. In this evaluation, social communication, interaction, behavior patterns, and developmental history are considered together. Therefore, the evaluation of autism suspicion is carried out through monitoring the child's development after birth and, when necessary, having expert evaluation made.

What Do Autistic Children Like Most?

Since autism spectrum disorder appears with different characteristics in each child, interests and activities they enjoy also vary individually. Some autistic children may show intense interest in certain toys, vehicles, animals, numbers, letters, music, or visual stimuli. Some may enjoy doing a certain game or activity over and over again. What is important here is not what the child likes, but how intense this interest is and to what extent it affects other activities in their daily life.

How Are the Movements of an Autistic Child?

In some children, repetitive movements such as hand flapping, rocking, playing with fingers, spinning around oneself, or repeating certain body movements may be seen. Some children, on the other hand, may exhibit behaviors such as spinning objects, arranging toys in a certain order, or focusing on a certain feature of an object for a long time.
These movements often become more evident in situations where the child is excited, experiencing stress, or encountering intense sensory stimuli. However, not every repetitive movement means autism. Since different repetitive behaviors can be seen in children depending on the developmental period, when making an evaluation, not only the movement itself but also when it occurs, how often it is repeated, and whether it affects the child's daily life should be taken into account.
In autism evaluation, movements are not considered alone. They should be evaluated together with social communication, language development, mutual play, interests, adherence to routines, and sensory characteristics. For this reason, instead of interpreting a specific movement that parents see on the internet directly as an autism symptom, it is a more correct approach to obtain expert opinion about the child's general development.

When Should Expert Support Be Sought in Case of Autism Suspicion?

In the event that distinct differences are noticed in the child's social communication, language development, play behaviors, or movements in terms of their age and developmental level, there is no need to wait for expert evaluation. Especially in cases where regression is seen in previously acquired language or social skills, the child does not regularly respond to their name, joint attention skills are limited, or repetitive behaviors significantly affect daily life, developmental evaluation is important.
An autism diagnosis does not rely on a single symptom or observation. The child's developmental history, social communication skills, behaviors, and functionality in daily life are evaluated as a whole. Evaluation made in the early period can help identify the child's needs and plan appropriate supports in a timely manner.
In children with autism suspicion, comprehensive evaluation is carried out by taking into account the child's developmental history, communication skills, social interaction, behaviors, and other accompanying characteristics. If you have concerns about your child's development, you can make an appointment for expert evaluation from Yeditepe University Hospitals.