Could my toddler be autistic or is it just language delay?

With young toddlers, identifying the signs that differentiate between autism and language delay can lead to early diagnosis. While language delay can occur independently, certain behaviours and developmental patterns can indicate the presence of autism in toddlers under 3 years quite reliably. In this blog post, we will explore key points that help distinguish between autism and language delay, including regression in language, limited response to name, delayed pointing, limited communicative intent, lack of reciprocity, and the presence of unique behaviours. It is important to note that these are just some differences we see, and do not apply to all children. It is also the collection and pattern of behaviour that is more important, rather than individual skills and preferences.

Regression in Language:

One distinguishing factor is a regression in language skills between 12 and 24 months of age. Some children with autism may experience a sudden loss of previously acquired language or social skills during this critical period. On the other hand, language delay typically involves a slower rate of progress or a temporary plateau in language development without a regression in skills.

Limited Response to Name despite Adequate Hearing:

A notable sign of autism is a limited or inconsistent response to their name being called, even when their hearing is intact. Children with language delay usually demonstrate a consistent response when their name is called.

Delayed Use of Pointing:

The development of pointing gestures is often delayed in children with autism or slightly different (e.g., using middle finger instead of their index, or continuing to mainly reach when they have pointed before). Pointing is a significant milestone as it enables a child to direct attention, share interests, and initiate communication. In contrast, children with language delay typically learn to point within expected limits and rely on it to get their needs and wants met.

Limited Communicative Intent to Get Needs Met:

Children with autism may struggle to use gestures, vocalisations and/or eye contact to express their needs or desires. They may exhibit difficulty initiating communication or may rely on unconventional methods to express themselves (e.g., going straight to the kitchen and reaching without looking for an adult). Children with language delay, while experiencing delays in communication, typically demonstrate clear communicative intent by approaching their caregiver or trying to gain their attention.

Lack of Reciprocity in Simple People Games like Peekaboo:

Reciprocity, the back-and-forth exchange of social interactions, is an area where children with autism often show challenges. Simple games like peekaboo, which involve turn-taking and reciprocal responses, may be challenging for children with autism or very short lived. While they might smile in response to these games, it can be difficult to initiate or indicate that they want the game to continue. Children with just language delay tend to find these types of interactions enjoyable and the game can continue easily and without much effort (although temperament of the child can impact on this) .

Unique Behaviours:

Certain unique behaviours can also serve as indicators of autism in toddlers. These behaviors may include frequent hand flapping, spinning the body in circles, or engaging in repetitive movements with objects (e.g., flicking light switches repetitively). Additionally, children with autism may display particular play preferences, such as lining up objects or showing a strong desire for specific patterns or groupings rather than playing with toys in a more typical way.

Conclusion:

Understanding the differences between autism and language delay in toddlers can lead to early diagnosis and helping parents and others to better understand the child, including their preferences and needs. Often the signs of autism can be quite clear in young children as their development starts to take a different trajectory. If you feel like your child displays many of the differences described above, please reach out to me for a chat.