At Community Psychiatric Centers, we diagnose and help treat many different childhood issues. One of the disorders that we specialize in is Autism Spectrum Disorder or ASD. When a parent suspects their child may be on the autism spectrum, one of the most reassuring things to do is to gather information. I am often asked some excellent questions about autism, including:
- When does autism usually show up in a child’s life?
- Can autism start later in a child’s life?
- Can autism get worse over the course of time?
- Can people “grow out” of autism?
Okay, here are the answers:
When Does Autism Show Up?
Autism typically shows up as early as 18 months of age. In fact, I’ve had many parents tell me that they noticed something was ‘different’ about their child in early infancy, even after only a few months of age. They noticed that their child was not particularly cuddly, did not want to be picked up, would arch their back when touched, or seemed content being left alone. These events are often described as their child being exceptionally calm and quiet.
Sometimes odd behaviors will surface by age two. Behavior like poor eye contact, flapping of hands, spinning in circles, jumping, or related behaviors. It’s important to note that, in mild autism, signs may not show until four, five, six years of age, or later. Here’s what happens in those circumstances: when a child has mild autism it is not uncommon for the child to be friendly, engaging, and pleasant. The child may get along quite well with their age mates, at that young age, because not much is expected in regards to play skills in terms of simply getting along and running around and playing games such as chase.
Signs as Kids Grow
However, as children get older, the level of sophistication of social interactions greatly increases. Much more is expected and sometimes it’s hard for children with even mild autism to keep up. They may fixate on various topics rather than have a free-flowing back-and-forth conversation. They might fixate on the solar system or some other topic to the extent that other children may find it off-putting. The kiddo may stand too close or not pick up on social cues. As they get older, these types of behaviors become less tolerable and more noticeable.
Sometimes the child’s pleasant demeanor and sociability outweigh their oddities such that they get along pretty well and there is little in the way of complaints from parents or teachers. In some circumstances, they grow into a teen or adult and get along relatively well with only some mild “quirks”. It would be questionable if, in such a case, the condition is even diagnosable. Again, it’s when those “quirks” become problematic and notably get in the way of a person’s life that something becomes diagnosable.
Can Autism Show up Later in Life?
Can autism start later in a person’s life? No, not so much. The symptoms of autism first present in the early developmental period. However, the actual signs and symptoms may not become fully manifest, or fully noticed, until later in life. Sometimes not till later childhood that social demands exceed social capacities or ability to mask. The general understanding is that autism is an early developmental condition. If signs of autism “show up” later in life, it’s because the subtle signs were missed during early childhood. There are some medical conditions that can have some accompanying signs of autism. For example, Down Syndrome, as well as an array of other medical and chromosomal conditions, but such invariably shows up quite early in life.
Can My Child Grow Out of Autism?
I am also often asked if a child can grow out of autism. I tell parents that it’s not so much a matter of “growing out of it”, but that their child will progress and show fewer symptoms over time. That really is what treatment is all about. The idea is to target the signs and symptoms of autism, improve them, and reduce the severity, intensity, and infrequency of the signs and symptoms. Then the condition improves and the child presents as less autistic over time.
What about the next question: Can the condition get worse over time? By and large, I found that, with treatment, the condition does not get worse, it gets better. However, that also depends on the severity of the condition. In that respect, a child with very mild autism can demonstrate notable improvement and, in a few years, may barely meet the diagnostic criteria. It’s rare that the condition worsens though there typically are ‘ups and downs’ in the treatment process.
For example, when a child is going through puberty sometimes there is an increase in emotional volatility, but that can also be true for neurotypical peers. If a child with autism is going through a difficult time, if there is a family disturbance or bullying at school, or if treatment is interrupted for whatever reason, then the condition can worsen for a period of time. But it’s also expected that the child will rebound when things stabilize.
Wrap-up
So, to recap, autism is generally an early developmental condition with signs and symptoms manifesting by 18 months of age. In the event of more mild autism, sometimes symptoms do not noticeably interfere with the child’s life until late childhood but, when looking back, most parents can see that the child presented with some idiosyncrasies even during the early childhood years. The condition does tend to improve over time, especially with proper treatment, and it’s unlikely to worsen. I’ve seen children diagnosed with mild autism who after a few years of treatment and much improvement, no longer meet diagnostic criteria for autism.
The Autism Center of Pittsburgh is part of the family of CPC practices. If you would like to learn more about how we diagnose and treat Autism, visit our website. I hope you found this post to be helpful. If you have any questions, or if you’re seeking treatment for your child, feel free to reach out to me at DrCarosso@aol.com.
