New guidelines lay out the evidence for non-pharmacological support, but early intervention is crucial

If a parent suspects their child may be experiencing developmental delays, it’s crucial to refer the child on for assessment rather than waiting to see if it resolves as they get older, autism experts say.

Professor Andrew Whitehouse is Autism CRC’s Research Strategy Director, and co-author of the new Supporting Autistic Children Guideline, which outlines best practice non-pharmacological support for autistic children and their families.

The guideline provides a “roadmap” to finding safe and effective support, but outcomes also hinge on families being able to access these services early on.

Professor Whitehouse says recent studies demonstrate the importance of referring to evidence-based therapies “at the earliest possible point.”

“In a study published in JAMA Pediatrics, we found the world’s first evidence that when children with early developmental delays commence a particular type of therapy called Inklings early in life (12 months), they have such significant developmental improvements that they are less likely to meet diagnostic criteria for autism at age 3 years,” Professor Whitehouse says.

“If in doubt, always refer on. If children do end up with a diagnosis of autism, then having that support in those early years is crucial,” he says.

Red flags to look out for

“We tend to look for clusters of behaviours… At 12 months of age, we typically expect children to respond to their name consistently, be imitating simple actions (e.g., wave bye bye, clap hands), and provide good eye contact during interactions, and have typical motor milestones (e.g., standing up),” Professor Whitehouse says.

“Any one of these indicators on their own is not much to be concerned about. However, when we see three or four of them occur in the same child, then greater monitoring of the child is warranted,” he explains.

Vicki Gibbs, head of research at Aspect Research Centre for Autism Practice, adds a few more. She says that for children under 2, red flags also include having few or no words, not using gestures such as pointing or waving, not smiling in response to people, not paying attention or looking at people’s faces, not showing or holding up items of interest to people and not following simple instructions.

But Ms Gibbs cautions that even if some of the classic signs aren’t present, the child may still be autistic.

“We do hear from parents that sometimes when children are able to speak and make some eye contact that doctors may rule out autism rather than asking more questions about a broader range of social and communication areas, perhaps only being familiar with more classical forms of autism which were often accompanied by intellectual disability or clear developmental delay,” Ms Gibbs says.

“This can particularly be the case for young girls who may show more social interest and engage in imaginative play and do not necessarily present in the same way as young boys.”

Professor Whitehouse says another common pitfall is to overlook delays in motor milestones, but these can be a signal too.

“If we see delays in achieving motor milestones (e.g., sitting up, standing up or walking) occurring along with delays with social communication, then we believe greater monitoring of the child is warranted,” he says.

Useful resources:

For more on what to look out for, Ms Gibbs recommends this resource by Autism Awareness Australia for information on key developmental milestones, and the ASDetect app, which includes age-appropriate assessments.