Writing about this topic is a challenge. We are not as familiar with inclusion; we grew up in a time when being different was bad, simply because it was unfamiliar. Now we live in a world with a much more open mind, which benefits all those who need extra help to achieve their goals.
As parents, we learn more every day, which empowers us and makes us more critical of every aspect of our children's upbringing. Being a pediatrician to the children of these newly informed parents leads us to read a lot and research constantly to provide them with the best possible information and recommendations.
There is a lot of information available about "normal" neurodevelopment, which sets goals according to each age and stage the child is in. However, there is a group of children who may begin to show delays in achieving these activities. That's why we must always recognize the warning signs to ensure appropriate and timely intervention.
To begin recognizing these red flags, I want to tell you that autism is not just one type of illness; it is currently grouped under the term "autism spectrum," where we can move within a group of conditions that share some common characteristics but vary when looked at in detail. This variation means that those affected will have strengths and other areas where they will need more help.
Within this spectrum, we find:
- Autistic disorder (autism)
- Pervasive Developmental Disorder Not Otherwise Specified (PDD NOS)
- Asperger's Syndrome/Disorder
- Rett Syndrome
- Childhood Disintegrative Disorder
My intention is not to explain to you in medical terms what each of them means. Today I want to provide you with tools to be alert to warning signs, those red flags that every parent should know, in order to achieve better neurodevelopment for their little one, and not lose that precious time in the first years of life, when there is greater neuronal plasticity (ease of recovery from alterations in the central nervous system).
These manifestations will generally be found before 3 years of age, with their peak around 18 months. The timing of diagnosis will depend on each parent's ability to detect that something is not right:
Warning signs at 6 months
Does not try to grasp objects within reach, shows no signs of affection for caregivers, shows no reaction to sounds around them, has difficulty bringing things to their mouth, does not make vowel sounds, does not roll over or turn around, does not laugh, appears stiff or limp.
Warning signs at 12 months
Does not crawl, does not stand with assistance, does not look for things, still does not say "dada" or "mama," does not make gestures, does not point with their hands, starts to lose skills they had already acquired.
Warning signs at 18 months
Does not point to show things to other people, does not walk, does not know the function of things they see every day, does not imitate people around them, does not learn new words, or does not know at least 6 words, does not show the importance of their caregivers. Loses skills they had acquired.
Warning signs at 24 months
Does not use two-word phrases, does not know what to do with common objects, like a brush. Does not imitate actions or words, does not follow simple instructions, loses balance easily. Loses skills they had acquired.
Warning signs at 36 months
Falls a lot or has trouble going up and down stairs, drools or is unintelligible when speaking, cannot use simple toys, does not use sentences to speak, does not understand simple instructions, does not imitate or use imagination in their games, does not want to play with other children or with toys, does not look people in the eyes.
If any of the warning signs mentioned above appear, you should speak with your doctor or your child's pediatrician and express your concerns openly. They can then be evaluated by other specialists who know more about these topics and can offer a multidisciplinary approach (by several specialties) to strengthen the neurodevelopment of the little one who needs help.
I am glad to know that every day we have more tools to help our little ones gain skills. I am very grateful to Andrea, from @_vazart_, for including me in her wonderful venture and allowing me to leave a message for so many parents who need guidance on their journey.
Nathalia Sanclemente López
Pediatrician
@tuguiapediatra
