Autism spectrum disorder is a lifelong developmental condition that can affect aspects of language, social interaction, communication, and behavior.
People are born with autism spectrum disorder (ASD), and researchers are still looking into the causes.
Symptoms of autism start to appear in infancy and early childhood. Autistic children can experience a wide range of these symptoms, depending on the type of ASD and its severity.
This article describes some ways that ASD might present in a 4-year-old. It also explores the types of ASD and how and when a doctor might diagnose it.
ASD is a lifelong condition that appears in infancy and early childhood. The condition affects around 1 in 54 children and is four times more prevalent in boys than in girls.
Many autistic children show symptoms by 12–18 months of age, while some symptoms become more apparent with age.
Below, find some of the ways that ASD can present in 4-year-olds.
Differences in verbal communication
Autistic children may have a different style of verbal communication, compared with their peers who do not have ASD.
An autistic 4-year-old may, for example:
- not respond to their name
- speak in a monotone voice
- continually repeat words or phrases
- forget language used previously
- have difficulty with two-way communication
- be less likely than their peers to initiate conversations
- tend to interpret information literally, which may seem like an inability to understand jokes or sarcasm
- have difficulty communicating their thoughts and feelings
Differences in nonverbal communication
Autistic children may also engage in nonverbal communication differently from their peers who do not have ASD. They may, for example:
- have difficulty making eye contact
- be less likely to point at things of note or look when directed by others
- seem to dislike cuddling and other types of physical contact
Differences in play
An autistic 4-year-old may have a play style that is different from their peers. They may, for example:
- prefer spending time alone
- have an unusually intense interest or attachment to a particular game, toy, object, or topic
- have a strong affinity for organization and rituals, such as arranging toys in a specific order or repetitively counting them
- have trouble with imaginative play
- have difficulty understanding conventional rules of behavior, which may cause them to behave inappropriately
- have difficulty maintaining friendships
Other behavioral differences
Autistic children may also be more likely than their peers to display:
There are various types and severities of ASD, and it can affect a child in many different ways.
ASD is an umbrella term that includes:
- Autistic disorder. General symptoms of this include:
- language delays
- unusual interests and behaviors
- intellectual disability
- Pervasive developmental disorder not otherwise specified. Children with this condition have fewer symptoms than those with autistic disorder. The symptoms that arise tend to affect communication and social interaction.
- Asperger’s syndrome. This differs from autistic disorder because it does not cause delays in language or cognitive development. It may instead lead to clumsiness and difficulties with nonverbal communication and social interaction.
While Asperger’s is now categorized as part of ASD, some people prefer to identify as having Asperger’s, or being an “Aspie,” rather than identifying as autistic.
If a parent or caregiver believes that their child is autistic, they should make an appointment with their child’s primary healthcare provider.
The doctor may make a referral to a developmental pediatrician or pediatric neurologist who specializes in identifying and treating ASD in children. They will carry out a comprehensive assessment of the child’s symptoms and behavior.
Caring for an autistic child can present challenges, and the following strategies may help improve the quality of life for the child and their caregivers:
- Creating a safe zone: Autistic children may need extra support to feel safe and secure in their homes. Healthcare providers who know the child can suggest specific ways to create a safe home environment.
- Providing consistency: Structure and routine are important and can help support the child’s learning and development. It may help to develop a strict daily schedule for various activities.
- Helping anticipate change: Give the child advance warning of any changes to their routine. Using photographs or drawings can help communicate these upcoming changes.
- Providing positive reinforcement: Reward the child for positive behavior and progress, even if the progress seems small.
- Avoiding sensory overload: Some autistic children are overwhelmed by loud noises, bright colors, or flashing lights, and it can help to avoid anything that inundates the child’s senses.
- Being flexible with communication: If the child has difficulty communicating their feelings or intentions, it can help to work with the child to develop gestures or facial expressions for communicating things such as “Help!” or “I’m stressed.”
- Getting outside: At first, it can be difficult to get an autistic child to visit new places, but working at this can help build their confidence and improve the child’s quality of life.
Caring for an autistic child can be time-consuming and challenging. A 2014 study shows, for example, that parents of autistic kids often experience financial concerns and episodes of depression.
Below are some ways that parents and caregivers can support their own mental and physical well-being while taking care of an autistic child:
- Avoid going without sleep: Getting a full night’s sleep can be difficult when a child has inconsistent sleep patterns. Take naps whenever possible.
- Avoid neglecting personal health: It is important that parents and caregivers receive the healthcare that they need.
- Develop coping strategies: Whenever possible, take time off from the role of a carer and focus on relaxing or personally stimulating activities.
- Ask for help: Many support groups and online social networks provide advice and support for people with autistic children.
Numerous websites, social forums, and communities provide advice, emotional support, and resources to people with autistic children. Some examples include:
- Autism Society: Founded in 1965, this is often seen as a leading source of trusted and reliable information.
- The Centers for Disease Control and Prevention (CDC): On this page, the CDC provide a regularly updated list of resources and information about ASD.
- The Department of Health and Human Services: On this page, the department provide general information about ASD and links to recent research.
- Autism Science Foundation: This organization provides news, general information, and resources for families, researchers, and service providers.
ASD is a lifelong condition that appears in infancy and early childhood.
The types and symptoms range widely, but autistic children may differ from their peers in verbal and nonverbal communication, styles of play, and other behaviors.
If a parent or caregiver thinks that their child is autistic, they should make an appointment with the child’s doctor. They may refer the family to an ASD specialist, who can provide a diagnosis, advice, and support. This will help improve the quality of life for the child and their family.