Understanding Autism Spectrum Disorder: A Clinical Psychologist's Guide for Parents

As a clinical psychologist who has worked with countless families navigating the journey of understanding their child's development, I know how overwhelming it can feel when you notice something different about your child. Perhaps they don't respond to their name the way other children do, or maybe they seem intensely focused on specific interests while struggling with social interactions. These observations often lead parents to wonder about autism spectrum disorder, and I want to help you understand what to look for and when to seek professional guidance.

Autism spectrum disorder is exactly what its name suggests—a spectrum. This means that no two children with autism present in exactly the same way. Some children may have significant challenges with communication and daily living skills, while others may be highly verbal and academically gifted but struggle with the nuances of social interaction. Understanding this variability is crucial because it helps us move away from stereotypes and recognise that autism can look very different from one child to another.

The word "spectrum" is important here because it acknowledges that autism exists on a continuum. Your child might show some characteristics associated with autism without having the condition, or they might meet diagnostic criteria while functioning well in many areas of life. This is why professional assessment is so important—it provides context and clarity that casual observation cannot.

Early Signs That Merit Attention

One of the most common questions I hear from parents is about the earliest signs of autism. While autism is typically diagnosed around four, some indicators can appear much earlier. In infancy, you might notice that your baby doesn't make eye contact during feeding, seems unusually passive or extremely irritable, or doesn't respond to their name by their first birthday. They might not point at objects to show interest or share attention with you, which is something most babies naturally do around nine to twelve months.

As children move into toddlerhood, differences often become more apparent. Many parents tell me they first became concerned when their child wasn't meeting typical language milestones. Perhaps their child wasn't using single words by eighteen months or simple phrases by age two. But it's not just about whether a child speaks—it's about how they communicate. Some children on the spectrum develop language on schedule or even early, but they use it in unusual ways, perhaps repeating phrases they've heard without understanding their meaning, or speaking in a formal, scripted manner that sounds precocious but lacks natural conversational flow.

Social communication is often where differences become most noticeable. You might observe that your child doesn't seem interested in other children, preferring solitary play even when peers are around. They might not engage in the back-and-forth of conversation, instead talking at people rather than with them. Pretend play might be absent or very limited—instead of creating imaginary scenarios, they might line up toys or focus intensely on specific aspects of objects, like spinning wheels repeatedly.

Behavioural Patterns and Sensory Experiences

Beyond communication and social interaction, many children on the spectrum display what we call restricted and repetitive behaviours. These can take many forms. Your child might insist on rigid routines and become extremely distressed by small changes—perhaps they need to take the same route to school every day or eat from the same plate. They might develop intense, all-consuming interests in specific topics, knowing everything about trains or weather patterns or a particular cartoon character, to the exclusion of other activities.

Repetitive movements, which we call "stimming," are also common. You might notice your child flapping their hands when excited, rocking back and forth, or repeating sounds or phrases. It's important to understand that these behaviours often serve a purpose—they can help a child regulate their emotions or sensory experiences. Many adults on the spectrum have helped us understand that stimming isn't something that needs to be eliminated but rather understood as a form of self-regulation.

Sensory sensitivities are another significant piece of the puzzle that parents often notice first. Your child might be extremely bothered by clothing tags, certain food textures, or the sound of the vacuum cleaner. Conversely, they might seem under-responsive to pain or temperature, or seek out intense sensory experiences like crashing into furniture or wanting very tight hugs. These sensory differences can significantly impact daily life, from getting dressed in the morning to navigating a busy grocery store.

When Should You Be Concerned?

This is perhaps the most important question, and my answer is always this: trust your instincts, but also trust developmental science. If you're worried about your child's development, that concern alone is worth exploring, even if others tell you everything seems fine. Parents know their children better than anyone else, and research shows that parental concerns about development are often accurate indicators that something needs attention.

That said, some red flags should prompt immediate action. If your child loses skills they previously had—for example, if they stop using words they once said or no longer make eye contact—this regression warrants urgent evaluation. Similarly, by eighteen months, if your child isn't pointing, showing you objects of interest, or responding to their name, these are concerning signs. By age two, the absence of any meaningful spoken language or the inability to engage in simple pretend play should prompt an evaluation.

It's also important to consider the bigger picture. A single trait or behaviour doesn't indicate autism. We look for patterns across multiple areas—social communication, behaviour, and sensory processing. We also consider how these differences impact your child's ability to function and connect with others. Some quirks are just personality traits; autism involves more pervasive challenges across contexts.

How to Check: Steps Toward Understanding

If you're concerned about your child, the first step is to talk with your paediatrician. They can conduct developmental screenings and may use standardised tools specifically designed to identify autism risk. The Modified Checklist for Autism in Toddlers (M-CHAT) is commonly used for children between sixteen and thirty months and can be completed during regular well-child visits.

However, a screening tool is just that—a screening. If concerns persist or the screening indicates risk, a comprehensive diagnostic evaluation is necessary. This typically involves a multidisciplinary team that might include a developmental paediatrician, clinical psychologist, speech-language pathologist, and occupational therapist. We conduct detailed interviews with parents, observe your child in different settings, and use standardised diagnostic tools like the Autism Diagnostic Observation Schedule (ADOS).

During these evaluations, we're looking at how your child communicates, plays, interacts socially, and responds to different situations. We're also gathering a detailed developmental history from you, because understanding how your child has developed over time provides crucial context. This process can feel lengthy and exhausting, but thoroughness ensures accuracy.

Moving Forward with Knowledge and Hope

Learning that your child is on the autism spectrum can bring a complex mix of emotions—relief at having answers, grief over expectations that may shift, worry about the future, and determination to help your child thrive. All of these feelings are valid and normal. What I've witnessed repeatedly in my practice is that early identification and intervention make an enormous difference. When children receive appropriate support early in life, they can make remarkable progress in areas that challenge them.

Remember that an autism diagnosis doesn't define your child's potential or limit their future. Many individuals on the spectrum lead fulfilling, independent lives, build meaningful relationships, and contribute their unique perspectives and talents to the world. Your child is still the same person they were before any diagnosis—you simply have more information to guide how you support them.

If you're concerned about your child's development, don't wait. Seeking evaluation doesn't mean you're overreacting or being an anxious parent. It means you're being an observant, proactive advocate for your child. Whether your child is ultimately diagnosed with autism or not, understanding their unique needs will help you provide the support they need to flourish. And that, ultimately, is what every parent wants for their child.