High Functioning Autism in Toddlers: Signs & Treatment

Instructor: Lisa Millraney

Lisa has 27 years of experience treating speech, language, memory and swallowing disorders. She has a master's degree in speech pathology from Vanderbilt University.

In this lesson, you will learn how parents and caregivers can recognize signs of high functioning autism in toddlers and some training and treatment options.

What is High Functioning Autism?

The autism spectrum is called that for a reason. People who have autism present with a wide range of abilities and challenges. In this lesson, we are going to concentrate on the upper end of the spectrum, known as high functioning autism or HFA. It is closely compared to Asperger's syndrome, though there is debate about this since some researchers note children with HFA have more delay in their language development. Autism spectrum disorders are more common in males than females, but no direct links to race or ethnicity have been identified.

Not Fitting In

Jeffrey and Barb were already the proud parents of six-year-old Jesse and three-year-old Jimmy when they welcomed little Kevin into their rollicking household. It wasn't long; however, before they noticed something seemed different about their youngest.

When he finally started to talk, his speech was practically adult-like in some ways, but what he said might have little to do with what was going on around him. He learned long stretches of dialogue from his favorite movies and repeated them verbatim, sometimes at inappropriate times. If they tried to change the subject, he became very upset.

In fact, nearly any change in an increasingly rigid routine could send Kevin into tears and tantrums. His brothers tried to include him in their games, but when they whooped and yelled, he ran to his room to hide and play with his box of plastic dinosaurs, the only toys he seemed interested in. At mealtime, he refused to eat anything but hamburgers cut into fourths and spread with mayonnaise.

Jeffrey and Barb grew more concerned. When Kevin was two and a half, they brought their worries to their pediatrician. At first, he reminded them young children often rely on routines or repetition to develop their understanding of the world around them. He explained that he was thoroughly tired of hearing the songs from his daughter's favorite Disney movies sung over and over. After some observation, though, he agreed that Kevin's behavior was unusual, and referred him for a developmental evaluation.

Making a Diagnosis

High functioning autism can be diagnosed as early as 12 months of age, but becomes stable at about 24 months, and is most commonly identified between the ages of two and five. Kevin was demonstrating many early signs of HFA. They include:

  • dependence on routine, including only eating a few foods
  • sensory disturbances, like intolerance of noise and running from his brothers' yelling
  • difficulty interacting with other children, even his siblings in Kevin's case
  • narrow interests, like only playing with his dinosaurs
  • echolalia, repeating things he heard, such as the movies he memorizes

No one child has all the signs of autism, though. Some other signs include:

  • poor eye contact
  • concrete thinking and not being able to play pretending games
  • not paying attention to people at all, and not imitating what they see others do
  • physical clumsiness or incoordination
  • unusual movements, like wandering, spinning in place, or staring at things for long periods of time

Jeffrey and Barb took Kevin to a developmental psychologist, Dr. Moseley. She assessed Kevin and explained her findings to them. She reassured them, pointing out Kevin had some excellent skills they could use to help him build a full life. His visual recall was sharp, and he could draw many dinosaurs from memory. He was even teaching himself to read from looking at books around the house! Barb and Jeffrey were amazed and comforted.

A Team of Helpers

After evaluation and diagnosis, the work of therapy begins. Young children with HFA may see a number of professionals for training, depending on their areas of need. To improve his communication, Kevin saw Jenny, a speech pathologist. She used his skill at memorizing and repeating to teach him new words, and combined it with behavioral therapy techniques to teach and reinforce conversational and play skills, like turn-taking, changing subjects, and letting others talk without interrupting. Kevin also learned how to tell his family when something bothered him instead of crying or having a meltdown.

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