Know the Early Signs of Autism

How Parents Can Access Support for Autism

By Rebecca Polchinski, DO, Developmental Medicine Specialist, Children’s Hospital at Montefiore Manhattan Voice 

April 17, 2025

NEW YORK - Autism spectrum disorder is just that – a spectrum. Each individual has their own set of strengths and weaknesses that makes them their unique self. Supporting an individual’s needs while also embracing their differences is important in creating a more inclusive community.

This is especially relevant as the rates of autism increase, with the CDC estimating that 1 in 36 children in the U.S. are on the autism spectrum. Improvements in diagnosis and awareness are likely contributing to this change. The American Academy of Pediatrics recommends that all children be screened for autism at 18- and 24-months of age in addition to regular developmental surveillance. Screening at this age allows young toddlers to receive critical therapies, such as those through Early Intervention, when the brain is rapidly developing. 

So, what are the early signs of autism? The hallmarks are differences in social communication or interaction skills, such as those indicated by the CDC:

*Not making eye contact, not showing a variety of facial expressions (like happy, sad, angry, and surprised), or responding to name by 9 months of age.

*Not engaging in interactive games, like peek-a-boo or pat-a-cake, or using gestures, like waving goodbye, by 12 months of age.

*Not sharing interests with others, such as showing objects, or pointing to something of interest by 18 months of age.

*Not joining in play with their peers by 3 years of age or engaging in pretend play, like pretending they are superheroes or making their dolls interact, by 4 years of age.

Repetitive behaviors and narrowed interests are other important aspects of autism. 

These behaviors may include:

*Lining up toys/objects and becoming upset when the order is disrupted.

*Playing with toys the exact same way without much flexibility, or focusing on parts of a toy, like the wheels on cars.

*Repeating words or phrases over and over, or quoting lines from shows and videos.

*Obsessing over certain characters or interests, like cars, trains, or space.

*Difficulty moving on from an activity or handling minor changes in routine.

*Walking on tiptoes, flapping hands, rocking, or spinning in circles.

*Sensitivities to noise or textures of food or clothing.

*Looking out of the corner of their eye or closely at objects, rubbing or mouthing items

How to Get Help

In New York City, unlike other areas, Early Intervention can make a diagnosis of autism during their evaluation. This is important because anyone can refer a child to Early Intervention for developmental or autism concerns - just call 311 or speak with your pediatrician. Another option is to ask your pediatrician for a referral to a developmental-behavioral pediatrician, a neurologist, psychologist, or psychiatrist, who can also confirm an autism diagnosis. 

So, after a diagnosis is made, what’s next? 

In Early Intervention, a therapy called Applied Behavioral Analysis, or ABA, may be offered. This treatment focuses on improving interaction skills, teaching developmental skills step by step, and reducing challenging behaviors by rewarding positive ones. 

For preschool-aged children, support in a mainstream or a specialized preschool may be considered following an evaluation by the Committee on Preschool Special Education (CPSE). Again, caregivers can request these evaluations themselves by contacting the CPSE office associated with their school district.

School-aged children can be supported in general education or attend various programs offered through the Department of Education, depending on the child’s needs. These autism-specific programs include Nest, Horizon, and AIMS. To apply, caregivers should contact their child’s school or the Committee on Special Education (CSE) office for their district. Further details can be found on the following website: www.schools.nyc.gov/learning/special-education/help/committees-on-special-education. 

The Office for People with Developmental Disabilities (OPWDD) is a statewide program that coordinates services for families outside of school and those with an autism diagnosis may be eligible. More information is located at www.opwdd.ny.gov.

As a community, it is important that we advocate for continued supports and services for people with autism, especially as agencies experience funding challenges. This support can be lifechanging for families and help those diagnosed with autism reach their unique goals.