Autism occurs on a spectrum, so the signs may also differ based on the individual child, says Dr Sim.

Spotting the signs can be tricky, but parents should observe their kids for unusual behavior or lack of meeting developmental milestones. Some early indicators of autism in young children include difficulties in various scenarios such as responding to their name, accepting changes, communicating needs and wants to others, and using non-verbal communication such as pointing, gesturing and eye contact.

She adds that they may also show avoidance or disproportionately large responses to noise or specific textures.

The first step would be to consult a doctor about their concerns, Dr Sim advises. In Singapore, the developmental paediatricians at the KK Department of Child Development and NUH Child Development Unit would be able to assess their concerns. Where required, the doctors may then refer the child for an autism assessment. 

Signs of ASD can manifest as early as infanthood but generally appear within the first three years of life.

Globally, children on the autism spectrum are usually diagnosed between three to five years of age, according to Dr Sim.  This is the case locally as well according to studies reported by public child development units in Singapore. “However, it should be noted that autism diagnoses can still be made in older children, teens, and also in adulthood,” she says.

Is there an appropriate age to talk to an autistic child about their condition?

“There isn’t a specific age such that it is ‘time’ to talk about the autism diagnosis with a child” shares Dr Sim. “The right time or age to discuss the diagnosis will vary according to each child’s individual abilities, their needs, and their emotional resilience.”

“It is also important to consider the parent or caregivers’ readiness to talk about autism in a positive manner,” she continues. “This includes their confidence in finding answers to the child’s questions about autism.”

In terms of discussing an autism diagnosis with the child, some parents may choose to broach the topic by first talking about the specific similarities and differences between people, such as their family members. After which, they can touch on the strengths and challenges of the child, and point out that there is a name for the child’s particular pattern of strengths and challenges, i.e., being on the autism spectrum.

“During the conversation, it’s important to use language that the child understands and ensure that the conversation remains positive. Also, remember that this should not be a “one-and-done” conversation. It is something that the parent and their child should come back to at different time points, so they should pace themselves and the child – give the right amount of information based on what they can deal with at that point in time. You know your child best!”

Every child on the autism spectrum is unique, so their needs would differ. When identifying the best ways to support each child, parents or caregivers have to first begin with understanding the child. Based on that understanding, Dr Sim says to then consider:

• Structure – How can the environment be modified to make it more predictable and safer for the child? Providing information visually is often helpful in creating a structured environment that supports the child to know what is going to happen and what is expected of him/her in that environment, thus reducing anxiety. 
• Empathy – What motivates or interests the child, and what are triggers that may distress them? Making efforts to understand and relate to these aspects of the child’s experience will allow the caregiver to engage them more effectively and to introduce strategies that will help them better cope with their environment. 
• Communication – How does the child understand the given information? How does the child express himself/herself? Communication styles should be adjusted to support understanding, such as slowing down the rate of speech and giving pauses for processing time for those who find that helpful. Adults should also be specific and direct in their communication (e.g., “Did you enjoy your math lesson today?” or “What did your math teacher teach about today?” instead of “How was your day?”

Apart from main caregivers, adults such as relatives or friends of parents should also take note of good practices when interacting with children on the autism spectrum. They should also check with parents or caregivers on the preferences of the child as each child is different and adults can then adjust their interactions accordingly.

General tips:

• Speak clearly and in a low, calm tone. It helps to use phrases or short sentences. Allow time (it can be up to 30 seconds or more) for them to respond before repeating.
• Many individuals on the autism spectrum respond better to visual information, so you can also try writing, drawing or typing.
• Try not to touch the child unless he or she initiates, as the child may be sensitive to touch, or it may trigger a surprised reaction. 

At Autism Resource Centre (Singapore), the focus is on supporting individuals on the autism spectrum in their daily lives. “It’s not about seeking a treatment or cure for autism,” says Dr Sim.

Helpful support services for people on the autism spectrum include early intervention and education, which are very important as good habits and soft skills can be fostered while they are young, she adds on. As the children grow older, they are also taught vocational and independent living skills to better prepare them for life as an adult.

For more on Autism Spectrum Disorder (ASD), visit Autism Resource Centre (Singapore)‘s website.

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