Time for a super important topic: Spotting those early signs of autism in kiddos! If you've been feeling something's a bit different with your little one or maybe a friend or teacher has raised some questions, you're definitely not alone and this is the episode for you!

We'll share our insights as clinicians in the field, giving you the lowdown on what to watch for, how to approach it, and how to trust your gut without jumping to conclusions. Plus, we'll provide you with practical tips and resources to help navigate this journey together. So, whether you're a parent or a professional, tune in for some great advice on recognizing those early signs and fostering connection and communication with your child.

Timestamps:

(01:25) - Welcome & Introduction

(13:05) - Understanding Autism: Communication and Interaction

(21:35) - Understanding Sensory Differences in Children

(31:28) - Looking At Earliest Months Of Life

(33:36) - Understanding Parental Gut Feelings

(35:05) - Where To Start & First Steps To Take

(37:00) - Things to Try At Home

(39:34) - Visual Support Strategies

(40:39) - Setting Up Predictable Routines

(41:25) - Our Closing Message

Mentioned In This Episode:

Kennedy Krieger Institute, Early Signs of Autism Video

Articles:

• Gale, C. M., Eikeseth, S., & Klintwall, L. (2019)1. Children with autism show atypical preference for non-social stimuli2. [Journal title, volume, issue, and page/article numbers not explicitly provided in source excerpts].
• Okoye, C., Obialo-Ibeawuchi, C. M., Obajeun, O. A., Sarwar, S., Tawfik, C., Waleed, M. S., Wasim, A. U., Mohamoud, I., Afolayan, A. Y., & Mbaezue, R. N. (2023). Early diagnosis of autism spectrum disorder: A review and analysis of the risks and benefits. Cureus, 15(8), e43226.
• Salgado-Cacho, J. M., Moreno-Jiménez, M. d. P., & de Diego-Otero, Y. (2021). Detection of early warning signs in autism spectrum disorders: A systematic review. Children, 8(2), 164.
• Shultz, S., Klin, A., & Jones, W. (2018)45. Neonatal transitions in social behavior and their implications for autism67. Trends in Cognitive Sciences, 22(5)45, 451–46945.
• Supekar, K., Kochalka, J., Schaer, M., Wakeman, H., Qin, S., Padmanabhan, A., & Menon, V. (2018)1011. Deficits in mesolimbic reward pathway underlie social interaction impairments in children with autism12. Brain11. [Volume, issue, page numbers, and DOI not explicitly provided in source excerpts].
• Volkmar, F. R., & van der Wyk, B. (2017)13. Understanding the social nature of autism: From clinical manifestations to brain mechanisms13. In J. B. Leaf (Ed.)13, Handbook of Social Skills and Autism Spectrum Disorder13 (pp. 11–25)13. Springer International Publishing AG13.

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And so if you're starting to feel or notice that things are a little bit different or maybe a friend has said something, or often people will say, like the daycare teacher, notice that they're maybe just behaving a little bit differently than some of their peers. We want to say this loud and clear. You're not alone. Hey, everyone. I'm Brittany, speech language pathologist.

And I'm Shauna, behavior analyst.

And we're your hosts at Neurodiversally Speaking.

This is a podcast where we bridge the gap between research and practice, exploring autism and neurodiversity through the lens of speech and behavior.

Whether you're a parent or a professional, we'll give you practical tips to bring into your home or your next therapy session.

Let's get started.

Welcome to the Neurodiversity Speaking podcast with Brittany Clark and Shauna Fleming from lmno, brought to you by the Sensory Supply.

While we aim to make neurodiversity speaking suitable for all audiences, mature subject matter can sometimes be discussed suitable only for those over the age of 18.

If you're under the age of 18, please talk to your parent or guardian before listening to our show or listen together with him to stay up to date on new episode releases and show updates. Connect with us on Instagram eurodiversityspeaking.

You can also send us listener questions to address on the show at helloeurodiversityspeaking.com neurodiversely speaking starts now.

Hey, everyone. Welcome back to Neurodiversely Speaking. It's Brittany here, speech language pathologist.

And I'm Shauna, behavior analyst. We're so glad you're here.

Today we're diving into something really important, something that caregivers wonder about and ask us about all the time. What are those early signs of autism? What if you're noticing something different? What should be looking for? And where do you go from here?

And we don't want this conversation to be about jumping to conclusions or putting a label on children, but we want to chat about noticing with care, staying curious, knowing what steps you can take and what supports out there.

I want to identify our learning objectives for the episode. So number one, identify and describe early indicators of autism.

We are hoping that you as a listener will be able to recognize early developmental indicators of autism in young children, including their differences in social communication, play, imitation, and sensory behaviors using language. That's really respectful, neurodiversity affirming, and strength based.

Number two, our second learning objective is to understand the role of interdisciplinary Support. So again, that's a long word. We just mean really collaborative.

So, listeners, we're hoping that you can understand the scope of practice for SLP and BCBAs in Canada, including how interprofessional assessments work without diagnosing, and how we can support families in understanding their child's development and accessing early intervention services. The third learning objective for this episode is to apply these practical strategies and know where to begin.

So we're hoping that listeners will learn actionable steps that you can take to observe early signs of autism in your child, including how to initiate conversations with healthcare providers, what screening tools are and what to request, and how to use at home strategies that foster connection and communication while waiting for formal assessments. Just to be clear, neither of us diagnose autism. That's not part of our scope as SLPs and BCBAs here in Canada.

But we do work with families every day, helping them make sense of what they're seeing and connecting them to the right support. And we're often the first ones they come to.

So true.

And so, before we dive into today's topic, the early signs of autism, we want to start with our mantra here at neurodiversely speaking and at Elemental when we know better, we do better. That applies not just to how we work with children and families, but also how we talk about autism and how that language has evolved.

For sure. I'm so glad we're starting with this piece.

We both feel so passionate about this, but we were taught to look for red flags, and you'll see that post online everywhere. One of those red flags for autism. The term red flags feels so heavy, like something's wrong or dangerous or scary.

Um, and so that's not what we want to frame here in this conversation. It's not how we want to frame neurodivergence.

So we're going to use the terms or use the words indicators instead because it kind of shifts that tone. Um, and so we're not trying to minimize any of those challenges that our neurodiverse individuals go through or their families, certainly.

Um, but we want to recognize that those indicator indicators are like part of a bigger, broader, more complex picture.

Exactly. And same with non compliance. Certainly in the ABA world, that's something that we used to use all the time.

It used to be common to hear professionals say the child is non compliant, as if they were being defiant. And certainly something as a mom that's been really eye opening to me is that it's not defiance.

It's like usually either they didn't understand my instruction or I don't have the right motivators for them. And so like we said before in our episode about bad behavior, there are no bad kids.

And so by calling kids non compliant, we're kind of making a synonym with bad kids.

Totally. So we're not saying red flags and we're not saying non compliant. Exactly. We know better and we do better about those things.

But I would say like early in my career and I think you probably feel the same, I was scared to have conversations with parents and families that I noticed these indicators of autism. So again, in Ontario, like we can't diagnose, um, and it made it feel really risky to say anything at all.

But I've learned Now in the 10 to 12 years that we've both been working that it's like having these open and respectful conversations about their child's strengths and then like what's kind of challenging for them and what's unique about them can be so helpful.

And honestly, I'm glad when we have them together because it does also feel nice having two of us in the room to kind of frame this conversation in a really supportive way.

Yeah, I think this comes up often. One of the things that Brittany and I have done together for several years is screeners.

And so families might book an appointment if their child's not meeting some of those developmental milestones. And then we would, we used to, at an old job offer these drop in screening clinics.

And so you never knew who was showing up, you never knew what was going to come through. And we would have our milestone checklist prepared.

Um, and then sometimes at the end of that conversation we would have to sort of delicately chat about what are some of those things that we observed. And it was always really nice to do that together.

Cuz I felt like if I felt like I was sort of stumbling on my words, I could pause and then you could kind of jump in.

And so doing these conversations together I find can really build trust and help families feel less alone because they see that we're seeing what they're saying too. And then helping them also figure out, okay, here's step one, here's step two, and here's some options for you.

And I think one thing I've learned from you too is like the way to frame the conversation. I know we're going to talk about this a little bit later, but like, let's look at all the cool things that you're doing too.

When we're meeting the child where they're at, which we often Say too. And then like recognizing that of course we're there.

This is a person here and this is a really lovely individual that has so many cool things about them. And it's not all just a checklist or a standardized assessment or something like that.

Like there's so much more to the person which kind of leads us into like how we sort of started all of this at Elemento. Right. And so like we were saying, we love doing the screenings together, but we also do our interprofessional assessments together. Such a mouthful.

Inter professional assessments. All that means is two of us together. So I like to call them collaborative assessments because the parent is such an important part of that as well.

So we're all collaborating. And so I again, Mia the speech pathologist and then you the behavior analyst.

We're working together and supporting the child with the family because often we're that first step where the family starts wondering about their child's development. And so they're coming to us and then we're having those discussions together.

And then other times they're coming to us because they've just recently had a diagnosis. But either the pediatrician or the physician may not have given them, okay, what's that next step? Or now what do I do with this information?

So in Ontario they may have gotten the formal diagnosis, but there's often not like, okay, now what exactly?

And then some families sort of are, do believe that their child is on the spectrum but can't even access an assessment. Certainly in Ontario, again, we've got long waits here.

And so we'll see families sort of either they just know they're not meeting those milestones, other times they've just gotten a diagnosis of autism, and then other times they have suspicions about autism.

And so our assessment process usually includes both like kind of standardized tools where we're asking the parents structured questions and, and learning about what they think about their child's development and their experiences with their child. And then we're also doing those dynamic play based sessions where we're looking at the child's unique skill set. And so how do they communicate?

How do they learn? How are they interacting with the world? How are they moving within the space?

And so we might fill out something like a VB map, which is a skills based assessment.

Yeah, and I find the standardized tools are really helpful if the parent is coming to us and they haven't seen their pediatrician at, or they really are just at the beginning of this journey.

And so the standardized test might be able to give us information to say, oh yeah, look at that, you're understanding or your child's understanding is this score. And then their expression is this score. And the test that I'm thinking of that I use specifically is actually parent mediated or the.

I'm asking the questions of the parents because they know the child best.

And then we'll tell parents, you know, sometimes John is going to play with them while I ask you a whole bunch of questions and then we'll trade places. And that's a nice sort of way that we're both looking at a lot of the same things, but taking turns kind of checking out what the child is into.

And I love just asking questions of the parents. And I see, I look over and you're like having this beautiful moment of a play chain.

And the parents, I feel like it's really nice that again, because there's two of us, so we're not, I'm not asking questions of the parent. And then the child's just kind of waiting there sitting up.

What's next? Yes. And I think it makes a nice experience for the child too. Right.

Like it's a strange environment and we're new people and so it's nice to have the parent there from a comfort standpoint that we're not just taking the child down a hallway into a room without their parent. Yeah.

And then like you said, for the parent as well to see, like, oh, you know, I actually at home they do usually go get their shoes when I ask them or something.

And it's nice for us to be able to factor that in too, to our assessment so that we know that we're getting, or we think a fairly accurate picture of their skills and abilities.

And then we've got it where I'll say, oh, does your child like follow three step directions or two step directions? Like, can you say, go to your room and get a diaper and bring it back to me? And they'll say, I've never tried that before.

So then I can say, oh, cool, no worries, we'll try that here and let's try it out a couple times and see. So I think that's what makes our approach different.

And certainly what we've both different from what we have both done in different parts of our career is working together, doing this nice blended collaborative approach. And then again, it's not just all about one form.

And we're not like hanging our hat on the one standardized assessment or just the one play opportunity. We're looking at everything holistically and understanding the whole child and hopefully in their environment by talking to the parents.

So what do things look like at home? What does it look like in school or daycare? What does it look like here in our clinical setting? And then, you know, how can we help? Yeah.

And I think we get, like, a really nice report then that the family can use and share with other people in the child's circle of care. Right. If they're going to the pediatrician, they've got a.

A nice report that kind of summarizes these standardized and observational notes about their child. And for me, at the heart of it, like, I truly, truly believe that all the kids that we meet are so sm.

And they're often just sort of paying attention to different things than what we see with typical kids. And I talk about this often with parents. It's not that they can't learn, is that they're not learning in the way that their typical peers are.

And so their learning is unique. And we can unpack that and help figure out what is unique, where is their motivation.

And as helping professionals, it's our job really to see that these kids are brilliant and to understand the ways that they learn and how we can support them in a way that honors who they are and what's important to them and their family.

I love the way that you talk about that in assessments.

I think it's so kind and so genuine, and I know it comes from your heart and your experience, but I think if I were a parent and you were saying that to me, like, you know, we think about those things with our own kids. They're all so different. All kids are different.

But, like, hearing it that way, that, hey, you've got your child is amazing in all of these ways, but they may be learning differently or they may experience the world differently. And so it's just like a different way that I'd never heard autism described in the way before you and I started working together.

Oh, thanks. I do love our job and I love those assessments because you always see something mind blowing. Right. Like where I was, hey, how come you can do that?

Wait, you know all the planets in their order, but aren't asking for your favorite drink or aren't asking for cookies? It's, like, so fascinating and great segue into, let's dive in. So let's start with the basics.

Autism is a neurodevelopmental condition, which means it affects how a person develops socially, how they communicate, and how they interact with their world. It is a spectrum, and so there's a common seeing if you know, one person with autism, you know, one person with autism.

And so no two people are experiencing autism in the same way.

And that's something, I think, clinically, that keeps you and I really engaged and motivated in our work, is that we're constantly thinking like, wow, this guy is so unique. What can I do to support that goal?

That's right. We often look for differences in essentially two main areas.

We're pulling this, of course, from the DSM 5, which is the Diagnostic and Statistic Manual of Mental Disorders, fifth edition.

So we're not going to read from the DSM here, but essentially what we look for is differences in social communication and interaction and then repetitive behaviors or intense interests. So this is kind of where I zoom in as an SLP and looking at these social and communication differences.

So some signs that might pop up, up early are things like not responding to their name in around nine months of age. So when they're little babes, are they. If you're calling out their name and you're saying, hey, Johnny, you know, are they looking towards you?

Are they. Some of the time, you know, at least essentially, we know that if a child is really distracted in an activity, you're engaged in it.

They may not look every single time, but are you finding that they're almost never responding to their name? And often families will comment saying that, like, when I call him, he really never looks at me or says anything, anything.

Other things are not using gestures like pointing or waving. These are some of those early ways that little ones communicate reliably before they even have spoken words.

We'll often see a child pointing or waving more in typical language development. And so some of the indicators that something's a little bit different or they're learning differently would be if they're not doing that thing.

So they're not pointing to you, they're not pointing up at the sky if they see something cool, or they're not waving when someone leaves their house or comes over. Another one is limited eye contact. And this one we see, like, not necessarily avoiding on eye contact, just not really seeing it at all.

And then other things are, like not showing you things or sharing excitement.

So in typical language development, we often see kids, whether they say it verbally or get your attention somehow, to be like, look, Mom, I'm doing this cool thing. And like, you gotta see this. Or like, with little kids, they'll often, like, have a rock and they run up to you and mama, Mama, check this out.

And so that's what I'm talking about. There, like showing you things just out of the motivation to show you something. And it's because it's cool. And I think you.

I think you're gonna think this is cool. And it's. It's all really social is where that's kind of coming from.

And then another thing is, by age 2 or 3, not engaging in pretend play or playing alongside other kids. So pretend play. Something we look. Love to look at.

For example, I was doing pretend play with a little person in my assessment this past week, and I was pretending to eat an ice cream cone. But I just put two blocks. I had to try triangle block and a round ball block on top of it. And I was pretending that that was an ice cream cone.

And actually, in my assessment, the girl did have a diagnosis and she did it and she imitated that for the first time. Mom almost cried. It was so exciting.

But again, some of those early signs that we see are potentially not engaging in that pretend play naturally or spontaneously or not imitating it. And then also, like, not really having a preference of wanting to be with or play with other children.

Yeah, exactly. I was just thinking, I'll link it in the show notes.

I have a really great video that I'd love to share when I go, like classes for guest lectures and things that shows sort of the difference between an autistic child's play and a typically developing child with that social motivation you see in the video, the child is. Both of them have a phone. And. But the way that they're interacting with the phone is different. It's so good. I'll put in the show notes.

Yeah, I don't think I've seen that.

And so as you can tell, it's not just if they're not talking.

Right.

There's so much more to it. And so as a behavior analyst, I'm looking at their non vocal communication. And so in the real world, we call it non verbal communication.

As a behavior analyst, we think of verbal behavior as anything that is communication beyond just vocal speech. And so what I'm talking about now is like, how are they communicating outside of the vocal speech?

So a lot of overlap with what Brittany was just seeing. As a speech pathologist. She's looking at. Are they pointing and waving? I'm also looking at that. Are they using facial expressions?

Are they checking in with their parent throughout? Like we sort of said before, we're strangers to these kids. Are they kind of like checking in, like, is this place safe?

Who are these people? And that would be really. We would expect that yes, yes, exactly.

But also we have kids come in that don't do that. Right. And they're also just like very friendly children.

And so I think that's like a takeaway thing here too is like we're talking about what are some of the indicators that we see and what are some of the things that you might be noticing as a parent. And some of those things can be very typical or normal in quotation marks.

But as professionals who've been doing this for a long time, what you and I are doing in these assessments is really looking for a cluster of things. Right. Like a few different things coming together. We're like, yeah, okay, this is different than what I would have expected. And this is two.

But this isn't. And so as a behavior analyst, I'm looking at those communication skills like you identified and as well those social interaction skills.

So if we look at imitating things, are they trying to imitate silly actions that I'm showing them for the first time? I'll never. Britney comes to my house.

I've got a young guy at home, he's 2, and she always does something fun with the toys that he's never seen before. And then now that becomes his thing. So like we have these blocks that have a hole in the middle.

They're always a bracelet now, they're never blocks anymore. And he has a few other as well that he's sort of held on to.

Yeah.

And so are they doing things like that? If I get excited, are they getting excited?

And so I'm paying really close attention to how they respond to what my I'm doing and then seeing how flexible they are too. Are they able to move from one activity to another? Are they really focused on this other activity that they don't want to leave?

And again, some of that could be very normal. And what we would expect for a two year old, you know, again, my two year old at home, very strong willed, he's got a lot of ideas.

He's not quite quite that flexible. Yeah, but are they kind of shifting their attention to check out what I'm doing? Right.

And that's what we would sort of expect is maybe you don't care to do this activity that I'm doing, but I would expect your eyes to sort of look over at what I'm doing and be curious about what I'm doing. And so again, that might be something I'm looking at.

And so when we talk about social communication, what we're really talking about is that reciprocity that back and Forth interaction or the shared experience. And at Elemento, that's like our founding principle.

And so if we're not seeing some of those little moments of connection or if they're rare, then we might pause and think, oh, we should look a little bit closer here.

Totally. I was thinking about too, like we might have this really cool toy that the child really loves.

But do they pull it into the corner and then their backs to you and then if you try to engage with them, are they wanting to do that or not? And again, that's like that back and forth piece where we often start is like, I want you to learn that I'm cool too.

And we can do even cooler things with those toys if we do it together.

But often if the child's coming in to see us, not often, but we see it sometimes where they'll be like, nope, these are my toys and I'm going to kind of squirrel everything away. And then I really don't want you coming near them or touching them. Right.

Yeah, exactly. Exactly. And so we're looking for some of those differences in their social kind of communication interactions.

Right.

And like we said, sort of like a one off or even like Brittany was saying, you were saying with the responding to name, it's sort of normal for kids not to respond to their name some of the time.

Yeah.

And again, as a clinician, this has been really eyeopening as a mom is. We used it as a behavior analyst. We love data. Everything has a mastery criteria. And so we would do. They must respond to their name.

90% of opportunities across three sessions. As a mother, I can tell you that is outrageous mastery criteria. A child is not. And like we don't want them to respond to their name.

90% of opportunities. You should ignore me sometimes, you know. And so I think some of those things as well are really insightful now that I'm a mom.

Totally, totally.

So switching over here, looking at those repetitive behaviors and sensory differences and certainly this is often when people think a behavior analyst is needed. Occupational therapists can be really helpful. Yeah.

And so we're seeing children engage in repetitive actions like rocking or spinning things or they might have intense interests. Like I mentioned before, we had a two year old recently who could name all the planets in order to. And so that was very fascinating.

Wasn't speaking to request things. And then you couldn't like, you couldn't say like what are the planets? Or something.

Like just every once in a while spontaneously would just list them from start to finish. Or I had a, a very early client that I worked with, and he knew the release date of every Marvel movie.

He could tell you, like, the day of the week, the full date, of course, in the year. And so, yeah, this, like, very specific interest in not even the movies themselves, just in their release dates. Dates.

Oh, I'm thinking of another learner that we had that we both knew, and I hardly knew him, truthfully. And he would always say, hey, Brittany, your birthday's coming up. And I'd be like, how do you know this?

And then he could also know that I was like, born on a Tuesday because I could tell him my birthday. And I'm like, my brain will just never be able to do that.

And I actually don't get it. Like, I don't understand how this individual knew the date.

I don't get it either.

What is the problem solving in your brain to even figure that out?

Yeah.

Is there an equation?

I know.

I don't know. I don't know.

Yeah, that one. I don't. I don't understand it either. But, like, the fascinating way that his brain worked and the remembering, like, hey, Britney. And like, oh, yeah.

And I think anniversary, too, or something. There was, like, so many things that he would remember about me and then anyone. It wasn't just me. Right.

It was like, you and everybody else in the clinic is, like, so fascinating and how cool your brain works, but mine doesn't work that way.

It's very different. No. Or like, I love the other kids that come in. They know an episode of a show from start to finish. Right. Like. Like, I could never.

No.

And so during assessments, sometimes the. We'll see these things directly. Right. Like, will the child spontaneously list the planets? We're like, oh, does he do this often?

Yeah.

And then we can ask kind of some more questions about it. Like, will he do it when you ask him to do it, or is it mostly under his own motivation?

So sometimes we see them come up, but more often they're coming up when we're chatting with parents, and they'll, like, kind of tell us a little story. We're like, oh, okay, that's interesting. I'm thinking of an intake we did. The child was young, I want to say two years old, maybe two and a half.

And he could, like, disassemble an air conditioner or something.

Oh, yeah, take that.

We did. It was so fascinating. Okay.

Yeah.

I don't think most two and a half year olds could figure that out. Right.

You know, the skills are just amazing. Like, so incredible.

Yeah, exactly. And then the Sensory differences as well. Right. So we might notice often Brittany will be the one to do the standardized assessments. Right.

And then I am doing usually like a skills based assessment assessment, looking at some of their learning behaviors. And so a lot of my questions for parents will be like, are they sensitive to noises? And then certainly around picky eating is one that comes up.

And again, I got two young children, they have their own picky eating. But there's usually like kind of a difference there where we're seeing like the text, certain textures are just like out of the occasion, out of the.

Cannot do that. Or I'm trying to think of other ones that come up. Sometimes times be like colors, like only beige foods, for example.

And so again, just asking some of those questions around their sensory preferences. Can't.

Can just like give us a little bit more information that we're starting to piece together and kind of put into, like I was saying before, like a cluster of things that we're starting to notice.

Yeah.

And so the key thing is looking at those patterns, not like a one off, you know, like they don't like chicken fingers, but every other child likes chicken fingers. You know, that could be just fine.

Yeah.

But we started saying they only eat McDonald's chicken fingers. Then that's like, interesting, right? Like, oh, why don't they also eat Wendy's chicken fingers or whatever?

Right. And the color is interesting. The beige is often the one. It is. Yeah. Yeah.

And also I would say I can't blame people that prefer beige food. It's like all carbs.

Yeah, exactly. My personal favorite, the bread, chicken nuggets and the fries. Why not? I love that too.

Yes. Don't give me the scary other colored food. No, thank you.

Yeah, for sure, for sure. And so, yeah, like, like how you described it, like patterns and clusters. I think, think there's.

Again, we don't have to go really deep into this, but there's an old sort of representation of autism that does this puzzle, like this thing that needs to be solved and how all the pieces come together. And we're saying now, like, I know that we've listened to the autistic community and people don't like that, of course.

Like no one wants to be a puzzle to be solved. And this now we're talking about it a little bit differently.

Like this, what are these sort of clusters of signs or indicators that kind of come together to just show who you are as a person? And then do these signs indicate that you learning a little bit differently or that you might see the world In a different way.

Right, yeah. And like we always say at the clinic, like we don't need a diagnosis to support your family.

Yeah.

And I diagnosis sometimes is helpful in a way that it can say like, oh, they might do better learning this way or they might benefit from support with this, you know. So a diagnosis is certainly something helpful. But for the most part what we're looking at is what are your goals and how can I help you?

Take step one, step two, step three to get to that goal.

Yeah, yeah, for sure. So let's switch gears again a little bit. We're going to be talking about now a bit more about the brain and autism.

So as you know as clinicians we often talk about the signs we can see. And so far that's kind of what we've been talking about, like things that we observe or parents observe.

But what's fascinating is how researchers are actually starting to uncover the why behind some of the these signs, especially around social engagement.

Yeah, it is so interesting.

I remember years ago, early clinician, I went to a conference and they shared some emerging research about one month old babies and seeing like differences in where their eyes were orienting and stuff.

A recent study that came out that was really interesting looked at how children with autism may actually prefer non social stimuli over social stimuli. So things like shapes and patterns instead of faces.

And so it's not just like a lack of interest in people, it's like a pull towards non social things. And so the kids with autism consistently chose abstract or moving geometric patterns over looking at videos of people's faces.

And it wasn't because they were avoiding faces, it's that the non social stuff was more interesting. And then therefore that changes how the individual is going experience the world and how they learn from the world.

And if I'm not mistaken, I know we said children here, but it's actually in babies, right? Yeah, like young, young brains and young who don't have.

We're not talking about an 8 year old who's been interacting with people in their life for eight years, we're talking about a baby like so interesting that the brains are just sounds like so different from such a yearly age.

Yeah, exactly.

And that's what is I think very interesting in the research that's coming out is seeing these differences, I would say like even under three years of age. Right.

Where diagnosis is still kind of late here in Ontario anyways, people can be getting diagnosis much later because the wait list and stuff can be quite long. And also awareness, sometimes people just aren't Aware. And so some of these early studies are quite interesting.

Yeah. So fascinating. I mean, I. I do. Was just thinking about how the podcast is named neurodiversity speaking. And then what's that word? Neurodiverse.

And neuro is brain. And diverse means difference. So we know there's a brain difference here, but again, that's why we're kind of diving into it.

Yeah.

And it goes even deeper than behavior. So another study used brain imaging to look at the reward systems in the brain, specifically the pathway between the nucleus and the accumbens.

Am I even saying that right?

Acumens, I been a long time since I did any neuroscience. A decade at least.

So apologies for those of you, if anyone's listening to this, and you're a neuropsych or a neuroscientist or something, give us feedback. But it's the pathway between the nucleus and the accumbens. I'm going to say. And the ventral tegmental area. You can tell I'm not a neural anything. No.

But these areas helped us find social interaction rewarding. Okay. So that's why these areas in the brain are all interesting, because they help us make that interaction rewarding, is what we're saying.

Yeah. Like you would see in a brain scan that part of the brain activated during, like, rewarding or preferred interaction, or.

Even like that example, or if I was like, hey, mom, look at my rock, that it would be activated. We would think, right? Potentially. But for kids with autism, that connection was weaker both structurally and functionally.

And so the weaker the pathway, the more challenges the kids had with social interaction. That's so interesting.

I know, exactly. The brain behavior link is so important. And so it's not that these kids can't connect.

And this sort of ties into my mantra, is that their brains might not be wired to find those social experiences naturally reinforcing. And when we think about it that way, it really shifts the conversation from why won't they engage?

To how can we make social interactions feel meaningful and safe? And I love that at the clinic.

Same. Same.

We always say, like, connection. Right. Is our mantra and one of our guiding values at the clinic. And that's why.

Yeah, exactly. Same. I just love that part. And I think that's, like, why. Why our. Our.

Like you said, our whole mantra is like, bringing connection, but also joy and like, whatever sparks joy. That's play. And then that's what we're doing all the time. So fun. We. We love our jobs. Okay.

So looking at another study, they looked at the earliest months of life. Again, so we're talking about young babies and found that newborns, even those later diagnosed with autism, do start off orienting to faces.

Interesting. But around two months, something shift shifts. For typically developing infants, eye contact increases.

For those later diagnosed with autism, it declines. So that eye contact declines. It's not that social interest is never there, it just doesn't follow the same developmental path.

Exactly.

And so if we notice some of these differences early, then we can provide support to help these individuals with finding joy and connection in their own ways, which we know can make a big difference.

Yeah, and that's where the, in the collaborative space, we really shine or the, the collaborative care is so wonderful. We're not trying to make the kid be someone they're not. And I do think that's really, really important. We want to.

That's like one of the take home messages from today.

We're trying to understand how they experience their world, support them with how they experience their world, and then increase that kind of connection or increase that joy that they can feel while being around others.

Yeah, exactly, exactly.

All right, so the next I want to jump into like what Parents often ask us that, what do I do then if I'm seeing some of these signs and we've talked about, you know, our process, like often parents will ask us these questions and we'll say, well, let's, let's talk about it, let's see, let's play and let's do some assessing to better understand where, where their strengths are and then what maybe some of those differences are.

And so if you're starting to feel or notice that things are a little bit different or maybe a friend has said something, or often people will say, like the daycare teacher notice that they're maybe just behaving a little bit differently than some of their pe. We want to say this loud and clear. You're not alone.

Exactly. That feeling in your gut, it matters.

And so whether your child isn't responding to their name or is avoiding eye contact or just seems more interested in objects than in people, those are all things that might indicate there's a difference in how they're experiencing the world. It doesn't mean it's wrong. It just means like maybe lean in with a little bit of curiosity.

Totally. I, and I think, like, as moms, we know this too, that the parent gut is like, you have these instincts. Right. And you know your child best.

And we like to say that too, like you're the expert on your child. But we might be, we Might have experience and like, clinical expertise in.

In looking at some of these indicators and looking at their language and their play skills and their learning skills.

Yeah, exactly. I was going to say that's why we offer the screeners. Right.

Like we at Elemental, you can book a free appointment with us to do a screener because we know sort of what are some of those key things that we're looking for and then we're able to help navigate, like, yeah, you know what, bring your child in, it'd be lovely to meet with you. Or, you know what, based on a couple of these things that you said, let's meet again in six weeks and just see how things are going.

And I think that's, as parents, why we love offering that free screening clinic is like, your gut matters.

And like, as parents, we are with our kids so much and have such a keen eye for what's going well and where their strengths are and then also tend to worry as well, for sure.

And so, again, as parents, we really love offering the screening clinics so that parents can, like, just share their questions, concerns, comments, et cetera, with a professional and see kind of what, what should they do.

Yeah, and truthfully, we're not the only ones that do that too.

So if you're listening from another area, lots of places will do a free developmental screen and then we'll share some resources in the show, notes about how you can actually, as a parent, do some developmental screenings yourself, too. And, like, they're separated by age. So where do we start? We recommend start having a conversation with your child's pediatrician or physician.

If you need a referral to the pediatrician, ask them to complete a developmental screening, especially if your child is under the age of three. That's important. So in Ontario, we sometimes use tools like the mchat for toddlers, which is the modified checklist for autism in toddlers.

That one's available online. Or you can use the PEDs, the parent evaluation of developmental status.

They don't diagnose it at autism, but they do help decide if more support is needed. Like, so you'll ask or you'll answer questions. Yes, no, and then it'll sort of give you a range. Like, if you answered.

I forget what the range is exactly for the mchat, but if you had 8 yeses or something, then, you know, it says, like, let's do a refer. A referral to a pediatrician for an assessment.

Yeah, exactly. And there's like lots of milestone checklists and stuff available. And then from our perspective as professionals, we often Say don't wait.

And so come in and get that diet, get that assessment done, or chat with a professional. Certainly in Ontario, and I would argue most of Canada. Canada, there's long wait lists for a formal autism assessment.

And then in Ontario, you cannot access any funding for therapy until you have that diagnosis. And then even once you get that diagnosis, the wait list for that funding is so long. We have very limited insurance funding.

And so that's where we sort of advocate with families, is like, well, you may as well get the process started, and then we can always pivot, you know, further down the line. This isn't saying like. Like, we sort of started at the beginning.

We're not trying to brand any children or put a red paint on them or anything like that. Right. We're just saying, let's get started here, and we can take it day by day and week by week and then navigate sort of what's next.

And we're here to help along the way.

Totally.

All right, so let's talk about a few practical things that you can try out at home starting today. And so one of my top recommendations is to imitate your child. So if they're spinning things, join in and spin them.

It might feel silly, but it can really cr. Create that social bridge. Like we were saying, you're getting into their world instead of expecting them to get into yours.

Let's say with a caveat, too. Right. Like, no one wants to be bothered.

And so if your child really enjoys, like, if their body's moving away from you every time you're coming in and spinning something beside them, I would say that's probably not a social bridge. It's more of an annoyance. And so you're kind of looking at their body language too. Right.

So I'm gonna come in and enter your world, but if that's seems like something that you're not liking, and I'm telling that because your body's moving away from me, or maybe you're knocking my skating top away. Something like you're, you know, their communication can be so clear.

Y.

And so then I'm not going to do that. I'm going to find another opportunity to come in and imitate.

Right.

Some of the things you're doing.

Yeah. Or maybe not bother your toys, but I might line up my own toys beside yours or something like that and see if they like that. Exactly.

I think it's like, definitely watching for their response.

Right.

Because again, if they're lining something up, could be cool that your things lining up beside them. Or you could really be miss messing with the visual that they're trying to set up and check out on the corner of their eye or something like that.

So imitate them, but follow their lead and notice those indicating behaviors is what you're saying. Yeah, exactly.

Narrating what you're doing. So saying out loud what you're doing in simple language.

So as you're getting them dressed, sock on, or another really good one would be numbering them like one sock, two sock, and you might get again, kind of capturing some of that motivation.

If your child really likes numbers, that's something that we'll often see in initial assessments, is that they can, like, count to 20 or something spontaneous simultaneously. And so even if they're not talking back yet, there's still a lot of input that can be provided by narrating all those things that you're doing.

And then the final thing is pausing and waiting.

And so after we're giving a direction or asking a question, we're giving them a little bit of time to think about what we've said, and then we want to follow through and show them. Right. So if I said, go get your shoes, I might wait a little bit, see if they go get their shoes.

And if they don't, I want to help them go get their shoes. So that then they're connecting this instruction of go get your shoes with what that actually means.

Means, yeah. Love those strategies. This is part of our let's Get Talking series that we do do some of these tips and tricks.

And one of my favorite things actually in the clinic is just helping parents see, hey, we can actually make these tiny little shifts, and it can make a big difference in your child's language development if you're doing those things like narrating and then pausing and waiting. So love it. And I've got some other SLPs approved strategies using some visual supports.

So for some kids, using a picture schedule can be super helpful using choice boards.

So giving an example, like having some something about the snacks that they like, where they can point to goldfish crackers or strawberries or something, or even simple pointing to objects can help build understanding and reduce that frustration.

So pointing to the one that I want to have another one is modeling gestures and so modeling that waving, pointing, clapping, and then pairing them with words. So, you know, also, of course, waving and then saying hi with a wave, and that goes a long way.

And then we say this all the time, and we'll continue to say it, but celebrate any form of communication. So just like Shawna was saying if they're pushing your spinning top away, they're communicating pretty clearly.

So a grunt, a point, or eye contact, or even a shared smile, you know, there's different forms of communication, like they're telling you they like something or they don't like something. And we want to honor all of that and meet your child where they're at.

Exactly. And on a similar line, this idea of setting up predictable routines with them. And.

And so maybe after bath time, then you do some play with blocks, and then you read a book and then you sing them a song and tuck them in. Or after a snack, you might have a routine where you go in the basement and do some trampoline jumping or something like that together.

And so coming up, these predictable routines can really create opportunities for connection and learning. The children sort of get to know what to expect from you, and then you see your opportunities to embed in communication opportunities for them, them.

Or notice some of the patterns that could be helpful in identifying what are their learning preferences and what are their strengths and what are the things that they really enjoy.

For sure.

And so if there's one message we hope you got from the podcast today, it's that you don't have to have all the answers to start supporting your child.

For sure. Absolutely. Early indicators don't mean necessarily that something's wrong. They mean your child might experience the world differently.

And that's what. Okay.

Autism is not a tragedy. Kids on the spectrum are smart, capable, curious, and full of potential.

They're often just tuned into different frequencies, and it's our job to listen into those totally.

And then we really, truly believe this, that when SLPs and BCBAs work together and then parents are a part of the team and supported, and when we meet kids where they're at, that's where the magic really happens.

So trust your yourself, stay curious, ask questions, reach out to us. You're not alone in this journey, and your child's so lucky to have you.

Oh, absolutely. And we're so glad that you joined us for this conversation. If you have questions, check out our resources on our website or reach out.

We'd love to hear from you. And we're happy to continue this conversation, and we will.

The science is going to keep evolving and we're going to learn more and more about the brain and learn more about how to support our neurodiversity learners. And so we'll have this conversation again and again. But we're so glad you joined in today.

Exactly. When we know better, we do better. So we're cheering for you and your amazing kid. Thanks for joining us.

Thanks everyone. Before we go, we want to remind our listeners that topics we discuss in the podcast are not a replacement for professional medical advice.

Please contact a professional if you have questions.

And just a heads up, we'll use both identity first and person first language.

To respect different preferences.

We'll also see treatment and therapy since we come from a clinical space, but always with respect and a focus on what works for each person.

See you next time.

Bye.