MY CHILD DOES NOT RESPOND TO CALLING HIS/HER NAME

Updated July 12, 2022

Often parents notice that their child (toddler) does not point (by 18 months) and wonder if there is something wrong. If you have observed this, please do take it seriously as this could be one of the common features of Autism. 

​​

Please have a chat with the educator from childcare/preschool and get

1. An observational report in general on

• Play/Interests/Learning

• Speech/Communication 

• Social skills/Group activities/Friendship

• Behaviours/Routine/Transition/Sensory issues

*The educator please use the appropriate age group - Common behaviours are listed at the bottom of this page

Toddler

Preschooler

Primary School and Teenagers

​

2. Educator to complete the Observation Checklist ​

EVAL-Observation-Checklist-ASD.pdf (allbelong.org)

SMART-Observation-Checklist-.pdf (medicalhome.org)

https://www.icdl.com/research/functional-emotional-assessment-scale

(Choose the age range and score the child only) 

19 to 24 Month Score Sheet

25 to 35 Months Score Sheet

3 to 4 Years Old Score Sheet

For School Age Children

ASD-Checklist-for-Parents-and-Teachers.pdf (parentingpod.com)

Self-Evaluation for Students (1).indd (parentingpod.com)

Autism in Girls Checklist (staffordshire.gov.uk)

https://novopsych.com.au/wp-content/uploads/2023/03/autism-assessment-social-cat-q-camoflaging-autistic-traits-questionnaire.pdf

​

3. Social skills and Social Pragmatic checklist - Preschool and Primary school age

SOCIAL-SKILLS-CHECKLIST-PreK+Elementary.pdf (successforkidswithhearingloss.com)

Pragmatics Checklist (yarrame.vic.edu.au)

​

4. Complete the Developmental milestones and fine motor skills checklist for age (Please tick) - for educators

DevelopmentalMilestonesEYLFandNQS.pdf (acecqa.gov.au)

Please choose the age range for the child's age and tick the skills as per the checklist (eg 1-2 years or 2-3 years or 3-5 years) also please complete the younger age range than the child's actual age if there were a significant lack of skills observed for age. For example, if a 4-year-old child does not demonstrate skills appropriate for the 3-5 years range, please complete the checklist for 2-3 years range as well.

​

Fine Motor Skills Checklist - for educators

Chap3-FineMotor.pdf (perkins.org)

​

Developmental checklist for parents

The Survey of Well-being of Young Children - Age-Specific Forms at Tufts Medical Center

​

5. Preschool Readiness Checklist - for educator

Microsoft Word - COMigrant_PreschoolReadinessChecklist.docx (weebly.com)

Preschool Functional OT Checklist - for educator

Microsoft Word - Preschool Functional Checklist OT_Sendero (cloverleaflocal.org)

School Readiness Checklist

​viewimage.aspx (buildsend.com)

US version

Preschool skills checklist (leapfrog.com)

Kindergarten skills checklist (leapfrog.com)

First grade skills checklist (leapfrog.com)

6. DSM-5 checklist (Teacher)

Mass General ASD DSM5 Symptom Checklist-Clinical.docx  

7. School Counsellor Assessment for School Age Children on

• ASRS - The Autism Spectrum Rating Scales AND

• ABAS-3 or Vineland-3

​

*The National Guideline for the Assessment and Diagnosis of Autism Spectrum Disorders in Australia (https://www.autismcrc.com.au/) suggested looking out for these features for specific age groups:

​

Toddler 

Social Communication

• Limited use of gestures such as giving, showing, waving, clapping, pointing, or nodding their head

• Delayed speech or no social babbling/chatting

• Makes odd sounds or has an unusual tone of voice

• Difficulty using eye contact, gestures, and sounds or words all at the same time

• Little or no pretending or imitating of other people

• Stopped using words that they used to say

• Uses another person’s hand as a tool (e.g., putting parent’s hand on a jar for them to open the lid)

Social Interaction

• Does not look right at people or hard to get them to look at you

• Does not share warm, joyful expressions

• Does not respond when someone calls their name

• Does not draw your attention to things or show you things they’re interested in

• Does not share enjoyment or interests with others

Behaviors & Interests

• Unusual ways of moving their hands, fingers, or whole body

• Develops rituals such as lining objects up or repeating things over and over

• Very focused on or attached to unusual kinds of objects such as strips of cloth, wooden spoons, rocks, vents, or doorstops

• Excessive interest in particular objects, actions, or activities that interferes with social interaction

• Unusual sensory interests such as sniffing objects or looking out of the corner of their eye

• Over- or under-reaction to certain sounds, textures, or other sensory input

Preschool-aged children (0–5years) ​

Spoken language

–         Language delay in babble or words

–         Reduced use of language for communication

–         Regression in speech and language skills

–         Repetition of the speech of others which may be immediate, delayed or mitigated (‘echolalia')

​

Responding to others

–         Absent or delayed response to name being called (assuming adequate hearing)

–         Reduced responsiveness to social smiling

​

Interacting with others

–         Reduced social interest in others

–         Reduced imitation of others’ actions

–         Reduced initiation of social play with others

–         Reduced enjoyment of situations that most children like (e.g. birthday parties)

–         Reduced sharing of enjoyment with others

​

Eye contact, pointing and other gestures

–         Reduced use of gestures and facial expressions to communicate with others

–         Reduced social use of eye contact (assuming adequate vision)

–         Reduced pointing or showing objects to share interest

Play

–         Reduced use of pretend play

​

Restricted interests and/or rigid and repetitive behaviours

–         Repetitive movements, such as hand flapping, spinning and finger flicking

–         Repetitive play

–         Over-focused or unusual interests

–         Excessive insistence on following own agenda

–         Over- or under-reaction to sensory stimuli (e.g. textures, sounds, smells, taste)​

​​

Preschooler

Social Communication Red Flags

• The child generally does not point to or share observations or experiences with others

• The child tends not to look directly at other people in a social way. This is sometimes referred to as a lack of eye contact

• There may be an absence of speech, or unusual speech patterns such as repeating words and phrases (echolalia), failure to use ‘I’, ‘me’, and ‘you’, or reversal of these pronouns

• Unusual responses to other people. A child may show no desire to be cuddled, have a strong preference for familiar people and may appear to treat people as objects rather than a source of comfort

• The child may appear to avoid social situations, preferring to be alone

• There is limited development of play activities, particularly imaginative play

• There may be constant crying or there may be an unusual absence of crying

Behavioural Red Flags

• The child often has marked repetitive movements, such as hand-shaking or flapping, prolonged rocking or spinning of objects

• Many children develop an obsessive interest in certain toys or objects while ignoring other things

• The child may have extreme resistance to change in routines and/or their environment

• The child may be resistant to solid foods or may not accept a variety of foods in their diet

• There are often difficulties with toilet training

• The child may have sleeping problems

• The child may be extremely distressed by certain noises and/or busy public places such as shopping centres

​

Primary school-aged children and teenagers:

Communication

• Issues with conversation, perhaps dominating conversations with their favourite topic and not knowing how to take turns.

• Not being able to interpret the non-verbal communication of peers and adults.

• Unusual speech patterns, a monotonous tone or an old fashioned way of talking.

Social interaction

• Seeking solitude, and finding being with others very stressful and exhausting

• Being rigid in following rules at school and in sports and games

• Finding it hard to read social cues and the unwritten rules of friendship

Interests/ Routine/ Sensory/ Behaviour

• Having unusual interests and obsessions, no breadth of interests

• Sometimes there are unusual physical movements, such as touching, biting, rocking or finger flicking

• Having sensory issues, either heightened or lack of sense of smell, touch, taste, sound and vision

• Need to follow routines to feel secure, become very upset when expected routines change

• Having few or no real friends

• Aggression is sometimes seen, usually as a way of avoiding overwhelming situations

• Anxiety is also common, especially as children enter the teenager years

​

What does autism look like in girls?

Girls and Autism - Autism Awareness Australia

With the diagnostic criteria for ASD based largely in how autism presents in males, girls can often ‘slip under the radar’ or get misdiagnosed. Girls with ASD seem to have less restricted and repetitive behaviours than boys, but it’s also possible that some of these behaviours go unrecognised — for example, an obsessive interest in collecting dolls may be misinterpreted as pretend play.

Although every child with autism is different, here are some common characteristics in girls with autism:

• A special interest in animals, music, art, and literature

• A strong imagination (might escape into the worlds of nature or fiction)

• A desire to arrange and organise objects

• Not wanting to play cooperatively with female peers (for example, wanting to dictate the rules of play or preferring to play alone to maintain control)

• A tendency to ‘mimic’ others in social situations in order to blend in

• An ability to hold their emotions in check at school, but be prone to meltdowns or explosive behaviour at home

• Strong sensory sensitivities, especially to sounds and touch (for example; clothing tags, socks or even deodorant).

​

If you are concerned about your daughter, please look at the checklist

Autism in Girls Checklist (staffordshire.gov.uk)

​

Why Do Many Autistic Girls Go Undiagnosed? | Child Mind Institute

Some characteristics of autism can lead girls on the spectrum to lack self-confidence and have poor levels of self-esteem. This can lead to anxiety and the development of co-morbid mental health issues, particularly if autism has not been formally diagnosed.

Some of the characteristics that adult women with an autism diagnosis commonly report, include:

• Being able to camouflage or mask the signs of autism

• Mimicking others’ behaviours as a means of gaining acceptance and blending in

• Imitating the gestures, expressions and body language of others

• Forcing themselves to make and maintain eye contact in social interactions

• Preparing expressions, phrases and jokes in advance to use in conversations with others.

Autism First Signs and Checklist in Girls | Autism SA
Signs of autism that are more commonly observed in girls and women, and which may account for the lower incidence of autism diagnoses in females. These can include:

• Masking or camouflaging the challenges presented by the characteristics of autism through a range of strategies

• Avoiding or not seeking social interaction

• Being seen by others as excessively shy, or preferring not to engage with others

• Can be seen as an extrovert when it comes to their interests and hobbies

• An ability to keep emotions under control in social scenarios, but prone to becoming upset or distressed at home as a means of release

• Seen by others as quirky, or a daydreamer

• Copying or mimicking others’ speech and actions in social situations

• Having a very limited number of close friendships

• A tendency to become very intense and possessive in friendships, which can also end very suddenly

• Having a tendency to get ‘mothered’ by peers at primary school

• A well-developed sense of justice means they may stand up for others

• Language skills that may appear to be advanced for their age

• A range of non-verbal communication skills

• A highly developed imagination and enjoyment of fiction, pretend and fantasy play

• Play can be one-sided, or overly controlled

• Repetitive behaviours, such as hair twirling

• Intense interests, which may be focused on culture, art, people, music or animals. These interests may stem from a desire to match those of their peers or to fit in with others of the same age

• Interests that are advanced for their age

• Being considered an overly fussy eater.

​

A. Challenges with social skills and communication

Remember, autism is a spectrum and presents differently in every individual. However, the list below offers some of the “common” difficulties girls with autism might face.

One of the more classic symptoms of the autism spectrum can be seen when looking at difficulties involving social interactions. This is much easier to spot in boys as girls and women tend to adapt to social situations more naturally than men.

Difficulty maintaining eye contact during social interactions or escaping difficult events through mental processing or daydreaming can provide clues that girls may be autistic.

Other examples include:

• Difficulty in forming intimate social interaction

• Lower levels of verbal cognitive ability

• A difficulty in the ability to adapt

• Literal understanding of information; struggle with sarcasm 

• Communication and language problems

• Require longer time for processing to engage and interact

• Often find it difficult to communicate; conversation becomes scripted

B1. Sensory processing issues

Sensory processing issues include difficulties processing intense lighting, sound, or touch. These are all characteristic symptoms of autism. For someone with an ASD, there are sensory inputs that increase the need for self-regulation through stimming, meltdowns or, in more extreme cases, self-injurious behaviors.

B2. Behavioral challenges

Girls with autism can sometimes act out or show aggressive behaviours. This can occur when they are trying to communicate something, or when there’s a sensory problem that they’re trying to regulate. Alternatively, it can be due to a physiological or health-related problem.

B3. Visual thinking

Visual thinking relates to the concept that individuals with ASD are visual learners, thinking more in pictures than language. This enables some people with autism to conceptualize patterns in their minds and solve complex problems.

​

What are the Symptoms of Asperger’s Syndrome?

Asperger's Syndrome: Symptoms, Diagnosis and Treatment (nationwidechildrens.org)

Children with Asperger’s Syndrome exhibit poor social interactions, obsessions, odd speech patterns, limited facial expressions and other peculiar mannerisms. They might engage in obsessive routines and show an unusual sensitivity to sensory stimuli.

While all children with Asperger’s Syndrome are different, what sets them apart are their unusual social skills and obsessive interests. For a child with Asperger’s Syndrome, you may see one or more of the following symptoms:

• Inappropriate or minimal social interactions

• Conversations that almost always revolve around themselves or a certain topic, rather than others

• Not understanding emotions well or having less facial expression than others

• Speech that sounds unusual, such as flat, high-pitched, quiet, loud, or robotic

• Not using or understanding nonverbal communication, such as gestures, body language and facial expression

• An intense obsession with one or two specific, narrow subjects

• Becoming upset at any small changes in routines

• Memorizing preferred information and facts easily

• Clumsy, uncoordinated movements, including difficulty with handwriting

• Difficulty managing emotions, sometimes leading to verbal or behavioral outbursts, self-injurious behaviors or tantrums

• Not understanding other peoples’ feelings or perspectives

• Hypersensitivity to lights, sounds and textures

​

If you are concerned about your child who has no eye contact, no respond to calling name or not pointing (9-24 months), to give you an idea of the risk and urgency, please go ahead and screen with 

​

Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R™) | Autism Speaks OR

Infant-Toddler Checklist (ITC). 

OR​

Aspergers Test for Children and Adults Online - Get Instant PDF Results using this Aspie Quiz (autism360.com)

​

Seek professional advice from a Paediatrician who is experienced in children with developmental issues.

​

Dr Winston Oo

​

Resources​

For more information on Autism, Support, School and Genetic testing:​​

​

Parenting course

• Parenting Events | Resourcing Parents (nsw.gov.au)

• Autism | Raising Children Network

• Aspect Australia | Autism Spectrum Australia (Aspect)

• Positive Partnerships | Homepage

• Early intervention (nsw.gov.au)

  – Early intervention in Preschool

• Offices and contacts in your area | NDIS

  – Early intervention – Early Childhood partner and NDIS locations for application

• Information Sheet 24 -Medicare benefits for people under 13 years.pub (amaze.org.au)

   -  Helping Children with autism – Item 135 information

​

Genetic Testing​

• fact-sheet-16-chromosome-microarray-cma-testing-in-children-and-adults (genetics.edu.au)

  -Chromosome Microarray testing

• Testing and Screening for Fragile X - Fragile X Association of Australia

  – Fragile X screening

​

Evidence Base Intervention

• A review of evidence for interventions for children on the autism spectrum (Summary 2 of 2: Umbrella review) (autismcrc.com.au)

• Evidence-Based Practices | Autism PDC (unc.edu)

​

To learn more about the normal development of pointing in children please visit Pointing for children 5-18 months - Therapies For Kids.

​

Fees Disclosure for AUTISM and GLOBAL DEVELOPMENTAL DELAY ASSESSMENT by Dr Winston Oo

Initial Consultation - Complex Problems Item 132 - $500 (Rebate est $240.75)
Follow-up Consultation - Complex Problems Item 133 - $280 (Rebate est $120.55)
The Helping Children with Autism Item 135 - $500 (Rebate est $240.75)

Formal Assessment Report Fees $500 (Non-Rebatable via Medicare) separate to the Consultations