Autism Spectrum Disorder (ASD)

Understanding Autism: Why Early Recognition Matters

Autism, or autism spectrum disorder (ASD), is a developmental condition that affects how a person communicates, interacts with others, and experiences the world. That definition may sound broad—and that’s exactly the point. Autism exists on a spectrum, meaning each child with autism is unique. Some may have stronger language skills but struggle socially; others might find communication more challenging but connect well in their own way. There’s no one-size-fits-all.

In the U.S., autism affects about 1 in every 54 children, and signs often appear by age 2 or 3. An early diagnosis can open the door to important support—speech therapy, occupational therapy, and specialized educational resources—that help children thrive. That’s why regular developmental screening is such a vital part of pediatric care. The earlier we notice differences, the earlier we can work together to support your child’s growth and well-being.

When Do We Screen for Autism?

At Keānuenue Pediatrics, we routinely screen for autism at your child’s 18-month and 24-month well visits. We use a trusted, research-backed tool called the M-CHAT (Modified Checklist for Autism in Toddlers)—you might remember filling it out during your visit.

While the M-CHAT helps us identify children who may benefit from further evaluation, it’s just one piece of the puzzle. We also rely on your insights as a parent and what we observe during the visit—how your keiki plays, communicates, and responds to the world around them. Together, this gives us a fuller picture of your child’s development and helps us decide if additional steps are needed.

How Is Autism Diagnosed?

If we have concerns about autism, we may refer your child to a specialist—typically a Developmental Behavioral Pediatrician or a clinical psychologist—for a formal evaluation. In some cases, your general pediatrician may also make the diagnosis.

Autism is diagnosed based on specific criteria, which include challenges in two main areas:

1. Social communication and interaction
A child must show signs in all three of these areas:

• Difficulty with back-and-forth social interaction (like conversation or shared play)
• Problems with nonverbal communication (such as eye contact or gestures)
• Trouble forming relationships or showing interest in others

2. Restricted and repetitive behaviors
A child must show signs in at least two of the following:

• Repetitive speech, movements, or use of objects
• Strong resistance to changes in routine or preference for rituals
• Intense or unusual interests (especially in objects or topics)
• Unusual responses to sensory input (e.g., avoiding touch, fixating on lights, or looking at people from the corner of the eye)

Symptoms must begin in early childhood and impact daily life or functioning.

Here’s what we want families to know:
We don’t wait for a formal diagnosis before offering help. If we suspect a developmental delay, we connect families with support and resources right away. Early intervention makes a big difference, and we’d rather act early than wait.

And remember, autism is a spectrum. Every child is different, and the level of support needed can vary widely. With early care and the right support, children with autism can grow, learn, and thrive.

What Are Some Other Signs of Autism?

Every child develops at their own pace—but when we see certain patterns, especially when they’re more intense or persistent, it may point to autism. Some signs to watch for include:

Difficulty with transitions
Many toddlers struggle with change, but for a child with autism, even small shifts in routine or activity can cause significant distress.

Limited eye contact
A child may avoid making or holding eye contact, even with familiar caregivers.

Delayed language development
Some children may not speak as early as expected or may have trouble using language to express their needs.

Low interest in others
A child may seem more focused on objects than people, and show little interest in playing with other kids or engaging with adults.

Strong resistance to changes in routine
Even minor disruptions—like a different bedtime or route to school—can be very upsetting.

It’s important to remember: one or two of these signs alone doesn’t mean a child has autism. But if several are present, or if you have concerns about your child’s development, talk to your pediatrician. We’re here to help, without judgment, and always in partnership with you.

What Resources Are Available?

Thankfully, there are many wonderful services available to support children with autism and developmental delays. These can make a big difference—especially when started early:

Early Intervention (EI)
Available for children under age 3, EI supports families with concerns about any area of development—not just autism. Services are provided in the home and tailored to each child’s needs.

Speech Therapy
Helps with both verbal and nonverbal communication—like understanding language, forming words, or using gestures.

Occupational Therapy (OT)
Supports fine motor skills such as writing, feeding, and dressing, as well as sensory processing and daily routines.

Applied Behavior Analysis (ABA) Therapy
A widely used and research-supported therapy for children with autism. ABA helps build skills in:

• Communication and language
• Social interactions and play
• Problem-solving and behavior
• Attention and focus

We can help connect your family to these services based on your child’s needs. You’re not in this alone.

Does the MMR Vaccine Cause Autism?

No—it does not. This is a common concern, and it’s important to set the record straight with care and facts.

In 1998, a now-discredited study by Andrew Wakefield claimed a link between the MMR (measles, mumps, rubella) vaccine and autism. The study involved only 12 children, had serious ethical issues, and was later found to be intentionally misleading. It was retracted, and Wakefield lost his medical license for spreading false information.

Since then, many large and well-designed studies have found no link between vaccines and autism.

We still don’t fully understand what causes autism—it may involve genetic, environmental, or developmental factors—but we do know that vaccines are safe, and they protect children from serious diseases.

If you ever want to read more about the original study or the science that followed, we’re happy to share trusted resources.

Our Message to Families

If you ever have concerns that your child may be showing signs of autism or a developmental delay, please reach out. We’re here to listen, support, and guide you every step of the way.

There is absolutely no shame in seeking help. Early support opens doors and gives children the best chance to thrive. Our goal is to reduce stigma and make sure every keiki gets the care they need to reach their full potential.

At Keānuenue Pediatrics, we walk with families in partnership—with respect, aloha, and a deep belief in your child’s strengths.