What are the key signs and symptoms to consider when assessing a child for Autism Spectrum Disorder (ASD) in a primary care setting?

When assessing a child for Autism Spectrum Disorder (ASD) in a primary care setting, key signs and symptoms to consider include:

• Social communication difficulties: persistent challenges in reciprocal social interaction, such as limited interaction with others, lack of responsiveness, difficulties understanding social cues, and limited social demonstration of empathy ¹,².
• Restricted and repetitive behaviours: including stereotypic behaviours like rocking or hand flapping, rigid routines, resistance to change, and marked repetitive activities especially under stress ¹,².
• Developmental history concerns: delays or regression in language or social milestones, unusual play patterns, or atypical use and understanding of language ¹,².
• Behavioural features: difficulties with socialisation skills, possible self-injurious behaviour, or behaviour that challenges daily functioning ¹,².
• Additional observations: consider sensory sensitivities, motor coordination problems, and adaptive behaviour difficulties ¹.
• Contextual factors: signs and symptoms should be considered in the context of the child’s overall development, family concerns, and cultural background; do not exclude ASD based on good eye contact or normal early language milestones alone ¹.

It is important to gather information from multiple sources including parents, carers, and educational settings, and to observe the child’s social and communication skills directly ¹. Referral to a specialist autism team is recommended if persistent and significant limitations or impairments caused by these features are present ².