The Challenges of Spotting Autism in Siblings

Whether I currently have one or two sons with autism, is waiting to be confirmed. I have an eight-year-old son whose autism was diagnosed at age three, and a second son who is strongly suspected to have autism but remains undiagnosed at age four. You may think that as a mother of an autistic child I’d have quickly and easily spotted the second child’s autistic traits – I thought that would have been the case too. But I’ve found that already having one child with autism actually created a whole set of challenges and distortions that made it a lot harder for me to recognise the autistic traits as possible autistic traits, in the second child. It took an autism specialist and a group of kindergarten teachers, to pick up on things I’d seen but had “mis-categorised.”

I’ve been reflecting a lot lately on why this is the case – how is it a mother like myself who is so emotionally and intellectually immersed in the world of autism, misses the signs in her very own son? I’ve reached some understanding of how this came about, for me at least, and quite possibly the same factors are at play in other families like ours.

Free use image.

Free use image.

It starts with the fact that my eldest son is my primary reference point for autism. The symptoms my eldest son has – and perhaps more importantly, their severity – blinded me to understanding what was going on with his younger brother: although the younger brother showed some unusual or concerning behaviours, to my mind they fell well short of actual markers for autism. I couldn’t help but compare the two children.

This is tied up in a second issue: I have only ever raised an autistic child. I don’t have personal experience with raising a child who went through “normal development,” I have intimate experience with the development of a severely autistic child though and comparatively my younger son’s development seemed to be going very well. As time went by I did start to notice significant differences between him and his unrelated peers, but there were two other factors at play that lead me to largely dismiss my observations as relevant to autism:

(1) I thought my younger son was simply copying some of the more concerning and unusual behaviours from his autistic older brother, such as the humming endlessly while he ran in circles. Indeed, when I brought up this concern when he was about two with a speech therapist who was assessing him at even that early stage, she also felt it must be a copying behaviour that would go after he’d spent a lot more time at kindergarten amongst more “normal” peers. Similarly my younger son’s seemingly delayed social skills; something that could be explained away by the daily presence of an autistic older brother whose own development and social skills were themselves so very different from the norm. We all know how influential an older child can be on their younger siblings, which made it easy – alongside the next factor I’m about to address – to explain away the younger sibling’s oddities.

(2) I was fully aware that I “see” autism everywhere. Just like anything you become hyper aware of, suddenly it is everywhere you look because your brain is focused on it and searching it out. If someone tells me about their concerns with their child’s development or behaviours, my brain starts by considering whether autism might be a relevant cause (it rarely is, but the point is my brain heads there first). Or if someone is discussing disability advocacy, my first reference point for what services are needed or lacking is to run the issues through an autism-experience filter, and this is completely natural and understandable considering my most intense interaction with disability experiences is through living with my own son. But because I am fully aware of this tendency of mine, I am also weary of jumping to “autism” as the answer or explanation for everything. So when I saw autism-like behaviours in my younger son, I chastised myself for thinking it might be autism. Instead I – and others who knew my son well – declared that he was just strong-willed, stubborn, independent… nothing pathological, just a particular personality type.

But as more professionals and teachers became part of my younger son’s life – and the same concerns got voiced across the board, and the concerning behaviours and traits weren’t lessening and became more intrusive, and the professionals in his life step-by-step ruled out parenting or other factors as causing the problems – I couldn’t dismiss autism as an explanation anymore. Autism does tend to run in families, we always knew this was a possibility. I just thought – for all the reasons outlines above – that autism wasn’t the explanation for my youngest son’s challenges.

So here we are, facing the start of that new autism journey. We’ll be just fine – we know the system well, we know the interventions that will be employed and have the experience and dedication already to make the most of them. We already love and live with one autistic son. This is not new territory, even if it will take a bit of getting used to. So even though my older son’s autism created various challenges to identifying the same base issues at play in his brother, I can confidently say that those experiences with his older brother will ultimately benefit my youngest. I’ve been through raising a very difficult autistic child, in comparison his quirky younger brother is a piece of cake. We already know we can handle this.

Though we’ve had an autism specialist say she does see mild autism in him, and she’s told us she’d be happy to go through the full diagnostic process if we find we need a confirmed diagnosis to access services, for now we’re doing OK without that final step of confirmation. “Suspected autism” gets us the services he needs right now, and that’s what matters. One day we’ll know for sure either way, but there are certain things a diagnosis could never change; I’ll just keep on loving my two boys just the same – they’re quirky and clever and independent and stubborn, and best of all, they’re both mine. I wouldn’t change that for the world.

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13 Responses to The Challenges of Spotting Autism in Siblings

  1. vinnysvoice says:

    So well written! My son is nearly 3 and has autism and we have often worried about his younger brother who has just turned 1. We constantly celebrate each little milestone which his brother never achieved and hope that all of them are signs we won’t have another child with autism. But you’re right, if he did turn out to have autism we know we could handle it and we would love them both just the same no matter what. Just the reminder I needed to stop worrying about it. Thanks

  2. Catherine says:

    Our youngest also has autism traits, but is quite different to his sister, who has Asperger’s. He is also 4, like your son. I figured I will only seek a diagnosis if it gets to the point he needs extra help at school because, like you, I now know how to ‘work the system’. Currently he has a speech therapist, but that’s it. It is still hard to see, even when you have another, and it can look very different. I think my son does copy things from his older sister, so it is hard to seperate things out.

  3. M.J. says:

    I remember very clearly the time up until my youngest daughter’s diagnosis. We watched her develop and counted every milestone. We kept a careful eye on her behaviors to make sure there weren’t any signs of autism. And for the longest time she showed no signs of autism. But then we started seeing little bits and pieces of what her sisters would do in her and we had the same thought as you – she was copying her older sisters’ behaviors.

    We took a different road than you did but got to the same place. When we first had possible concerns we took her to be evaluated. The specialist we took her to said there wasn’t enough there to make a diagnosis and he couldn’t figure out if she was just imitating her sisters or not. Fast forward six months to a year and it was apparent that she had her own issues that she was dealing with and she was diagnosed by the same specialist.

    The punch line of the story is that we did eventually figure out that she does copy her sisters’ behaviors and stims. It seems like one of her obsessions is to imitate the behaviors and stims of any child with autism that she meets. She doesn’t have that many behaviors of her own so I guess she feels left out or something. If you put her in room with other children with autism she starts copying their behaviors and doing exactly what they are doing. Unfortunately she doesn’t find typical children nearly as much fun to imitate.

    I think that when the second child has a milder form of autism that it becomes more difficult to see. It is only natural to use the older sibling’s issues as a reference point when you look at the younger children.

    I also think it is very interesting just how different autism can look even in siblings, even in identical twins. You have two people who presumably have the same underlying condition and yet the outward signs can look very different.

    Good luck with the second journey with autism. Just keep in mind that it can be very different than the first one. It took us a while to realize that the same approach we used with the twins wasn’t necessarily going to work with their younger sister.

    • Good point M.J, and yes I am open-minded to that fact that we may have to use different approaches for the two children. Still, it does help to have a starting point for what approaches might be helpful. Thanks as ever for commenting.

  4. Autism Mom says:

    “I “see” autism everywhere” – yup! I constantly have to tell myself that everything is not a nail (autism) just because I have a hammer (autism awareness) 🙂

  5. I am forever checking out babies and toddlers! Yes, you are right….. you know exactly what to do! You will be just fine.

  6. Ha! I’ve never had a “normal” kid either – one is tiny, one is ginormous; one is autistic, one has an attachment disorder; one is scarily mature, one is charmingly innocent…
    I never know who’s normal for their age or neurologically or behaviorally…
    i will say my two are a great match, and I hope yours will be too…

  7. Lola says:

    I could have written this. My older ASD son is almost four. I knew early on that something was up with him. His younger brother is 15months. He’s showing some red flags, but not enough to qualify for a dx. It could just be part of the delayed speech that is sometimes exhibited by younger sibs. Aside from those few red flags, he’s 100% different than his brother at this age. He’s better at some things than his brother is. My feeling is that if he does end up with a dx, it will be much milder. That being said, I was POSITIVE that given how his brother presented, I would know for certain by the time he was 12 months whether he would have dx or not, but it appears not to be the case.

  8. A grateful thank to the author of the post. Yes, its quite difficult to diagonise whether the younger child have autism or not when his/her older brother have ASD and also the age difference between the two is few years. Often the copying behavior of the younger ones may be misunderstood and it is considered that he/she has autism too.

    As Autism is a very broad spectrum and often mild autistic child behaves like normal fellow and only some particular tests can prove his autistic behavior.

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