Autism – Dr. Medhat Abu Shaaban Pediatrician in Dubai

Autism spectrum disorder (ASD) is one of the most common neurodevelopmental conditions affecting children worldwide, yet it remains widely misunderstood by many families and even some healthcare providers. As a pediatrician at myPediaClinic in Dubai, Dr. Medhat Abu Shaaban has worked with countless families navigating the complex journey of autism, from initial concerns through diagnosis and beyond. This comprehensive guide provides parents with essential information about autism in children, including early signs to watch for, how autism is diagnosed, conditions that can be mistaken for autism or occur alongside it, and how families can best support their autistic children to thrive.

Understanding Autism Spectrum Disorder

Autism spectrum disorder is a neurodevelopmental condition that affects how individuals perceive the world, communicate with others, and experience daily life. The term “spectrum” reflects the tremendous diversity among autistic individuals, with presentations ranging from those who need significant support in daily life to those who live independently with minimal challenges.

What Is Autism?

Autism is characterized by differences in two main areas: social communication and restricted/repetitive patterns of behavior, interests, or activities. In social communication, autistic individuals may have difficulty understanding non-verbal cues like facial expressions and body language, may struggle with the back-and-forth of typical conversation, may find it challenging to develop and maintain friendships, and may communicate in ways that differ from neurotypical norms.

Regarding restricted and repetitive patterns, autistic individuals often have intense, focused interests in specific topics, may engage in repetitive movements or speech, may have strong preferences for sameness and difficulty with changes in routine, and may experience sensory input differently, being either more or less sensitive to sounds, lights, textures, or other sensory experiences than neurotypical individuals.

It’s crucial to understand that autism is a neurological difference, not a disease or a defect to be cured. Autistic individuals have unique strengths alongside their challenges, and with appropriate understanding and support, they can lead fulfilling, meaningful lives.

How Common Is Autism?

Autism affects approximately 1 in 36 children according to recent estimates from the Centers for Disease Control and Prevention, though prevalence varies across different studies and populations. The rate of diagnosed autism has increased significantly over the past few decades, likely due to a combination of broadened diagnostic criteria, increased awareness, and improved identification rather than an actual increase in occurrence.

Autism occurs across all racial, ethnic, and socioeconomic groups worldwide, including throughout the UAE and broader Middle East. However, access to diagnosis and services varies significantly, and autism may be underdiagnosed in certain communities due to cultural factors, language barriers, or limited access to specialized evaluations.

At myPediaClinic, Dr. Medhat Abu Shaaban works with families from Dubai’s diverse international community, understanding that perspectives on child development and neurodevelopmental differences vary across cultures. He provides culturally sensitive care that meets each family where they are while ensuring children receive the evaluations and support they need.

Autism Affects Boys More Than Girls, But Girls Are Often Missed

Autism is diagnosed approximately four times more often in males than females. However, growing evidence suggests that autism in females is significantly underdiagnosed. Girls and women with autism may present differently than males, showing more subtle social differences, better masking of symptoms through learned social behaviors, and interests that, while intense, may be more socially typical than the stereotyped autism interests often described.

Healthcare providers, including Dr. Abu Shaaban at myPediaClinic, are increasingly aware of these differences in presentation and work to identify autism in girls and women who might otherwise be missed. A girl who seems “quirky but social” may still be autistic, even if her presentation doesn’t match the classic male-focused descriptions of autism.

Early Signs of Autism in Children

Early identification of autism allows for early intervention, which research consistently shows leads to better outcomes. While autism cannot be definitively diagnosed in very young children, certain early signs may indicate increased risk and warrant closer monitoring or evaluation.

Signs in Infancy (Under 12 Months)

Even in the first year of life, some differences may emerge that could indicate autism risk. Limited eye contact or seemingly looking through people rather than at them, reduced or absent social smiling, limited response to their name being called, reduced babbling or vocal experimentation, and lack of gestures like pointing or waving may all be present. Additionally, some infants who later receive autism diagnoses seem particularly content when alone, not seeking interaction as intensively as many neurotypical infants do.

It’s important to note that many of these signs are subtle and overlap with normal developmental variation. One or two of these signs in isolation doesn’t necessarily indicate autism. However, if parents have concerns about their infant’s social development, discussing these with Dr. Abu Shaaban at myPediaClinic allows for appropriate monitoring and early intervention if needed.

Signs in Toddlers (12-24 Months)

By the toddler period, signs of autism often become more apparent. Language delays are common, with limited or absent spoken words by 16 months and absence of two-word phrases by 24 months being potential indicators. However, some autistic children develop language on schedule, so presence of language doesn’t rule out autism.

Social communication differences may include limited pointing to show interest in objects (not just to request), reduced showing of objects to others to share interest, limited imitation of actions or sounds, reduced interest in other children, and preference for solitary play. Joint attention, the sharing of focus between child and caregiver on an object or event, is often reduced in autistic toddlers.

Restricted and repetitive behaviors may emerge, including unusual ways of playing with toys (like lining them up or spinning wheels repetitively rather than imaginative play), intense focus on specific objects or topics, distress with small changes in routine or environment, and repetitive movements like hand flapping, rocking, or spinning.

Sensory differences may become apparent, with children seeming oversensitive or undersensitive to sounds, textures, lights, tastes, or movement. A child who covers their ears at ordinary sounds, refuses certain food textures, or seems not to notice pain may be showing sensory processing differences common in autism.

Signs in Older Children (2-5 Years)

If autism wasn’t identified earlier, signs often become clearer as children enter preschool age and social demands increase. Difficulty playing with peers, preference for playing alone or parallel to others rather than interactively, and challenges with sharing and turn-taking may emerge or become more pronounced.

Language may develop but with unusual patterns. Some children develop large vocabularies but struggle with conversational use of language, may speak in a formal or adult-like manner, may repeat phrases from movies or books (echolalia), or may have difficulty answering questions appropriately. Understanding of figurative language, jokes, and implied meanings may be limited.

Restricted interests often become more apparent and intense, with children becoming expert in specific topics and wanting to talk about them extensively. Difficulty transitioning between activities, need for sameness in routines, and distress when expectations aren’t met may cause challenges in preschool settings.

Signs in School-Age Children

Some children aren’t identified until they enter school, when academic and social demands reveal differences that weren’t apparent in less structured environments. Children may struggle to make and keep friends, may be bullied or excluded by peers, and may seem naive about social rules that other children pick up intuitively.

Academic performance may be uneven, with areas of strength (often reading, memory, or specific subjects of interest) alongside areas of difficulty. Executive function challenges, including difficulty with organization, planning, and flexible thinking, often affect school performance even when cognitive abilities are strong.

Anxiety and depression are common in school-age autistic children, particularly those who are aware of being different from peers but don’t understand why. Behavioral challenges may emerge as children struggle to cope with overwhelming social and sensory demands. If a child is struggling in these ways, evaluation for autism may be warranted even if it wasn’t suspected earlier.

Regression in Development

Some children with autism show typical development in the first year or two of life, then appear to lose skills they had gained, particularly language and social skills. This regression pattern, which occurs in approximately 20-30% of autism cases, is often particularly alarming for parents who saw their child developing normally.

If your child loses previously acquired skills at any age, prompt evaluation is important. While regression can occur in autism, it can also indicate other medical conditions that require different treatment. Dr. Medhat Abu Shaaban at myPediaClinic can help determine appropriate evaluation steps if regression occurs.

Conditions That Can Be Mistaken for Autism

Several conditions can produce symptoms that overlap with autism, potentially leading to misdiagnosis in either direction, either autism being diagnosed when another condition is responsible, or another condition being blamed for symptoms that are actually due to autism. Accurate diagnosis is essential because appropriate treatment depends on correct identification of the underlying cause.

Hearing Impairment

Children with hearing loss may show several behaviors that can be mistaken for autism. They may not respond when their name is called, may have delayed language development, may appear to ignore others or seem “in their own world,” and may watch faces intently (to read lips) or seem to stare past people. Frustration from communication difficulties can also lead to behavioral challenges that might be attributed to autism.

For this reason, hearing evaluation is an essential part of any autism assessment. At myPediaClinic, Dr. Abu Shaaban ensures that hearing is thoroughly evaluated in children presenting with possible autism signs. Sometimes, what appears to be autism turns out to be hearing impairment; other times, a child has both hearing impairment and autism; and sometimes hearing is normal and the signs are indeed due to autism alone.

If a child has hearing impairment, appropriate intervention including hearing aids, cochlear implants, or communication support typically leads to significant improvement in the concerning behaviors. If behaviors persist despite addressing hearing issues, further autism evaluation may be warranted.

Vision Problems

Vision impairment can also produce behaviors that might be mistaken for autism. Children with poor vision may seem to look through people or not make eye contact (because they can’t see faces clearly), may have unusual gaze patterns, may show limited response to visual social cues, and may seem uninterested in visually-based play.

Additionally, some children engage in behaviors like looking at lights, pressing on their eyes, or flapping hands near their face as a form of self-stimulation related to their visual impairment, which might be confused with the repetitive behaviors seen in autism.

Comprehensive vision evaluation should be part of any autism assessment. While many autistic children have normal vision, confirming this prevents misattribution of behaviors to autism when vision problems are actually responsible.

Language Disorders

Developmental language disorder (DLD), formerly called specific language impairment, affects a child’s ability to learn and use language without affecting overall cognitive abilities. Children with DLD may struggle with spoken language, have difficulty with conversational skills, and become frustrated by communication challenges, all of which can appear similar to autism.

The key distinction is that children with DLD typically show typical social motivation and non-verbal communication. They want to interact with others and understand social cues; they just struggle with the language aspects of communication. In contrast, autistic children often show differences in social motivation and non-verbal communication as well as any language challenges.

Sometimes the distinction is clear, but other times it’s quite subtle. A child may have both autism and a co-occurring language disorder, further complicating the picture. Careful evaluation by experienced professionals is necessary to untangle these possibilities.

Intellectual Disability

Intellectual disability (ID) affects learning and adaptive functioning across all areas. Some children with ID show behaviors that overlap with autism, including communication delays, social difficulties, and repetitive behaviors. Autism and intellectual disability can and do co-occur, with approximately 30-40% of autistic individuals also having intellectual disability.

However, it’s important not to assume that developmental delays necessarily indicate intellectual disability or to attribute all differences to ID when autism is also present. Autistic children with co-occurring intellectual disability benefit from interventions targeting both conditions, and their autism-specific needs shouldn’t be overlooked because of assumptions that differences are “just” due to cognitive limitations.

ADHD (Attention Deficit Hyperactivity Disorder)

ADHD and autism share several features and frequently co-occur. Children with ADHD may have difficulty with social relationships due to impulsivity and poor attention, may seem not to listen when spoken to, may have trouble with transitions and flexibility, and may be intensely focused on activities of interest while struggling to attend to less interesting tasks.

Distinguishing ADHD from autism can be challenging, and many children have both conditions. Generally, children with ADHD alone show typical social motivation and understanding of social cues but are prevented from successful social interaction by impulsivity, inattention, or hyperactivity. Autistic children show more fundamental differences in social communication and understanding.

When both conditions are present, treatment needs to address both. ADHD-focused interventions alone won’t address autism-related challenges, and autism-focused interventions won’t adequately address ADHD symptoms.

Anxiety Disorders

Anxiety can produce behaviors that mimic some aspects of autism. Anxious children may avoid eye contact, may appear withdrawn or socially avoidant, may engage in repetitive behaviors for comfort, and may strongly prefer routine and predictability. Selective mutism, where children speak normally in some settings but are unable to speak in others due to anxiety, can particularly be confused with autism.

Many autistic individuals also experience significant anxiety, so the presence of anxiety doesn’t rule out autism. Understanding whether anxiety is the primary cause of symptoms or is co-occurring with autism guides treatment appropriately.

Social Communication Disorder

Social communication disorder (SCD) is a diagnosis introduced in 2013 that describes difficulties with the social use of verbal and non-verbal communication without the restricted/repetitive behaviors required for an autism diagnosis. Some individuals who might previously have been diagnosed with autism or Asperger syndrome now receive SCD diagnoses if they don’t have significant restricted/repetitive behaviors.

The distinction between autism and SCD can be subtle and somewhat controversial among professionals. Children with either diagnosis may benefit from similar social communication interventions, though those with autism may also need support related to sensory differences and flexibility.

The Autism Diagnosis Process

Obtaining an accurate autism diagnosis involves comprehensive evaluation by experienced professionals. Understanding the process helps families know what to expect and how to prepare.

When to Seek Evaluation

Parents who have concerns about their child’s social development, communication, behavior, or play should discuss these with their pediatrician. At myPediaClinic, Dr. Medhat Abu Shaaban takes parental concerns seriously and conducts developmental screening as part of regular well-child visits. If screening or parental report suggests possible autism, referral for comprehensive evaluation is made.

It’s always better to evaluate and find nothing concerning than to wait and miss an opportunity for early intervention. Parents know their children best, and if something doesn’t seem right, that intuition deserves professional attention.

Components of Comprehensive Autism Evaluation

A thorough autism evaluation includes multiple components. Developmental history involves detailed information gathering about the child’s development from birth to present, including pregnancy and birth history, developmental milestones, medical history, and family history. Parents are often asked to complete questionnaires and bring any records from schools, therapists, or previous evaluations.

Behavioral observation is a critical component. Evaluators observe the child’s social interaction, communication, play, and behavior either in structured assessment settings, naturalistic observation, or both. Standardized tools like the Autism Diagnostic Observation Schedule (ADOS-2) provide systematic observation opportunities.

Cognitive and developmental testing assesses the child’s overall cognitive abilities, language skills, and adaptive functioning. This helps characterize the child’s strengths and weaknesses and identify any co-occurring intellectual disability or learning differences.

Medical evaluation rules out medical conditions that might explain symptoms or co-occur with autism. This includes hearing and vision assessment, genetic testing in many cases, and any other medical workup indicated by the child’s specific presentation.

The evaluation may be conducted by various professionals including developmental pediatricians, child psychologists, child psychiatrists, or multidisciplinary teams. The specific evaluators and tools used vary, but the goal is always a comprehensive understanding of the child’s functioning that supports accurate diagnosis.

What Happens After Diagnosis

Receiving an autism diagnosis can trigger many emotions for families, from relief at finally having an explanation to grief about what the diagnosis might mean for their child’s future. Both reactions, and everything in between, are completely normal.

The diagnostic report should provide not just the diagnosis but also information about the child’s specific profile of strengths and challenges, and recommendations for intervention and support. Dr. Abu Shaaban at myPediaClinic helps families understand the diagnosis and connect with appropriate services and supports in the Dubai community.

An autism diagnosis is not a prediction of what a child will or won’t achieve. It’s a starting point for understanding how to support a child’s development and help them reach their potential, whatever that may be.

Supporting Autistic Children

With appropriate support, autistic children can thrive. Understanding effective approaches helps families and caregivers provide the best possible environment for autistic children’s development.

Early Intervention

Research consistently demonstrates that early, intensive intervention leads to better outcomes for autistic children. The brain is most plastic in the early years, and interventions during this period can have particularly significant effects on development.

Early intervention may include various therapies and approaches. Applied Behavior Analysis (ABA) uses behavioral principles to teach skills and reduce challenging behaviors, and is one of the most extensively researched interventions for autism. Speech and language therapy addresses communication challenges, whether a child needs help developing spoken language, alternative communication methods, or social communication skills. Occupational therapy helps with sensory processing, motor skills, and daily living skills. Play-based interventions help develop social and communication skills through child-led, relationship-focused play.

The specific interventions appropriate for a child depend on their individual profile, and Dr. Abu Shaaban at myPediaClinic works with families to identify and connect with appropriate services.

Educational Support

Autistic children have the right to appropriate education, though the specific setting and supports needed vary tremendously across individuals. Some autistic children thrive in mainstream classrooms with appropriate accommodations. Others benefit from specialized classrooms or schools. Many need some combination of mainstream and specialized support.

Individualized education plans (IEPs) or equivalent documentation ensure that schools provide appropriate accommodations and services. Parents are essential advocates for their children in educational settings, and understanding your child’s rights and needs helps you work effectively with schools.

Managing Sensory Needs

Many autistic individuals experience sensory input differently, and unaddressed sensory needs can lead to significant distress and behavioral challenges. Identifying each child’s specific sensory sensitivities and preferences is important for creating supportive environments.

Accommodations might include reducing overwhelming sensory input (dimming lights, providing quiet spaces, allowing headphones), providing preferred sensory input (weighted blankets, movement breaks, fidget tools), preparing children for unavoidable sensory challenges, and gradually desensitizing children to difficult sensory experiences when appropriate.

Occupational therapists specializing in sensory processing can provide detailed sensory profiles and recommendations for supporting individual children’s sensory needs.

Supporting Social Development

While autistic individuals may communicate and relate differently than neurotypical people, most desire connection with others. Supporting social development involves teaching social skills explicitly (what neurotypical children often learn implicitly), providing structured opportunities for social interaction with accepting peers, helping children understand and navigate social situations, and respecting that social preferences may differ from neurotypical norms.

Social skills groups, where children practice social interaction with guidance and feedback, can be helpful. Pairing autistic children with understanding neurotypical peers through buddy programs or structured activities can also support social development.

Managing Challenging Behaviors

Behavioral challenges in autistic children often stem from communication difficulties (behavior as a way of expressing needs when words are difficult), sensory overload, difficulty with transitions or unmet expectations, or co-occurring conditions like anxiety or ADHD. Understanding the function of challenging behavior guides effective intervention.

Strategies focus on preventing problems by addressing underlying causes, teaching replacement behaviors that meet the same needs as the challenging behavior, and providing appropriate consequences that don’t inadvertently reinforce problem behavior. Punishment-based approaches are generally ineffective and can cause harm.

If challenging behaviors are significant or safety is a concern, consultation with behavioral specialists is warranted. Dr. Abu Shaaban at myPediaClinic can help families access appropriate behavioral support.

Supporting Mental Health

Autistic individuals experience high rates of anxiety, depression, and other mental health conditions. These may be inherent to autism, may result from the challenges of living in a world not designed for neurodivergent minds, or both. Supporting mental health is an essential component of supporting autistic children.

Modified cognitive behavioral therapy and other mental health interventions can be effective for autistic individuals when adapted to account for different communication and processing styles. Addressing underlying stressors, including sensory overload, social difficulties, and lack of accommodation, is also essential.

Building on Strengths

Autistic individuals often have significant strengths that should be recognized and nurtured, not overshadowed by focus on deficits. Many autistic individuals show exceptional memory, attention to detail, pattern recognition, or deep knowledge in areas of interest. These strengths can form the basis for academic success, career paths, and sources of joy and pride.

Nurturing special interests, even when they seem unusual, provides autistic children with motivation for learning, topics for social connection with like-minded peers, potential career directions, and sources of regulation and comfort. Rather than trying to redirect intense interests toward “more appropriate” topics, wise support helps children build on their natural enthusiasms.

The Importance of Acceptance

Perhaps the most important factor in autistic children’s well-being is acceptance. Being accepted as they are, without pressure to be someone they’re not, allows autistic children to develop positive self-identity and thrive.

Understanding Neurodiversity

The neurodiversity paradigm views autism and other neurological differences as natural variations in human neurology, not disorders to be cured. From this perspective, the goal isn’t to make autistic individuals appear “normal” but to support them in living fulfilling lives as their authentic selves while providing accommodations and interventions that address genuine disabilities.

This doesn’t mean ignoring real challenges or declining helpful interventions. Rather, it means approaching autism with respect for the autistic individual’s perspective and preferences, supporting development while accepting the person as they are.

Learning from Autistic Voices

Autistic adults are increasingly sharing their experiences and perspectives, providing invaluable insight into what it’s actually like to be autistic and what kinds of support are truly helpful. Parents of autistic children are encouraged to seek out and listen to autistic voices, including memoirs, blogs, advocacy organizations led by autistic individuals, and personal connections with autistic adults when possible.

The perspectives of autistic adults can help parents understand their children’s experiences, avoid approaches that autistic individuals report as harmful, and envision positive futures for their autistic children.

Creating Accepting Environments

Children thrive when they’re accepted not just by their families but by their broader communities. Advocating for acceptance and inclusion in schools, extracurricular activities, religious communities, and other settings benefits individual children and contributes to a more accepting society for all neurodivergent individuals.

Educating others about autism helps reduce stigma and misunderstanding. When peers, teachers, and community members understand autism, they’re better able to accept and support autistic children rather than judging or excluding them.

Frequently Asked Questions

Partner with myPediaClinic for Your Child’s Care

Whether you’re concerned about your child’s development and wondering if autism might be a factor, navigating the diagnostic process, or seeking ongoing support for your autistic child, myPediaClinic in Dubai is here to help. Dr. Medhat Abu Shaaban provides compassionate, knowledgeable care for autistic children and their families, from developmental screening through ongoing pediatric care.

We understand that every autistic child is unique, with their own profile of strengths and challenges, their own personality, and their own potential. Our goal is to support each child in reaching that potential while helping families access the resources and support they need.

If you have concerns about your child’s development, don’t wait. Early identification and intervention make a difference. And if your child has already been diagnosed with autism, we’re here to partner with you in supporting their health and development throughout childhood.

Take the first step toward understanding and supporting your child. Contact myPediaClinic today to schedule an appointment with Dr. Medhat Abu Shaaban. Together, we can help your child thrive.