Children with autism often show signs of the disorder before age three, but a new report from the National Institutes of Mental Health finds less than 40 percent of autistic children are being diagnosed before age four and the average age of diagnosis is five.

The report said nine out of 10 children with autism have special health care needs, including social skills training, and speech or language therapy. The report also states more than half of school-aged autistic children use psychotropic medication, which span a variety of medication classes, and may reflect an absence of clear practice guidelines for use of these medications in children.

“A lot of these kids need services when they’re two, not when they’re five. Now, if you get them services when they’re five, can you help them? Absolutely, they’ll improve and they’ll get better, assuming that the services are for them. But if we capture them at two we can really make a difference in their trajectory and engage in the kind of daily living activities that they need to do, whether it be school or functional stuff, adaptable stuff, like getting things that they need to do at home: putting their shoes on, getting their coat, listening to their parents," said Dr. Thomas Frazier at the Cleveland Clinic.

Frazier did not take part in the study, but treats children with autism at the Cleveland Clinic. He said early diagnosis is key. He also said it’s important for parents, especially first-time parents, to pay attention to the warning signs.

“Is the child responding to their name when they’re called? Or is there response really weak? You might have to raise your voice or get in front of them and actually get their attention. When you need their attention, do they actually look at you? Do they look through you or around you or do they look at you briefly and then look away," said Frazier.

For more information on the study, click here.