Understanding Early Signs of Autism

As a parent, I believe monitoring your child’s developmental milestones is a crucial aspect of raising a child. By observing these milestones, caregivers can identify delays — in areas such as motor skills, language, and social interactions — allowing timely intervention and support. 

Studies indicate that receiving an autism diagnosis and obtaining intervention services early can lead to significant improvements in symptoms and skills. (Robins et al., 2009) Children under the age of two frequently do not receive an autism diagnosis from their pediatrician, as clinicians may prefer to allow additional time for the child’s development. 

This give-it-time approach acknowledges that children can progress at varying rates, and a diagnosis may be more accurately determined as the child continues to grow and develop. (Miller, 2024) In addition, some children who initially show typical development by reaching all milestones may exhibit regression around the age of two. Many children have been misdiagnosed or remain undiagnosed because the signs of autism are not well recognized. 

There are many signs and symptoms that may indicate your child has a developmental delay. However, It is important to remember that not all children with ASD will exhibit every symptom listed in this article.

Signs and symptoms that may indicate a delay in development

2-6 months 

• Slow to smile or laugh 
• Resists cuddling or holding 
• Avoids eye contact 
• Shows little interest in others
• Doesn’t orient toward people speaking near them
• Difficult to calm when upset

8-12 months 

• Limited expressive communication, with little to no babbling 
• Does not show a range of facial expressions 
• Doesn’t consistently react to sounds
• Doesn’t respond to their name or orient towards people speaking to them
• Minimal interest in simple interactive games such as peek-a-boo and pat-a-cake
• Doesn’t orient toward objects when another person points it out
• Prefers not to be touched or cuddled
• Limited or no communicative gestures such as pointing, waving, or reaching toward caregivers to indicate they want to be picked up or held

12-16 months 

• Limited response to bids for their attention, such as calling to them “come here” with arms out
• Does not follow simple instructions
• Little to no imitation of others during both play and daily activities
• Does not engage in pretend play
• More interested in objects than people
• Repeats unusual movements with objects, such as spinning or lining up items
• Gets excessively upset over changes to routine and activities
• Unusual reactions to sounds and textures

16-24 months 

• Limited expressive communication may use single-word phrases such as “mama” and “dada”
• If communication is present, does not communicate to share or show interest with others and instead labels items in their environment
• Limiting speech to repeating words or phrases
• Unable to follow instructions related to their daily routine (e.g. get your shoes)
• Becomes upset frequently and unable to soothe, longer and more intense tantrums
• Carrying specific objects for long periods of time
• Forming specific routines with toys and being unable to play in different manners
• Playing with parts of toys instead of the whole toy set

Signs of autism that can occur at any age: 

• Loss of skills 
• Fails to respond to name 
• Lack of eye contact 
• Delayed speech and language development 
• Repetitive behaviors (finger movements, arm flapping) 
• Repetitive sounds or words 
• Sensory issues (loud sounds, food textures) 
• Rigidity in their daily routines 
• Lack of social interactions 
• Lack of empathy toward others 
• Sensory sensitivities (such as textures, lights, colors, sounds and smells) 
• Limited or restrictive interests 

If you’re worried about your child’s development: 

• Complete the M-CHAT-R screening: The Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) is an easy online questionnaire that can help assess whether your child might need a professional evaluation for autism. It only takes a few minutes to fill out and you are able to complete this form on your own. Follow this link for free access to the M-CHAT-R Screening (Robins et al., 2009). If the results suggest a high likelihood of autism, consult your child’s doctor. 

Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R™) | Autism Speaks

• Bring your concerns to your pediatrician: If you have any concerns regarding your child’s developmental progress, please do not hesitate to discuss them with your pediatrician. Should you have any doubts or require further clarification, consider seeking a second opinion. 

 

References

Babycenter.com Signs of autism in babies and toddlers | BabyCenter

Robins , D., Fein, D., & Barton , M. (2009). Modified checklist for autism in toddlers, revised (M-chat-RTM). Autism Speaks. https://www.autismspeaks.org/screen-your-child 

U.S. Department of Health and Human Services. (2021, April 19). Early intervention for autism. Eunice Kennedy Shriver National Institute of Child Health and Human Development. https://www.nichd.nih.gov/health/topics/autism/conditioninfo/treatments/earlyintervention#f1 

Miller, C. (2024, February 19). Why autism diagnoses are often delayed. Child Mind Institute. https://childmind.org/article/why-autism-diagnoses-are-often-delayed

 

Desare Fleming specializes in early childhood intervention. She began working in ABA at the advice of a friend. The more she learned about the signs of autism, the more she realized a relative showed signs at an early age but never received a diagnosis or any form of intervention. With over nine years of experiences as an RBT, she plans to pursue becoming a BCBA to help more children and families accomplish their goals. Desare has a master’s degree in Special Education with a concentration in Applied Behavior Analysis from Arizona State University.