Early Signs of Autism in Young Children: What to Watch For and What to Do

What autism is, and why signs show early

The Centers for Disease Control and Prevention (CDC) describes autism as a developmental disability caused by differences in the brain. Autistic people often have differences in social communication and interaction, and restricted or repetitive behaviors or interests.

The National Institute of Mental Health (NIMH) explains that autism is called a developmental condition because signs generally appear in the first two years of life, even though it can be diagnosed at any age. Every child develops at their own pace, and no single sign means a child is autistic. CDC notes that children who are not autistic may show some of these signs, and autistic children may not show all or any of the examples listed.

Social and communication signs by age

CDC gives examples of social communication and interaction signs linked to autism, organized by the age when most children have reached the skill. These include a child who:

• Does not respond to their name by 9 months
• Does not show facial expressions such as happy, sad, angry and surprised by 9 months
• Does not play simple back-and-forth games like pat-a-cake by 12 months
• Uses few or no gestures, such as waving goodbye, by 12 months
• Does not share interests with you, such as showing you a favorite object, by 15 months
• Does not point to show you something interesting by 18 months
• Does not notice when others are hurt or upset by 2 years
• Does not notice other children and join them in play by 3 years

Behavior, play and sensory signs

CDC also describes restricted or repetitive behaviors and interests. In young children these can look like lining up toys and getting upset when the order changes, playing with toys the same way every time, focusing on parts of objects such as wheels, repeating words or phrases, getting upset by small changes, needing certain routines, flapping hands, rocking or spinning, and unusual reactions to how things sound, smell, taste, look or feel.

NIMH adds that autistic children may make little or inconsistent eye contact and may be slow to respond to their name or to other bids for attention. CDC also lists delayed language or movement skills and unusual eating and sleeping habits among other traits that often come with autism.

CDC's milestone guidance is clear on one more point: if your child has lost skills they once had, act early and talk with your child's doctor.

Why early identification matters

CDC says autism can sometimes be detected at 18 months or younger, and by age 2 a diagnosis by an experienced professional can be considered reliable. Even so, many children are not diagnosed until much later, and CDC notes that this delay can mean they miss early help.

NIMH explains that the earlier autism is diagnosed, the sooner services and supports can begin, and that early detection helps families choose the services, programs and therapies most likely to help. CDC describes early intervention as having a significant impact on a child's ability to learn new skills. NIMH also notes that accurate early detection sheds light on a child's unique strengths and challenges.

Talking with your pediatrician

You know your child best. CDC encourages parents to keep track of milestones and to talk with the doctor or nurse about any concerns. The American Academy of Pediatrics recommends developmental screening for all children at 9, 18 and 30 months, and autism screening at 18 and 24 months, or whenever a parent or provider has a concern.

A screening is a short questionnaire or check that compares your child with other children the same age. It does not give a diagnosis. If it shows an area of concern, the doctor may refer your child for a formal evaluation by a specialist. If your doctor does not offer screening, CDC says you can ask for it.

1. 1Write down what you noticeNote specific examples and the age they started, including any skills your child has lost.
2. 2Raise it at the visitTell the doctor you are concerned about development and ask about developmental and autism screening.
3. 3Share family historyLet the doctor know if relatives have autism, ADHD, learning disorders or intellectual disability.
4. 4Ask about next stepsIf you or the doctor are still concerned, ask for a referral to a specialist and contact early intervention.

Early intervention, and how we can help

CDC explains that every state has a publicly funded early intervention program for babies and young children with developmental delays and disabilities, with services free or at reduced cost for children who are eligible. If your child is under 3, you can call your state's program yourself and ask for an evaluation; a doctor's referral is not necessary. If your child is 3 or older, CDC suggests calling your local public elementary school and asking for an evaluation for preschool special education services.

For families with older children who wonder about autism, our free autism signs checklist may help you decide whether to talk to someone. It is an informal checklist only: it is not a screening test, it has not been validated and it cannot diagnose.

Locascio Wellness offers a child autism evaluation by secure video, only for children physically located in Pennsylvania, West Virginia or Arizona during appointments, with a parent or guardian taking part. We carry out autism evaluations for children from age 5; tell us your child's age on the short evaluation request form. Evaluations are private-pay with a sliding scale, and the cost is given in writing first. You can also book a free 15-minute consultation.

Therapists on our team offer child therapy for children from age 7 and family therapy for parents and families adjusting to a new understanding of their child. Therapy clients must be physically located in Pennsylvania, West Virginia, Arizona, Colorado or Florida during sessions, and not every service is offered in every state. If you are in crisis or thinking about harming yourself, call or text 988, or call 911. Locascio Wellness does not provide emergency services.