Early Signs of Autism & Questions to Ask Your Pediatrician


October 25, 2022

The symptoms of autism spectrum disorder (ASD) usually emerge over time. But as a parent, you might notice things earlier that give you pause. You might wonder if your child’s behavior is typical compared with other kids her age. Parental instinct can be strong. It can also be correct. And by knowing what to watch for, you’ll be prepared to seek help from the pros. 

Disclaimer: The following article is intended as information only and should not be used to diagnose or treat any medical condition, including but not limited to autism spectrum disorder (ASD). If you have questions or concerns about medical conditions or your/your child’s health, talk to your doctor.

Signs of Autism

Every child with autism is different, just as every child without autism is different. But there are common traits that many kids with autism share. Consider these traits if you have early suspicions about your child.

Social Engagement

For many parents, social interactions — or lack thereof — are one of the first signs of autism that they pick up on.

Even young babies typically make eye contact with other people. But children with autism may avoid it. Or, when they do make eye contact, they quickly break it. This may be apparent to you as early as 6 months of age.

By 6 months, children are often quite expressive. They break into big, happy smiles or laugh when something delights them. Babies also make faces that show they’re sad or angry. If you’re not seeing such expressions by 6 to 9 months, it may be something to discuss with your child’s doctor.

Snuggling is another area where a child with autism may show differences from his neurotypical peers. Most children enjoy cuddling up with caregivers and being held at times throughout the day. Children with ASD may resist these things unless they are sick or hurt.

Verbal Skills

Language is another key area to pay attention to.

Little ones with autism may not engage in baby babble. Typically, that skill emerges by 12 months. Rather than babbling, kids with autism may make repetitive, monotone sounds. Humming is a prime example.

At 16 months, a toddler with ASD may not speak or may say only a handful of words. The difference may be even more pronounced by 24 months. At that point, a child should be putting together phrases of two words or more.

Echolalia is an autism sign that may develop as kids are working on language skills. The term refers to the repetition of words or phrases. Kids might latch onto lines from a favorite show or something a parent says. The words may also be used out of context.

Finally, at any age, losing speech skills is a red flag.

Nonverbal Communication

Just as kids with ASD may have trouble with verbal communication, nonverbal communication can be a challenge, too.

Babies and toddlers typically use a variety of gestures to communicate with others. That can include waving to people, pointing at items and reaching for things.

Waving should be happening by 12 months. Pointing, by 18 months. The absence of these behaviors could indicate autism.

Along the same lines, most children approach their caregivers with precious treasures to show off. Or, they grab caregivers by the hand to drag them to items of interest. Toddlers with autism may not do either of these things during their second year of life.

Responses to Others

When speaking to youngsters with autism, it can seem that they don’t even hear you. When you call their name, you get no response. In neurotypical children, name recognition is a skill that usually emerges by 9 months.

Also, your facial expressions may not mean much to kids with ASD. They can’t seem to understand whether your face shows that you’re happy, sad or mad.


Children with ASD may engage in unusual activities with their bodies. They may do these activities over and over.

Babies might twirl their hands. Older children may spin in circles. Rocking back and forth and flapping hands are other versions of this behavior.

Collectively, these behaviors are referred to as stimming. Children’s stims are often related to their sensory needs. Stimming can serve as a form of self-soothing.

Interests and Activities

Kids on the autism spectrum may have different interests than their peers, and they may engage in unusual forms of play.

Some children with ASD prefer to explore items from unusual points of view. For example, they may hold toys right up to their eyes or gaze at them from the side.

It’s common for kids with autism to have a narrow set of interests. They may become fixated on certain items or topics. Some children insist on carrying particular items with them everywhere.

Rather than engaging in imaginative play, youngsters with autism may spend time organizing their toys. Lining items up into neat rows is a particular favorite.

Sensory Input

Children with ASD experience the world differently than their peers. That can play out in a variety of ways.

Some kids experience heightened sensations. Loud noises and strange smells may bother them more than they do other children. The feel of certain clothing could be especially triggering.

For other kids with autism, sensations are reduced. They don’t seem at all affected by sounds, lights or smells.

A Word of Caution

Perhaps you recognize many of the above characteristics in your child. Maybe that means she’s on the spectrum – or maybe it doesn’t. Diagnosing very young children can be hard because kids are still learning how to function at this age.

The only way to know for sure whether your child has autism is to seek a professional diagnosis. An expert can perform an evaluation and let you know what’s going on.

Autism may be the cause of your child’s symptoms. Or, there might be a different reason for the things you’ve noticed. It’s even possible that it’s nothing at all — just some regular kid behaviors that your child will eventually outgrow.

If you spot signs of autism, it’s good to get it checked out. But until you receive an official diagnosis, you won’t know for sure.

Next Steps

If you’re concerned about the signs you’re seeing in your kid, start by setting up an appointment with your child’s pediatrician. 

After an initial chat about symptoms, your child’s doctor might refer you to a specialist. That person or team may perform a full evaluation to determine a diagnosis. Specialists in this field can include neurologists and psychiatrists.

If appropriate, your child may be referred for therapies and services. Your state’s early intervention program is usually the best option for kids 3 and under. Older children may be eligible for services through your local school district.

Questions to Ask in the Process

Starting the process of autism evaluation may feel overwhelming at first. Knowing what to ask your doctors can restore your sense of control.

Come into a pediatrician appointment with specific examples of your child’s behavior or developmental delays. Then start with these questions:

  • Can you please run a developmental screening on my child?
  • Who do we see next for an evaluation?

Before a diagnosis, ask the autism specialist who evaluates your child:

  • What other reasons could there be for these symptoms?
  • Why is getting a diagnosis important?
  • When can we expect results?
  • Are there any therapies we can start while waiting for a diagnosis?

After a diagnosis, ask:

  • What does this mean for my child?
  • What therapies do you recommend for my child?
  • Do you recommend any resources for learning more or getting support?

There’s no single path for someone with autism, just as there’s no single path for any child. All you can do as a parent is arm yourself with information and talk to people who can help you develop a plan. Because the sooner you can identify autism, the sooner you can get support and specific therapies to improve your child’s quality of life and chances for success.