Skip Ribbon Commands
Skip to main content
Health Issues
Text Size

What are the Early Signs of Autism?

What are the Early Signs of Autism? What are the Early Signs of Autism?

​Many children with autism spectrum disorder (ASD) show developmental differences when they are babies—especially in their social and language skills. Because they usually sit, crawl, and walk on time, less obvious differences in the development of body gestures, pretend play, and social language often go unnoticed.

In addition to language delays and behavioral differences, families may notice differences in the way their child interacts with peers.

​Subtle differences related to autism may be present before a child's first birthday and typically show up before 24 months.

Recognizing the Signs of Autism

Here are some examples of social, communication, and behavioral differences in children with autism.

Keep in mind: one child with ASD will not have exactly the same symptoms as another child with ASD. The number and severity of symptoms can vary a lot!

Social Differences in Children with Autism

  • Doesn't keep eye contact or makes very little eye contact

  • Doesn't respond to a parent's smile or other facial expressions

  • Doesn't look at objects or events a parent is looking at or pointing to

  • Doesn't point to objects or events to get a parent to look at them

  • Doesn't bring objects of personal interest to show to a parent

  • Doesn't often have appropriate facial expressions

  • Unable to perceive what others might be thinking or feeling by looking at their facial expressions

  • Doesn't show concern (empathy) for others

  • Unable to make friends or is uninterested in making friends

Communication Differences in Children with Autism

  • Doesn't point at things to show needs or share things with others

  • Doesn't say single words by 16 months of age

  • Repeats exactly what others say without understanding the meaning (often called parroting or echoing)

  • Doesn't respond to name being called but does respond to other sounds (like a car horn or a cat's meow)

  • Refers to self as "you" and others as "I," and may mix up pronouns

  • Often doesn't seem to want to communicate

  • Doesn't start or can't continue a conversation

  • Doesn't use toys or other objects to represent people or real life in pretend play

  • May have a good rote memory, especially for numbers, letters, songs, TV jingles, or a specific topic

  • May lose language or other social milestones, usually between the ages of 15 and 24 months (often called regression)

Behavioral Differences (Repetitive & Obsessive Behaviors) in Children with Autism

  • Rocks, spins, sways, twirls fingers, walks on toes for a long time, or flaps hands (called "stereotypic behavior")

  • Likes routines, order, and rituals; has difficulty with change or transition from one activity to another

  • Obsessed with a few or unusual activities, doing them repeatedly during the day

  • Plays with parts of toys instead of the whole toy (e.g., spinning the wheels of a toy truck)

  • Doesn't seem to feel pain

  • May be very sensitive or not sensitive at all to smells, sounds, lights, textures, and touch

  • Unusual use of vision or gaze—looks at objects from unusual angles

Parents: Trust Your Instincts

If you have concerns about how your child plays, learns, speaks, acts, or moves, talk with your pediatrician. Before you go to the appointment, complete a free developmental milestone checklist, and read these tips about "How to Talk with the Doctor."

Remember, you know your child best and your concerns are important. Together, you and your pediatrician will find the best way to help your child. If you're uneasy about the doctor's advice, seek a second opinion.

Don't wait. Acting early can make a big difference in your child's development!


How to Distinguish a Child with Autism from Other Typically-Developing Children:

Here are some examples that may help a parent tell the difference between normal, age-appropriate behavior and early signs of ASD. Also see When Not to Worry About Autism.

At 12 Months

  • A child with typical development will turn his head when he hears his name.

  • A child with ASD might not turn to look, even after his name is repeated several times, but will respond to other sounds.

At 18 Months

  • A child with delayed speech skills will point, gesture, or use facial expressions to make up for her lack of talking.

  • A child with ASD might make no attempt to compensate for delayed speech or might limit speech to echoing what is heard on TV or what she just heard.

At 24 Months

  • A child with typical development brings a picture to show his mother and shares his joy from it with her.

  • A child with ASD might bring her a bottle of bubbles to open, but he does not look at his mom's face when she does or share in the pleasure of playing together.

Additional Information:

Last Updated
American Academy of Pediatrics (Copyright © 2019)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
Follow Us