Early Signs in Infants and Toddlers

Early signs of autism can often be detected in infants as young as 6-18 months. For example, if a baby fixates on objects or does not respond to people, he or she may be exhibiting early signs of an autism spectrum disorder.

Older babies and toddlers may fail to respond to their names, avoid eye contact, lack joint attention (sharing an experience of observing an object or event by gazing or pointing), or engage in repetitive movements such as rocking or arm flapping. They may play with toys in unusual ways, like lining them up or focusing on parts of toys rather than the whole. Parents who notice these signs, or are concerned their children are not meeting developmental milestones, should contact their pediatricians and request a developmental screening. The American Academy of Pediatrics recommends routine screening of all infants for autism as part of 18-month and 24-month well-baby examinations.

Early diagnosis and early intervention are critical. Studies show that about half of children with autism who are in an evidence-based early intervention program from age 3-5 can gain enough skills to be mainstreamed for kindergarten. There are now evidence based interventions for babies as young as 12 months old, and studies are underway to design treatments for 9 month old babies at risk for autism.

If you are concerned about your child reaching various developmental milestones, or if you are not sure if your child’s behaviors are autistic, these resources can help. The Center for Disease Control (CDC) and Autism Navigator both have tools to help you figure out whether your child’s behaviors are within typical development. If you are concerned, it’s best to speak with a physician or specialist.

Learn more about the early warning signs of autism including milestones for development up to age 5 and what to do if you are concerned.

Center for Disease Control: Learn the Signs, Act Early Campaign

The Autism Science Foundation is a partner in the CDC’s “Learn the Signs, Act Early Campaign”. The following early indicators of autism were developed by the experts in this program.

Get a PDF of these early warning signs. Also, read more about the importance of early diagnosis.

If your child is two months old, you should consider talking to your doctor if your child exhibits the following behavior:

  • Doesn’t respond to loud sounds
  • Doesn’t watch things as they move
  • Doesn’t smile at people
  • Doesn’t bring his/her hands to mouth
  • Can’t hold his/her head up when pushing up on tummy

If your child is four months old, you should consider talking to your doctor if your child exhibits the following behavior:

  • Doesn’t watch things as they move
  • Doesn’t smile at people
  • Can’t hold his/her head steady
  • Doesn’t make sounds or coo
  • Doesn’t bring things to his/her mouth
  • Doesn’t push down with legs when feet are placed on a hard surface
  • Has trouble moving one or both eyes in all directions

If your child is six months old, you should consider talking to your doctor if your child exhibits the following behavior:

  • Doesn’t reach for things
  • Shows no affection for caregivers
  • Doesn’t respond to sounds around her/him
  • Doesn’t make vowel sounds (eh, ah, oh)
  • Doesn’t laugh or squeal
  • Seems unusually stiff or unusually floppy

If your child is nine months old,  you should consider talking to your doctor if your child exhibits the following behavior:

  • Doesn’t look where you point
  • Doesn’t respond to his/her own name
  • Doesn’t babble (mama, dada)
  • Doesn’t play back and forth type games
  • Doesn’t seem to recognize familiar people
  • Doesn’t sit with help
  • Doesn’t bear weight on legs with support
  • Doesn’t transfer toys from one hand to the other

If your child is one year old,  you should consider talking to your doctor if your child exhibits the following behavior:

  • Doesn’t point to things
  • Doesn’t learn gestures like waving bye bye, or shaking head yes or no
  • Doesn’t search for things that she sees you hide
  • Doesn’t say single words like mama, dada, up, bye, this, that, juice
  • Doesn’t crawl
  • Loses skills he/she once had
  • Can’t stand when supported

If your child is 18 months old, you should consider talking to your doctor if your child exhibits the following behavior:

  • Doesn’t point to show things to others
  • Doesn’t know what familiar things (cup, spoon, phone) are used for
  • Doesn’t imitate or copy others
  • Doesn’t have at least six words
  • Doesn’t gain new words
  • Doesn’t notice or react when a caregiver leaves or returns
  • Doesn’t walk
  • Loses skills he/she once had

If your child is 2 years, you should consider talking to your doctor if your child exhibits the following behavior:

  • Doesn’t use 2-word phrases (mama up, want milk)
  • Doesn’t know what familiar things (cup, spoon, phone) are used for
  • Doesn’t imitate actions and words
  • Doesn’t follow simple instructions
  • Doesn’t walk steadily
  • Loses skills he/she once had

If your child is 3 years old, you should consider talking to your doctor if your child exhibits the following behavior:

  • Has unclear speech or drools a lot
  • Doesn’t speak in sentences
  • Doesn’t follow simple instructions
  • Can’t work simple toys (simple puzzles, turning knobs/handles, peg board)
  • Shows little interest in toys
  • Doesn’t want to play with other children
  • Doesn’t play make believe or pretend
  • Doesn’t make eye contact
  • Falls down often or has trouble on stairs
  • Loses skills he/she once had

If your child is 4 years old, you should consider talking to your doctor if your child exhibits the following behavior:

  • Ignores other children
  • Doesn’t respond to people outside the family
  • Shows no interest in make believe or pretending games
  • Can’t retell a favorite story
  • Doesn’t follow 3-step directions
  • Doesn’t use “you” and “me” correctly
  • Doesn’t understand “same” and “different”
  • Speaks unclearly
  • Doesn’t scribble or has trouble scribbling with a crayon
  • Loses skills he/she once had

If your child is 5 years old, you should consider talking to your doctor if your child exhibits the following behavior:

  • Doesn’t show a wide range of emotions
  • Shows behavioral extremes (unusually aggressive, fearful, sad, shy)
  • Is unusually withdrawn and not active in social situations
  • Is easily distracted and has trouble focusing on an activity for more than five minutes
  • Doesn’t respond to people or responds only superficially
  • Can’t tell the difference between real and make believe
  • Doesn’t participate in a wide variety of games and activities
  • Can’t give his/her first and last name
  • Doesn’t use plurals, pronouns or past tense properly
  • Doesn’t talk about daily activities
  • Doesn’t draw pictures
  • Loses skills he/she once had
  • Can’t do daily activities (brush teeth, wash and dry hands, or get undressed) without help

If you of autism in older children, teens and adults:

  • Impared social skills
  • Avoiding eye contact
  • Rigid adherence to daily activities
  • Unusual interests or obsessive/repetitive behaviors
  • Being highly sensitive or underresponsive to sound, light or touch

Autism Navigator

Autism NavigatorAutism Navigator is collection of web-based tools and courses that transforms science and current research to interactive web modules. It uses video footage from research projects at the Autism Institute at Florida State University to better explain the symptoms and science behind ASD.