Early signs of autism: what parents may notice

Autism spectrum disorder affects how a child communicates, interacts and experiences the world. It looks different in every child. Early signs are often noticed by parents in the first two years, and early support can make a real difference to a child’s development and family life.

The signs below are not a diagnosis. Many children show one or two of them for other reasons. They are a reason to talk to a doctor, not a reason to panic.

Social and communication signs

The US Centers for Disease Control and Prevention lists signs such as a child who:

• does not respond to their name by around 9 months;
• does not show facial expressions such as happy, sad or surprised by around 9 months;
• does not play simple back-and-forth games such as pat-a-cake by around 12 months;
• uses few or no gestures, such as waving, by around 12 months;
• does not share interests, for example showing you an object they like, by around 15 months;
• does not point to show you something interesting by around 18 months;
• does not notice when others are hurt or upset by around 24 months.

Behaviour and play

• Lining up toys or objects and becoming very upset when the order changes.
• Repeating words, phrases or movements such as hand flapping or rocking.
• Very strong reactions to sounds, textures, smells or light, or seeming not to notice pain.
• Great difficulty with small changes in routine.

One sign needs quick attention

If a child loses words or social skills they used to have, at any age, speak with a doctor promptly.

What to do if you are concerned

• Write down what you notice and when, with short videos if possible.
• Speak with your child’s doctor. Paediatric guidance recommends autism screening at 18 and 24 months, and at any time a parent is concerned.
• Ask for a hearing test, which is a routine part of checking communication.
• If a full assessment is recommended, it should be done by qualified professionals, usually a developmental paediatrician, child psychiatrist or psychologist, often with speech and occupational therapists.

You do not need to wait for a diagnosis to start helping. Talking, playing face to face and following your child’s interests all support communication.