Autism signs in children

Spotting the early signs of autism in young children can be hard if you’re not an autism expert.

Many of these signs are common to all young children, but they are seen more often in children who have autism. We’ve listed some common signs for autism here – if your child shows some of these, then it’s time to check in with a qualified professional.

We also list typical developmental milestones which may be used as a guide to gauge a child’s development. If there are any concerns about a child’s development, or if there is a loss of any skills at any age, talk to a doctor as soon as possible.

Signs in toddlers - expected developmental milestones

12 months

• Watches faces intently; responds to other people’s expressions of emotion
• Smiles, imitates some facial expressions, follows moving objects with eyes
• Begins to babble, imitates sounds and words, brings hand to mouth
• Has single words like “dada”; repeats sounds or gestures for attention
• Turns head toward the direction of a sound; responds to own name
• Pushes down on legs when feet placed on a firm surface; raises head and chest when lying on stomach
• Smiles at mother or primary care-givers voice, prefers them over all others
• Can sit up without assistance, can pull self up to stand, walks holding on to furniture
• Waves ‘bye-bye’ and points to objects

24 months

• Walks alone, with support, can negotiate stairs and furniture and carries and pulls toys while walking
• Has several single words by 15 to 18 months; uses simple phrases by 24 months
• Imitates the behaviour of others, excited about the company of other children

36 months

• Uses 4-5 word sentences, understands most sentences and instructions
• Imitates adults and playmates, expresses affection openly, separates easily from parents
• Sorts objects by shape and colour
• Plays make-believe
• Climbs well, runs, kicks a ball, negotiates stairs unaided

Speak to your doctor if

By 12 months

• Does not pay attention to or frightened of new faces
• Does not smile, does not follow moving objects with eyes
• Does not babble or laugh and has difficulty bringing objects to the mouth
• Has no words
• Does not turn head to locate sounds and appears not to respond to loud noises
• Does not push down on legs when feet placed on a firm surface
• Does not show affection to primary caregiver, dislikes being cuddled
• Does not crawl, cannot stand when supported
• Does not use gestures such as waving or pointing

By 24 months

• Cannot walk by 18 months or walks only on their toes, cannot push a wheeled toy
• Does not speak; does not imitate actions; cannot follow simple instructions
• Does not appear to know the function of common household objects such as a telephone by 15 months

By 36 months

• Has very limited speech, does not use short phrases, has difficulty understanding simple instructions
• Has little interest in other children, has difficulty separating from mother or primary caregiver
• Difficulty in manipulating small objects
• Has little interest in 'make-believe' play
• Frequently falls, has difficulty with stairs

Signs in preschoolers

With some children, the signs of autism might not become entirely obvious until they reach preschool (or even school age), when suddenly the developmental gap between them and their peers becomes more pronounced. In addition to the signs for babies/toddlers, here are some of the more common ways autism might present itself in a preschool-aged child.

Social communication signs

• The child generally does not point to or share observations or experiences with others
• The child tends not to look directly at other people in a social way. This is sometimes referred to as a lack of eye contact
• There may be an absence of speech or unusual speech patterns such as repeating words and phrases (echolalia), failure to use ‘I’, ‘me’, and ‘you’, or reversal of these pronouns
• Unusual responses to other people. A child may show no desire to be cuddled, have a strong preference for familiar people and may appear to treat people as objects rather
  than a source of comfort
• The child may appear to avoid social situations, preferring to be alone
• There is limited development of play activities, particularly imaginative play
• There may be constant crying, or there may be an unusual absence of crying

Behavioural signs

• The child often has marked repetitive movements, such as hand-shaking or flapping, prolonged rocking or spinning of objects
• Many children develop an obsessive interest in certain toys or objects while ignoring other things
• The child may have extreme resistance to change in routines and/or their environment
• The child may be resistant to solid foods or may not accept a variety of foods in their diet
• There are often difficulties with toilet training
• The child may have sleeping problems
• The child may be extremely distressed by certain noises and/or busy public places such as shopping centres

Signs of autism in primary school-aged children

Children are often diagnosed with autism once they get to school when their social communication and behavioural characteristics mark their development as different to their peers.

• Issues with conversation, perhaps dominating conversations with their favourite topic and not knowing how to take turns
• Not being able to interpret the non-verbal communication of peers and adults
• Unusual speech patterns, a monotonous tone or an old-fashioned way of talking
• Seeking solitude and finding being with others very stressful and exhausting
• Being rigid in following rules at school, in sports and games
• Finding it hard to read social cues and the unwritten rules of friendship
• Having unusual interests and obsessions, no breadth of interests
• Sometimes, there are unusual physical movements, such as touching, biting, rocking or finger flicking
• Having sensory issues, either heightened or lack of sense of smell, touch, taste, sound and vision
• Need to follow routines to feel secure, become very upset when expected routines change
• Having few or no real friends
• Aggression is sometimes seen, usually as a way of avoiding overwhelming situations
• Anxiety is also common, especially as children enter the teenage years

Screening tools and tutorials

There are some great screening tools and tutorials to help parents and carers spot the early signs of autism. Below are some we highly recommend. Please be mindful that they are just screening tools, and not a diagnosis.

Early autism detection - ASDetect

This is a free app that empowers parents and caregivers to assess the social attention and communication behaviours of their children younger than 2½ years (between 11 and 30 months). This video-led self-assessment app is based on comprehensive, rigorous, world-class research conducted at the Olga Tennison Autism Research Centre.

The app guides parents and carers through each assessment using a combination of videos and questions, as well as activities that you can do with your child. Once you have completed an assessment, you receive both an on-screen result of either ‘low’ or ‘high’ likelihood of autism, as well as a comprehensive formal assessment results email. Visit the ASDetect website to learn more.

Early signs of autism tutorial - Kennedy Krieger Institute

This is a free 9-minute video tutorial on the behavioural signs of autism in one-year-olds. The tutorial consists of six video clips comparing toddlers who show no signs of autism to toddlers who show early signs of autism. Each video is presented with voice-over explaining how the specific behaviours exhibited by the child, as they occur on screen, are either indicative of autism or typical child development.