- Signs usually show up in communication, play, routines and senses. - One sign alone doesn't mean autism. Look for a pattern. - Losing words or skills at any age is a reason to call your doctor right away. - Pediatricians screen at 18 and 24 months, but you can ask any time.
What are the most common early signs?
Doctors look at two main areas.1
Communication and connecting with people, for example:
- Doesn't respond to their name by about 9 months
- Few facial expressions or shared smiles
- Uses few gestures, like waving or pointing, by 12 to 18 months
- Doesn't bring or show you things to share interest
- Avoids or doesn't keep eye contact
Play, routines and senses, for example:
- Lines up toys and gets upset when the order changes
- Plays with toys the same way every time, or focuses on parts (like spinning wheels)
- Repeats words or phrases (called echolalia)
- Gets very upset by small changes in routine
- Flaps hands, rocks or spins
- Reacts strongly to sounds, textures, tastes, smells or lights
What signs show up at each age?
These are examples the CDC lists. Every child is different, and missing one milestone doesn't mean autism.1
| By about | A child may not yet... | Why it matters |
|---|---|---|
| 9 months | Respond to their name or show facial expressions | Early social connection |
| 12 months | Play back-and-forth games like peekaboo, or wave bye-bye | Shared attention and gestures |
| 15 months | Show you things they like | Sharing interest with others |
| 18 months | Point to show you something interesting | A key early communication skill |
| 24 months | Notice when others are hurt or upset | Reading other people's feelings |
| 36 months | Notice or join other children in play | Early friendships |
| 48 months | Pretend, like playing chef or superhero | Imagination and play |
What's normal variation, and what's a pattern?
Plenty of kids line up toys, love routines or talk late. That alone isn't autism. What matters is a pattern across areas: for example, few gestures and little shared play and strong upset when routines change.
It also helps to notice how your child communicates. A child who doesn't talk yet but points, brings you toys and looks back at you to share excitement is communicating a lot.
Do older kids show different signs?
Some autistic kids aren't identified until school age, especially children who talk well. Signs at 5 to 12 can include:
- Finding friendships or group play hard, or preferring adults
- Very intense interests in one topic
- Taking words very literally, or missing jokes and sarcasm
- Big reactions to noise, clothing tags or crowded places
- Needing things done the same way, and struggling with transitions
Some kids, often girls, copy their peers and seem fine at school, then fall apart at home. That's worth mentioning to your doctor too.
What should I do if I notice signs?
- Write down examples. What happened, where, and how often. Our free appointment notes sheet makes this easy.
- Talk to your pediatrician. Ask for an autism screening. Pediatricians screen at 18 and 24 months, and can screen at any visit.3
- Ask about a full evaluation if the screening or your gut says so. Screening doesn't diagnose; an evaluation does.4 See How is autism diagnosed in children?
- Start support now. Children under 3 can be evaluated for early intervention at no cost, and can get services without an autism diagnosis. See How do I find an autism evaluation near me?
What can I try at home while I wait?
You don't need a diagnosis to make the day easier. Picture routines and first-then boards help many young children, autistic or not. Start with the part of the day that's hardest right now.
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The 2-minute quiz gives you one plan for your child's hardest part of the day, and a free printable to try tonight.