Signs of Autism in Toddlers

Learn about the signs of autism in toddlers and why intervention can help manage her symptoms.

toddler smiling
Photo: Melpomene/Shutterstock

Autism is a developmental disorder affecting one in 40 U.S. children today, according to a December 2018 report from the American Academy of Pediatrics. The disorder, which ranges on a spectrum from mild to severe, impairs social skills like playing, learning, and interacting with others. There's no known cause, but doctors claim a variety of environmental and genetic factors can contribute to autism.

The signs of autism may first appear when your child is 6 to 12 months old, but many parents don't recognize the developmental delays until later. "The first year to 18 months is really important for diagnosing autism," says Mandi Silverman, PsyD, MBA, senior director of the Autism Center at the Child Mind Institute. "Generally, parents start getting concerned if their child has no words by 18 months or two years."

She also stresses that early diagnosis is key to effectively managing autism. "The less time a child engages in learned behavior, the easier autism is to treat," she says. Be on the lookout for the following signs and symptoms of autism in toddlers.

Early Signs of Autism

Your baby might display signs of autism when she's a few months old. Some telltale symptoms: she won't react to audio and visual stimuli, and she might not track objects with her eyes, says Silverman.

According to the Center for Disease Control and Prevention, your child should grasp objects, babble, smile at people, and pay attention to faces by three months of age. By seven months, she should show affection, reach for objects, smile, turn her head in response to noise, and communicate through actions. Finally, a one-year-old baby should crawl, point, and gesture. If your baby doesn't meet any of these developmental milestones, visit a pediatrician to rule out autism.

Signs of Autism in Toddlers

Even though your child might display signs of autism within the first few months of life, most parents often don't recognize them until later. That's because every child develops at her own pace, and parents may not think their child's behavior is abnormal.

Take Chrissy George, a mother of a 10-year-old daughter (Cassie) with autism. She first noticed signs of autism at around 18-20 months, when Cassie wasn't making eye contact or responding to her name. "She wasn't talking or babbling as much as other children her age," says George.

Here are other early signs of autism in toddlers, according to the Centers for Disease Control and Prevention (CDC).

  • Not walking
  • Speaking less than 15 words
  • Never using two-word sentences
  • Seeming confused by the function of common household objects, such as a telephone, fork, and spoon
  • Not responding to her name
  • Not imitating your actions or words
  • Being unable to push a wheeled toy
  • Playing inappropriately with toys
  • Not following simple instructions
  • Wanting to be alone
  • Repeating words or phrases
  • Engaging in ritualistic behavior: "You may notice that she'll engage in repetitive motor movements, like hand slapping and staring at her fingers," explains Thomas Frazier, PhD, a clinical psychologist, autism researcher, and chief science officer of Autism Speaks.
  • Being uncomfortable with physical contact
  • Not understanding feelings or emotions
  • Regressing – or losing language skills and physical abilities

Diagnosing Autism in Toddlers

Do you suspect your toddler has autism? Silverman suggests visiting your pediatrician right away. Assessments like the Autism Diagnostic Observation Schedule (ADOS) – as well as discussions about your parental observations– can help doctors secure a diagnosis.

Silverman warns that most families go through a grieving process after receiving an autism diagnosis – and George can attest to that. "The diagnosis hit like a ton of bricks," she says. "You have a dream for your child, and the dreams turn into worries about her independence, and whether she will be OK." But both Silverman and George argue that best course of action is starting therapy as soon as possible.

Intervention can help your child manage her autism symptoms, and it may also lead to a reversal of the symptoms. Dr. Frazier says that many types of interventions exist, ranging from speech therapy to occupational therapy and social skills classes. Your doctor will determine the best course of action for your child's need.

"Autism isn't just one expression of a condition, but multiple subtypes of a condition," explains Valerie Paradiz, vice president of services and supports at Autism Speaks. "If your family is new to the diagnosis, take time to inform yourself in a way that's structured and vetted" for the best results.

George's daughter, for example, started in-home therapy and speech therapy after receiving a diagnosis. This helped Cassie navigate the world and learn coping strategies – and it also let George understand her child's condition. "The goal of early intervention was not to force Cassie out of her bubble and into our world, but to bridge the gap between the two and to recognize the benefits of her autism that we don't normally recognize," she says. "Try and stay positive and see the silver lining."

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