Early signs of autism in toddlers: what to watch for and what to do next

Every child grows at their own pace, and one missed milestone doesn't mean autism. But you know your child best. If something keeps nagging at you, it's worth checking, because support that starts early tends to help the most.

Signs in how a child connects and communicates

The CDC lists these as examples of social communication signs, with the ages by which most children do them:

• Doesn't respond to their name by 9 months
• Shows few facial expressions, like happy, sad or surprised, by 9 months
• Doesn't play simple back-and-forth games like peek-a-boo by 12 months
• Uses few or no gestures, like waving goodbye, by 12 months
• Doesn't share interests with you, like showing you a toy they like, by 15 months
• Doesn't point to show you something interesting by 18 months
• Doesn't notice when others are hurt or upset by 24 months
• Avoids or doesn't keep eye contact

Signs in play and behavior

• Lines up toys or other objects and gets upset when the order changes
• Repeats words or phrases over and over
• Plays with toys the same way every time, or focuses on parts of objects, like the wheels of a car
• Gets very upset by small changes or has to follow certain routines
• Flaps hands, rocks or spins in circles
• Reacts strongly to sounds, smells, tastes, textures or the way things look

Losing skills a child already had, like words they used to say, is always worth raising with your pediatrician right away.

When doctors check for autism

The American Academy of Pediatrics recommends autism screening for all children at the 18-month and 24-month well-child visits, along with general development checks at 9, 18 and 30 months. A screening is a short questionnaire, not a diagnosis. If it raises concerns, the next step is a full evaluation by a specialist. According to the CDC, a diagnosis by an experienced professional can be considered reliable by age 2.

What to do if you're worried

1. Write down what you notice, with examples and ages. Short phone videos help too.
2. Tell your pediatrician and ask for an autism screening. You don't have to wait for the next checkup.
3. If your child is under 3, call New Jersey Early Intervention at 888-653-4463. You can call yourself, without a doctor's referral. The evaluation is free, and a child with an autism diagnosis is eligible for services.
4. Ask for a referral for a full evaluation with a developmental pediatrician, child psychologist or another specialist. Our guide How to get an autism diagnosis in New Jersey explains how.

You don't need to wait for the diagnosis to talk to an ABA provider. At Little Haven we can check your insurance and explain the steps while you're waiting.

Sources: CDC, Signs and symptoms of autism spectrum disorder; CDC, Screening and diagnosis; Autism New Jersey, Early Intervention. This guide is general information, not a diagnosis; talk with your child's doctor about your child.