An early sign of autism in toddlers can be found in how they play with toys.
Autism can start to show symptoms in children ages six to 18 months old.

Helping Parents and Caregivers Understand

Parents and caregivers need to be aware of how to spot early signs of autism. Earlier identification of autism can lead to more effective interventions.

Early Signs and Symptoms of Autism

Autism can start showing in children as young as six to 18 months. Autism screening is recommended by the American Academy of Pediatrics (AAP) as part of a toddler's 18-month and 24-month wellness exams. Parents and caregivers should also be aware of these early signs of autism.

Avoiding Eye Contact

Children with autism may appear uncomfortable or unable to look their caregivers in the eyes, even when being directly spoken to. They may look at an object away from the person's face when the person is talking directly to them.

Exhibiting Repetitive Movements

Autistic children may display repetitive movements like rocking back and forth. Children with autism may perform the same motions over and over, like rocking or swaying from side to side repeatedly. They may also shake their hands or nod over and over, for no apparent reason.

Failure to Respond to Their Name

Children with autism may fail to respond to their names, even when called directly in front of them. They may look forward or continue with their task, not acknowledging their parents.

Resistance to Changes in Routines

Children with autism may feel comfort in routines and predictability. They may find it a challenge to cope when their methods are suddenly changed. For instance, not getting the same cookie after lunch can become a source of frustration.

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Frequent Tantrums or Outbursts

Because of their speech delays and communication needs, autistic children may find it difficult to express their concerns in an appropriate manner. They may react with an emotional outburst or a tantrum out of frustration.

Limited Social Interactions With Peers

When placed with children their age, autistic children may prefer to remain on their own, even when approached by other children. They may fail to respond to other children's requests or efforts to engage in play. Autistic children may prefer to play on their own and not be able to learn social cues from their peers.

Flat or Monotonous Speech or Reactions

Autistic children may not respond in an emotionally appropriate manner. Their interactions may be short and monotone without inflections. Even when sad or happy, an autistic child may have difficulty exhibiting emotions.

Does Not Ask for Assistance

When autistic children find themselves in a challenging situation or task, they may not think to look around for assistance or ask for help. They will continue to struggle alone.

Impaired Ability to Participate in Shared Experiences

When a caregiver points out something they might find interesting, like an airplane or fire truck, an autistic child may not respond or share in the interest. They may also be unable to provide the same level of engagement or affection as other children their age.

Unusual Play With Toys

Autistic children might play with toys differently from other children. For instance, instead of playing with a doll, they may focus on one leg and move it back and forth repeatedly.


Some children with autism meet their developmental milestones and then may stop performing at their milestones and regress. They may stop saying words they formally knew or stop interacting with others.

Not all autistic children exhibit these symptoms. More often, autistic children may not display all the above symptoms; they may only have two or there of these symptoms.

A Brief Overview of Autism

Autism is part of a spectrum of developmental disabilities caused by differences within the brain. There are multiple risk factors for autism, though the exact causes are unknown.

Toddlers with autism often look just like other toddlers, with no outward differences in appearance. However, their social responses, developmental milestones, and coping and problem-solving skills can differ significantly from other children.

The Autism Spectrum

Autism occurs on a "spectrum," meaning that on one side of the spectrum are autistic children who have only one or two autistic symptoms and are very independent and functional. These children require very little daily assistance. On the other side are children who have many autistic symptoms and require constant monitoring.

Autistic Spectrum Disorder (ASD) includes children who used to be diagnosed apart for the “autism’s umbrella.” These include autistic disorder, pervasive developmental disorder not otherwise specified (PDD-NOS) and Asperger’s Syndrome.

What to Do if You See Signs of Autism

Parents and caregivers should trust their instincts and report what they observe to the child’s physician. Often, pediatricians have a formal screening for autism or can refer the child to someone as a consult. Knowing whether your child has autism or not can lead to better evidence-based therapeutic options for the child.