Signs of Autism in Toddlers

Autism spectrum disorders are diverse in how they present themselves. At different ages critical signs and red flags are present based on a child's stage of development. Early diagnosis has become the standard of care, making it important to know and be able to identify the first signs of autism in young children so they can receive the help and services needed for the best possible outcome. 

Autism in toddlers 

Autistic symptoms can be identified in toddlers as young as 18 months.  During this time, toddlers typically make eye contact and respond when called by their name, show emotion and feelings through physical expressions and vocal sounds and enjoy being held or cuddled.  These are just a few examples of common behaviors and responses. Toddlers experience a significant period of growth and development in the first 2 to 3 years, which can make it challenging to provide a clear diagnosis.  

To add to the complexity, some toddlers may exhibit all common symptoms or some symptoms, while others may show none. For this reason, The American Academy of Pediatrics (AAC) recommends that autism screeners are done at 18-month and 24-month checkups. Although there are broad symptoms that may be connected to autism, some of the key differences in children on the autism spectrum include problems with social skills, communication, repetitive behaviors, restricted interests and sensory sensitivities.

Signs and symptoms in toddlers can be tricky. Not only are most toddlers a bit rigid in their communication and overall preferences but they can also be a bit subtle, making it difficult to distinguish between neurotypical behavior and neurodiverse behavior. Here are some common red flags for autism: 

• little or no eye contact, especially with parents or caretakers 
• language delay or does not verbally communicate 
• repetitive behavior like rocking back and forth, repeating phrases or certain words
• prefers to play alone instead of with peers
• dislikes changes in routine
• abnormal sensory sensitivities (to light, sound, touch, texture, temperature, taste, etc.)
• does not engage in physical responses like pointing or waving 
• narrow interests, hyperfocus on specific toys or activities
• difficulty sharing with others 
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A more elaborate list of symptoms, per category, can be found here.  

Regression

Regression refers to the loss of skills that were previously gained or a decline in growth markers. Young children with autism can present with a loss of developmental milestones between approximately 15 – 24 months of age. Most often, these are toddlers who display skills such as eye contact, pointing or language use then suddenly stop. Although this is not a common occurrence, studies do show it exists in a minority of children diagnosed with autism without a specifically identified cause. When this occurs, it can be quite alarming to both parents and caregivers. Parents often assume a tie to an illness, injury, vaccine or other reasons, however, none of these factors are proven cause.  It’s important to note that in certain cases, further medical evaluations may be recommended to exclude other potential issues. Although there is not conclusive information as to why some children with autism experience regression while others do not, we do know that a history of lost milestones or regression is a significant red flag for autism.

If you are concerned your child may be displaying early signs of autism, please reach out to a professional with expertise in early diagnosis. Well-informed professionals (like those as Positive Development!) can help alleviate concerns. We are here to provide guidance, help and support to you and your family.