Signs of Autism in Babies and Toddlers

Mother kissing her toddler on the cheek

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For good reason, the focus of most parents is to provide for their baby's basic needs, like making sure they get the food, sleep, care, supervision, and love they need. Managing these tasks is a full-time job. But it's also key to be aware of your young child's behavior, including their emerging social and communication skills, as differences in these skills can be traits of being autistic.

These skills can develop within a wide time frame but if you notice anything that seems concerning, contact their pediatrician or healthcare provider for evaluation. Children are routinely screened for autism, which is also called autism spectrum disorder (ASD), at their 18-month and 24-month well-child visits. But signs of ASD may be noticeable before then. Note, though, that every child develops at their own pace. So, a slow to develop skill does not necessarily mean that your child is autistic.

However, you know your baby and toddler best, so if you notice signs that concern you and/or you suspect your baby or toddler may be autistic, it's important to check in with their healthcare provider. Getting an early diagnosis can connect them with support, services, or therapies that can help them thrive, and knowing the signs can be helpful for parents and caregivers.

What Is Autism?

Autism spectrum disorder is a neurological developmental disability that includes a wide range of symptoms, affecting how people see the world around them. Each child with ASD is unique and may need different levels and types of interventions or treatments. Every child also develops differently, and at different rates. ASD may include differences in: communication methods or styles, social skills, self-regulation, intensity of interests, and frequency of specific behaviors.

Autism spectrum disorder encompasses a variety of traits and behaviors that used to be labeled as different conditions, such as autistic disorder and the eugenics-based Asperger's syndrome. This is one reason that there is such a variety of traits that now fall under the umbrella of ASD. The severity and combination of traits plus the need for support vary widely among autistic individuals, as well.

Researchers believe that there are both genetic and non-genetic factors that contribute to ASD. It is not a disease; rather, being neurodivergent simply means that you experience the world differently than others. It's estimated that 1% to 2% of the population has ASD.

While there is no need for a cure for autism and one does not exist, early intervention and treatment can make a big difference, says Abigail Angulo, MD, attending physician at Children's Hospital Colorado and assistant professor of pediatrics at the University of Colorado School of Medicine.

"I hope caregivers will trust their instincts if they wonder if their child is autistic," says Dr. Angulo. Having an open conversation with your pediatrician, including any signs you notice, can be very helpful for evaluating whether or not a child is autistic.

What Are the Signs of Autism in Babies?

Autism can be difficult to detect in babies. Typically signs are not as apparent, particularly to laypeople, until children are older, says Dr. Angulo. "However, lack of a social smile by 6 months old could be a sign of autism spectrum disorder in young babies."

Additionally, some caregivers may also notice that it is difficult to play baby games like peek-a-boo with their young child who will eventually be diagnosed with ASD. "Sometimes lack of baby conversation (cooing or babbling back-and-forth) or lack of response to their own name can be noticed by caregivers as babies near their first birthdays."

"Signs of ASD should be present from an early age, sometimes in infancy. However, we sometimes miss these early signs as parents and caregivers as they can be subtle differences," says Dr. Angulo.

Signs of Autism in Babies

  • Showing no signs of smiling by 6 months
  • No babbling, pointing, or use of other gestures by 12 months
  • No use of single words by age 16 months
  • No use of two-word phrases by 24 months
  • Having a regression in development, with loss of language or social skills
  • Arching away from being held by a parent or caregiver to avoid physical contact
  • Avoiding eye contact with others
  • Seeming not to notice when people come and go

What Are the Signs of Autism in Toddlers?

Signs of autism in toddlers include limited sharing in play with caregivers, limited pointing or unusual pointing, or preferring to pull family members to what they want, rather than pointing or talking, says Dr. Angulo. "Caregivers may also notice that it takes a long time to get a child’s attention when calling their name or that a child will walk on their toes or make unusual hand/finger movements."

Additionally, we can also see a speech delay in toddlers or atypical speech development patterns. "Echoing, for example, can be indicative of ASD, though this is not always the case," says Dr. Angulo.

"Toddlers can show more clear signs for ASD than babies," says Dr. Angulo.

There is significant research showing that children with ASD can be diagnosed accurately as young as 14 months old. However, notes Dr. Angulo, some parents will say that they suspected much earlier while others report that they didn’t notice difficulties until much later.

Note that physicians don’t routinely screen for ASD in children until they are 18 months old. Waiting until the year and a half mark increases the likelihood that they can identify these differences in young children, while still diagnosing at a young age, says Dr. Angulo. However, if you notice signs of ASD before 18 months, it really helps to mention them to your child's pediatrician or healthcare provider, as they may not be screening for autism at earlier visits.

Conditions With Overlapping Signs

Sometimes, other conditions may be confused with autism due to similar presentation. This overlap can make diagnosis tricky.

For example, children who have delays in development may have immature social skills, which can be mistaken for autism, says Dr. Angulo. "We would want to look at all areas of development to determine if this is just a social delay or delays across multiple areas (global developmental delay) or both."

Some young autistic children may have a speech delay. However, many toddlers with speech challenges do not have autism. "The quality of communication can help us to differentiate between ASD and isolated speech delay," explains Dr. Angulo. "Children with ASD may have limited eye contact, limited facial expressions, and/or limited social desire to communicate. These would not be impaired in children with an isolated speech delay."

Children with anxiety may also present as autistic. "Many times, children with anxiety can be rigid in play, struggle with transitions, or have a strong interest in a comfort item," says Dr. Angulo. "These can be attributed to ASD symptoms, but would also need to have social difficulties, which is the hallmark of ASD."

The Benefits of Early Intervention

Early diagnosis can provide early access to intervention. "There is good literature reporting that when intervention is provided to young children with any delay, they make good gains in skills," says Dr. Angulo. "Infancy and toddlerhood is a time of rapid brain development and helping a child who has some delays or difficulties during this time can help a child to make more gains than they would at other time periods in their life."

However, any time a diagnosis is made, it can be helpful for the child. "Humans are always learning and growing, so intervention can be started at any time during the lifetime," explains Dr. Angulo. Early diagnosis can also help families and friends understand areas that can be challenging and help the child get any extra or different support they need.

Another benefit of early intervention is that guardians and family members can learn more about autism and neurodiversity, allowing them to be a caregiver that respects, understands, empowers, and advocates for their child.

It can take time and experience to determine if ASD would describe the behavior seen in a child, says Dr. Angulo. "Ongoing conversation and continuity with the same pediatrician can help everyone to know and love your child better. These children have much to teach us and I hope we celebrate the wonderful uniqueness they bring to the world!"

A Word From Verywell

It can be worrying to think that your child may have a developmental disorder or intellectual disability. However, a diagnosis of ASD simply means that your child’s brain works and behaves differently than allistic, or non-autistic, people. Realizing your child is autistic early on can benefit your child and help you parent them with an understanding of who they are that you would not have otherwise. Most importantly, every allistic or autistic child has their own gifts, flaws, and beauty to share with the world.

7 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Academy of Pediatrics. How pediatricians screen for autism.

  2. American Academy of Pediatrics. Autism spectrum disorder in children.

  3. Autistic Self-Advocacy Network. About Autism.

  4. American Academy of Pediatrics. What are the early signs of autism?

  5. Harvard Medical School. What Is Neurodiversity?

  6. U.S. Department of Labor. Autism.

  7. American Academy of Pediatrics. What is early intervention?.

By Sarah Vanbuskirk
Sarah Vanbuskirk is a writer and editor with 20 years of experience covering parenting, health, wellness, lifestyle, and family-related topics. Her work has been published in numerous magazines, newspapers, and websites, including Activity Connection, Glamour, PDX Parent, Self, TripSavvy, Marie Claire, and TimeOut NY.