According to the CDC, approximately 3.2 percent of children are diagnosed with autism spectrum disorder by age eight.  As such, it’s important to learn the red flags and early signs of autism  so that you can take action promptly.  The earlier a child with autism receives intervention therapy, the better the outcomes can be. 

The purpose of this blog post is to describe the common red flags for autism so that you can increase your awareness.  Note that one red flag by itself is not necessarily indicative of autism, but if a child displays multiple red flags, there is a possibility that he or she is on the autism spectrum.

Early Signs of Autism in Babies Under 1 Year:

1. Few to No Smiles

Most babies will smile  and  engage with you. It is atypical for infants to never smile or express joy.   

2. Limited Engagement

If your baby  does not react to your sounds and facial expressions, this could be a sign of autism.  We expect that before a baby's first birthday, he or she will  react to this type of engagement.

3. Limited Babbling

Neurotypical children usually begin babbling around six months old and say their first words around their first birthday. 

Signs of Autism in  Babies Age 1-2 Years: 

1. Limited Pointing, Waving, Reacting, and Reaching

Before speaking, many neurotypical children use gestures to convey information, such as clapping when they are happy, waving to say hello or goodbye, and pointing at objects they want or are interested in.  However, children with autism spectrum disorder are often limited in their use of gestures and may not be able to use motions to convey meaningful thoughts.

2.  No Reaction to Names

If your baby does not react to his or her name  between ages one and two, this is a potential red flag for autism. Neurotypical children understand and respond to their names from a very young age. By the first birthday, we expect babies to react when hearing their name.   

3. Delayed Speech and Language Development

We expect toddlers to begin combining words into phrases by their second birthday.  Children with autism,  on the other hand, typically experience delayed speech and language development.  

Signs of Autism in Children Ages 2+: 

 1. Delayed Play Skills

As  neurotypical children grow, they develop a variety of play skills for imaginative purposes.  Based on the Westby Play Scale, children as young as 17 months begin using toys in pretend play.  Conversely, children with autism are often delayed in these skills and may not demonstrate imaginative play at all.  Instead, children with autism may use toys and objects in less typical ways, such as lining cars up in a row rather than pretending to drive them.

2. Restricted and Repetitive Behaviors

Many neurotypical children are flexible and varied in their behaviors, whereas children with autism often have restricted and repetitive behaviors.  For example, children with autism may demonstrate repetitive and seemingly unusual movements with their limbs or body. These behaviors may include rocking and  flapping.  

3. Under- or Over-Developed Reactions to   Sensory Inputs

A child with autism may demonstrate an over- or under-reaction to different types of sensory input (e.g. sounds, physical sensations, flavors, and textures). 

4. Difficulties with Eye Contact

Neurotypical children often look at, and make eye contact with, their family members and friends.  On the other hand, a child with autism spectrum disorder often avoids or has trouble maintaining eye contact with others.  It may be difficult to get a child with autism to look at you.

5. Difficulty Breaking Routines

Disruptions to a daily routine can be difficult for anyone, but for those on the autism spectrum, schedule changes can cause extreme anguish. 

If your child is demonstrating any or all of the red flags listed above, it’s best to speak with your pediatrician to determine the appropriate next steps.  There are a number of therapeutic options available to assist your child, including but not limited to applied behavior analysis, speech therapy, occupational therapy, and physical therapy.  Decisions for intervention should be based on the needs and interests of your family and child.  

Photo by Sandy Millar on Unsplash