Signs of Autism in Toddlers: What Parents Should Watch For

Understanding Early Signs of Autism

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition that affects how a person communicates, interacts, and experiences the world. Research consistently shows that early identification and intervention lead to significantly better outcomes. Many signs can be observed between 12 and 36 months of age.

It is important to remember that having one or two of these signs does not mean your child has autism. Many of these behaviors can be typical at certain ages or part of other developmental variations. Only a qualified professional can make a diagnosis.

Social Communication Signs (12–36 Months)

Limited Eye Contact

• Does not make or maintain eye contact during interactions

• Looks away when you try to engage them face-to-face

• Does not look at you to share interest in something (joint attention)

Reduced Social Smiling

• Does not smile back when you smile at them

• Smiles less frequently in social situations

• May smile at objects or in solitary play but not in response to people

Limited Pointing and Gestures

• Does not point to show you things of interest by 14 months

• Does not wave "bye-bye" by 12 months

• Does not use other gestures like reaching, showing, or nodding

Difficulty with Joint Attention

• Does not follow your gaze when you look at something

• Does not look where you point

• Does not bring objects to show you

Limited Response to Name

• Does not consistently turn when their name is called

• May seem "in their own world" at times

• Responds to other sounds but not to social bids

Behavioral Signs

Repetitive Behaviors

• Lines up toys or objects repeatedly

• Spins wheels or parts of toys rather than playing with them as intended

• Flaps hands, rocks body, or spins in circles

• Opens and closes doors or drawers repeatedly

Restricted Interests

• Becomes intensely interested in specific objects or topics

• Plays with the same toy or activity for extended periods

• Gets very upset when specific routines are changed

Sensory Differences

• Over-reacts or under-reacts to sounds, textures, tastes, or lights

• Covers ears at everyday sounds

• Avoids certain textures in food or clothing

• Seeks out specific sensory experiences (spinning, visual patterns)

Language and Communication Signs

• Does not babble by 12 months

• Does not use single words by 16 months

• Does not use two-word phrases by 24 months

• Repeats words or phrases (echolalia) without communicative intent

• Uses a flat or unusual tone of voice

• Does not engage in back-and-forth conversation appropriate for age

What These Signs Look Like in Daily Life

At 12 months, you might notice your child does not look up and smile when you enter the room, does not point at things they find interesting, or does not respond consistently when you call their name.

At 18 months, you might notice limited pretend play, a preference for playing alone, difficulty with transitions between activities, or unusual responses to sensory input like certain sounds or textures.

At 24 months, you might notice your child does not try to share experiences with you, has very limited language, shows repetitive play patterns, or has strong reactions to small changes in routine.

When to Talk to Your Doctor

The American Academy of Pediatrics recommends autism-specific screening at 18 and 24 months. However, if you have concerns at any age, do not wait for a scheduled screening. Talk to your pediatrician about:

• Any loss of previously acquired skills (words, gestures, social behaviors)

• Persistent lack of response to name by 12 months

• No pointing or gesturing by 14 months

• No single words by 16 months

• No two-word phrases by 24 months

• Any combination of the signs listed above

What Happens After a Concern Is Raised

Developmental screening — Your pediatrician may use a standardized questionnaire

Referral for evaluation — A team (psychologist, speech pathologist, occupational therapist) conducts a comprehensive assessment

Diagnosis or monitoring — Not all evaluations result in a diagnosis; some children are monitored over time

Early intervention — If identified, services can begin immediately (speech therapy, occupational therapy, behavioral support)

The Importance of Early Intervention

Research shows that children who begin intervention before age 3 show the most significant improvements. Early intervention can help with:

• Communication and language skills

• Social interaction and play

• Adaptive behaviors and daily living

• Cognitive development

• Reducing challenging behaviors

How Nurtoora Supports Early Identification

Nurtoora helps parents track developmental observations across all domains — social, communication, sensory, behavior, and motor skills. By logging daily observations, you build a detailed picture of your child's development that you can share with healthcare providers. This data can help professionals identify patterns and make more informed assessment decisions.