Autism spectrum disorder is a developmental disability caused by differences in the brain that impacts about one in 44 children in the US, making it a fairly common health condition. Autism can present itself in various ways, with some children experiencing delayed developmental milestones while others have severe disabilities.
With that, it's understandable to want to have early signs of autism on your radar. But these early signs can be tough to notice. "Symptoms of autism are not always obvious due to the fact that the presentation of symptoms can vary significantly across the spectrum from relatively mild to very severe," says Steven Pastyrnak, PhD, pediatric psychologist, Corewell Health Helen DeVos Children's Hospital.
Daniel Ganjian, MD, a pediatrician at Providence Saint John's Health Center in Santa Monica, CA, agrees. "Autism is a spectrum, so there is mild, moderate, and severe autism," he explains. "The severe ones are easier to diagnose, but the mild and moderate cases are harder to spot."
While your child should be screened for autism during routine visits to the pediatrician, given that you spend the most time with your little one, you may be able to spot something their provider misses. If you have concerns about your child's development, keep this information for early signs of autism in mind.
According to the NIH, these are more typical early signs that babies and toddlers have autism:
Children may also have the following laundry list of symptoms of autism, the CDC says:
But doctors warn against assuming your child has autism if they have just one of the symptoms listed above. "I always tell parents it's a cluster of signs, not just one or two," Ganjian says.
The Centers for Disease Control and Prevention (CDC) has created developmental milestones that break down what skills babies and toddlers are generally expected to have mastered by particular ages. Developmental milestones, the CDC explains, are things most children can do by a certain age.
When it comes to red flags for autism, "delayed speech and limited interest in others are two of the first signs that we look for," Pastyrnak says. Regression of speech, which is when a child uses a number of words to communicate and then seemingly stops using those words, happens in nearly a quarter of children with autism, Pastyrnak says.
"Atypical sensory processing, repetitive motor behaviors, and repetitive speech can also be early signs," he says.
If you have concerns about your child's development, Jennifer Twachtman-Bassett, MS, autism clinical specialist at Connecticut Children's, recommends looking at the CDC's developmental milestones and seeing how well your child meets the expectations for their age.
Many children show symptoms of autism by 12 to 18 months of age or earlier, according to the National Institutes of Health (NIH). "We typically start to see symptoms as early as 9 to 12 months, although we may see symptoms earlier," says Twachtman-Bassett. "A lot of times, the symptoms before 9 months aren't as reliable." Plus, many of the symptoms of autism are nonverbal "so it's not as easy as whether a child says their first words on time," Twachtman-Bassett says.
Again, your child should be screened for autism spectrum disorder by their pediatrician during routine visits, but "sometimes parents do notice things earlier than we do," Ganjian says.
He recommends bringing up your concerns to your child's pediatrician. They can evaluate your child to see if they may benefit from more intensive testing that can be done by a behavioral psychologist or other specialist, Ganjian says.
Pastyrnak agrees. "Early identification is ideal as there are typically interventions and school-based services available to help," he says. These early intervention programs may include family training, speech therapy, hearing impairment services, physical therapy, and nutrition services, according to the NIH. And they typically begin at or before preschool age, as early as 2 or 3 years of age, to ensure that they are as effective as possible.
"With early intervention, some children with autism make so much progress that they are no longer on the autism spectrum when they are older," the NIH reports.