Signs and Symptoms of Autism

How Do I Know If My Child Has Autism?

Many parents report feeling concerned about their child’s early development. Children develop at different rates and it can be difficult to know what is considered “typical” development or when to be more concerned about things like developmental delays or autism spectrum disorder. While some signs of a developmental delay may become apparent as early as 2-4 months of age, most parents start to notice signs of a developmental disability when their child is around 15-18 months old.

Typically, parents notice these signs first:

Lack of smiling (by six months)
Lack of imitation of social and emotional cues (by 9 months)
Lack of babbling or cooing (by 12 months)
Lack of responding to their name (by 6-12 months)
Lack of eye contact with people or objects
Lack of interest in seeking others’ attention
Lack of gesturing at people or objects (by 10 months)
Lack of meaningful, 2-word phrases (by 24 months)
Repetitive behaviors and/or stereotypy
Delayed motor development

Some of the less obvious signs include:

Your child may be easily startled by noise or agitated by background noise
Overreaction to environmental stimuli, or no reaction at all
Difficulty socializing, or no interest in socializing
Trouble starting or maintaining social interactions
Clumsiness or poor motor skills
Preoccupation with certain toys, objects or concepts to the point of obsessiveness
Lack of desire for physical affection
Not responding to a conversation, but mimicking the sentence

If you ever have concerns about your child’s development, see your child’s pediatrician for more information or evaluation.

Important developmental milestones and when children usually hit them:

2 Months
What most children do at this age…	Act early if your child…
Begin to smile at people Self-soothe Tries to look at parent(s) Coos or makes gurgling sounds Turns their head towards sounds Pays attention to faces Follows objects with their eyes Acts fussy if they are bored Can hold their head up when on tummy	Does not respond to loud sounds Does not watch things as they move Does not smile at people Does not bring their hands to their mouth Does not hold their head up when on tummy

4 Months
What most children do at this age…	Act early if your child…
Smile spontaneously Enjoy playing with people, and upset when it stops Attempts to copy movements, sounds and facial expressions Cries in distinct ways (i.e., hungry, tired) Begins to babble Responds to affection Lets you know if they are happy or sad Reaches for toys Uses hands and eyes together to reach for something Watches faces closely Recognizes familiar people or objects Follows moving objects with eyes Rolls over from tummy to back Holds head on their own Can hold and shake a toy	Does not watch things as they move Does not smile at people Does not hold their head steady on their own Does not coo or make sounds Does not bring things to their mouth Does not move one or both eyes in all directions Does not push down with legs when feet are on a hard surface

6 Months
What most children do at this age…	Act early if your child…
Recognizes familiar faces vs. strangers Likes to play with others, especially parents Responds to others emotions Likes looking at themselves in a mirror Often seems happy Responds to sound by making sounds Responds to their names Makes sounds voicing joy or displeasure Begins saying consonant sounds Looks at things nearby Shows curiosity and tries to get things that are out of reach Passes things from one hand to the other Rolls over in both directions Begins to sit unsupported Bounces when standing Rocks back and forth	Does not try to get things that are in reach Does not show affection for caregivers Does not respond to sounds around them Does not easily get things to their mouth Does not make vowel sounds Does not roll over in either direction Does not laugh or make squealing sounds Does not exhibit normal muscle movement: they either seem very stiff, with tight muscles, or very floppy, like a rag doll

9 Months
What most children do at this age…	Act early if your child…
May fear strangers May act clingy with familiar adults Have favorite toys Understands “no” Makes many different sounds (“bababa”) Copies other’s sounds and gestures Uses finger to point at things Watches the path of a falling object Plays peek-a-boo Looks for things they see you hide Picks small objects up with thumb and index fingers Stands holding on Gets into a seated position Sits unsupported Crawls Pulls to stand	Does not bear weight on their legs with support Does not sit with help Does not babble Does not play any games involving back-and-forth play Does not respond to their own name Does not recognize familiar people Does not look where you point Does not transfer toys from one hand to the other

12 Months
What most children do at this age…	Act early if your child…
May act shy or nervous around strangers Cry when a parent leaves Have favorite things or people Shows fear in some situations Repeats sounds/actions for attention Puts out arm/leg to help with dressing Plays games like peek-a-boo, patty-cake Responds to simple spoken requests Uses simple gestures, like shaking head “no” or waving “bye” Makes sounds with changes in tone Tries to imitate words you say Says “mama” and “dada” Explores objects by shaking, banging, or throwing them Finds hidden things easily Copies gestures Bangs things together Starts to use items correctly Follows simple directions Lets things go unassisted Gets into a seated position unassisted Pulls up to stand and walks holding on May stand alone May take a few steps alone	Does not crawl Does not stand when supported Does not search for things they see you hide Does not say “mama” or dada” Does not learn gestures like shaking their head or waving Does not point to things Loses skills that they once had

18 Months
What most children do at this age…	Act early if your child does not…
Hand things to others when playing Throws temper tantrums Fears strangers Shows affection to familiar people Plays pretend Clings to caregivers in new situations Points to show things to others Explores alone, but with a parent nearby Says several single words Shakes head and says “no” Points to show someone what they want Knows what ordinary objects are for Points to get attention Points to a body part Scribbles on their own Can follow one-step verbal commands Walks alone Walks up steps Pulls toys while walking Can help undress themselves Drinks from a cup Eats with a spoon	Does not point or show things to others Cannot walk Does not know what familiar things are for Does not copy others Does not gain new words Does not have at least six words Does not notice or mind when a caregiver leaves or returns Loses skills they once had

2 Years
What most children do at this age…	Act early if your child…
Copies other adults and children Is excited to see other children Shows increasing independence Shows defiant behavior Plays beside other children, and begins to include other children in their play Points to objects when they are named Knows names of familiar people and body parts Says 2-4 word sentences Follows simple instructions Repeats words that they overhear Points to things in a book Finds items hidden under 2-3 covers Begins to sort shapes and colors Completes sentences in familiar books Plays make-believe Builds towers of 4+ blocks May use one hand more than the other Follows two-step instructions Names pictures in a book Sands on tiptoes Can kick a ball Begins to run Walks up and down stairs holding on Throws things overhead Makes or copies straight lines or circles	Does not use 2-word phrases Does not know what to do with common things or household items (e.g., brush, spoon) Does not copy actions or words Does not follow simple instructions Does not walk steadily Loses skills they once had

3 Years
What most children do at this age…	Act early if your child…
Copies adults and friends Shows affection for friends unprompted Takes turns in games Shows concern for crying friends Aware of what is “mine” vs. “theirs” Shows a wide range of emotions Separates easily from parents May be upset by major changes in routine Dresses and undresses themselves Follows 2-3 step instructions Can name familiar things Can name friends Says their first name, age, sex Talks well enough for strangers to understand Carries on a conversation with 2-3 sentences Plays make believes Does simple puzzles Can play with toys with moving parts Turns pages one at a time Can copy a circle with a pencil/crayon Builds 6+ block towers Turns door handles, opens jars Climbs well Runs easily Walks up and down stairs unassisted Pedals easily (i.e., tricycle)	Falls down a lot or has trouble using stairs Drools or has very unintelligible speech Cannot work simple toys Does not speak in sentences Does not understand simple instructions Does not play pretend or make-believe Does not want to play with other children or with toys Does not make eye contact Loses skills they once had

Sources:
https://www.cdc.gov/ncbddd/actearly/milestones/index.html
https://www.autismspeaks.org/what-autism/learn-signs

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