Signs of autism in children: what to look for at each age and when to get an assessment

Autism spectrum disorder is not one condition with fixed symptoms but a wide "spectrum": one child barely speaks, another speaks fluently but struggles with friendships and changes in routine. No single sign is enough to decide; what matters is a cluster of signs that persists.

Signs in communication and social interaction

• Little eye contact, or not turning when called by name after the first year.
• Not pointing to show you something interesting (like a plane in the sky) by 12–18 months.
• Not returning smiles or expressions, or seeming to be "in their own world".
• Speech delay, or repeating words and phrases they heard (echolalia) instead of using them to communicate.
• Difficulty with shared or pretend play with other children.

Signs in behaviour and interests

• Repetitive movements: hand flapping, spinning, rocking.
• Strong attachment to fixed routines and great distress at small changes.
• Very intense interests: lining toys up, moving parts, numbers or letters.
• Over- or under-sensitivity to sounds, textures, lights and foods.

Signs by age

• 6 to 12 months: little smiling or engagement, no response to their name.
• 12 to 18 months: no pointing or waving, very few or no words.
• 2 to 3 years: not combining two words, no pretend play, repeating movements or words.
• At any age: losing words or social skills they had — this calls for an immediate assessment.

Autism or just a speech delay?

A child with only a speech delay usually compensates with gestures and facial expressions and enjoys interacting and playing with people. In autism the difficulty includes non-verbal communication and interaction itself, not just speech. An article cannot settle this; a specialist assessment that combines observing the child with their developmental history can.

What is the next step?

A final autism diagnosis is made by a child psychiatrist or a developmental paediatrician. Our role at the center starts with a comprehensive assessment of communication, language, sensory and motor skills, referring you for a medical diagnosis when needed, then building an individual early intervention plan: speech therapy, occupational therapy and sensory integration, social skills, and parent training.

The earlier intervention starts, the better the results. Don’t wait for your child to "grow out of it" if you see more than one of the signs above.