Recognizing autism in children

April 3, 2024

Providence Health Team

[5 MIN READ]

Early signs of autism in toddlers: A guide for parents

Parenting is one of the world’s most difficult jobs. You want to do what’s best for your child, and you strive to make each decision based on their individual needs. You try not to compare your child to other children — but sometimes, it’s hard not to notice when your little one acts differently than others their age.

According to the Centers for Disease Control and Prevention, one in 36 children have been diagnosed with autism spectrum disorder (ASD). But it is a spectrum, which means the symptoms one child experiences could be different from another’s.

Understanding autism spectrum disorder

Autism spectrum disorder refers to a range of disorders that causes difficulties with communication and social, verbal and motor skills. Because it’s a spectrum, each person with autism has different strengths and challenges. While some people could need daily support, others may be able to function with very minimal outside assistance (known as high-functioning autism).

“We teach parents to look for the signs and symptoms of autism so we can catch and treat it early,” says Emily Morgan, Ph.D., a psychologist at Providence Pediatrics – Southwest in Portland, Oregon.

So, how do you know if your toddler is showing signs of autism? Here’s a guide.

Signs of autism in 1-year-olds

Every baby develops at a different rate, which is why it can be difficult to spot signs of autism in children younger than 1. But by the time a child is 18-24 months old, there are certain milestones they should be reaching.

Social interaction and communication

Some of the common communication signs of autism in 1-year-olds include:

Limited or no speech (very few or no meaningful two-word phrases).
A loss of previously acquired speech.
Difficulty in following simple verbal instructions.
Avoidance of eye contact.
Little or no response to hearing their name.

Behavioral signs to notice

The most common behavioral signs of autism in 1-year-olds are:

Only walking on their toes.
Rarely imitating others’ behavior and actions.
Showing an intense interest in certain objects above others.
Not being willing to share objects or activities in which they are interested.
Engaging in repetitive actions.

Recognizing autism in 2-year-olds

Pediatricians and family doctors now offer the Modified Checklist for Autism in Toddlers-Revised at well-child visits, says Dr. Morgan. But you can also study the checklist at home and bring the results to your doctor.

Developmental milestones and delays

Some of the developmental delays that a 2-year-old with autism might experience include:

Not noticing when others are hurt or sad.
Not engaging in pretend when playing.
Not noticing other children and wanting to play with them.
Not asking “who,” “what,” “when,” “where” or “why” questions.

Physical and emotional signs

Physical and emotional signs of autism in a 2-year-old could include:

Getting upset if they don’t like a certain taste or sound.
Not smiling when you smile at them.
Making repetitive or flapping movements with their hands.

Identifying autism in 3-year-olds

Autism spectrum disorder is most commonly diagnosed at the age of 3 or later. This is when signs and symptoms become more apparent, including:

Delays in speech and other developmental milestones.
Responding to a question by repeating it, rather than answering it.
Loss of previously acquired speech.
Avoiding eye contact.
Not responding to their name.
Preferring not to be touched, held or cuddled.
Not showing facial expressions or emotions such as happy, sad or upset.
Lining up toys.
Banging their head or having tantrums.
Not engaging in pretend play.
Having a peculiar attachment to inanimate objects.

Dr. Morgan also recommends using the CDC’s Learn the Signs. Act Early. resource to check on your child’s progression with their milestones.

How autism is diagnosed

If you wonder whether your child might have ASD, you will need to take them to a professional. You can request a screening at any time from your doctor or your state’s early intervention program.

The American Academy of Pediatrics recommends that all children get screened for autism in early childhood, preferably around their 18- or 24-month exams. Screening, however, does not lead directly to a diagnosis of autism. Rather, it lets caregivers know if they should order a formal evaluation. This evaluation can be performed by a psychologist, developmental pediatrician, speech-language pathologist or other specialist. They may observe your child, give them a structured test, ask the parents or caregivers questions or all the above.

According to the CDC, a diagnosis of ASD now includes several conditions that used to be diagnosed separately: autistic disorder, pervasive developmental disorder not otherwise specified (PDD-NOS) and Asperger syndrome.

Support from the Providence Autism Center

It may give you some relief to have a definitive diagnosis for your child’s condition, but that doesn’t make the path forward any easier. The biggest question many parents have immediately following an ASD diagnosis is, “What now?”

The Providence Boyden Family Autism Center, located at Providence Regional Medical Center in Everett, Washington, offers both diagnostic services and applied behavior analysis (ABA) therapy. We provide diagnostic assessments for children as young as 18 months, and we will give you feedback about your child the day of the evaluation.

We offer two main routes for treatment:

The Intensive Day Treatment Program (IDTP) is a 12-week program designed for young children between ages 2 and 5. Children receive three hours of therapy for four days each week. The therapy helps them improve their communication skills and social interaction through play-based teaching strategies.

Graduates of the IDTP can participate in the Bridging Program, which focuses on individual therapy for up to one year after the IDTP. Therapy rooms are designed as “centers,” throughout which the children rotate during their session, giving them the opportunity to interact with other children. We also provide additional support and care coordination services to help our families.

Not only will your child be learning in our therapy programs, but you as the caregiver will also find the education and support you need.

“We’re trying to understand where each child is, where our goal is, and where that goal will take them next,” says Dr. Morgan. “Children are just developing so rapidly. The earlier we can detect that there are these concerns, the earlier we can start teaching these skills.”

It’s certainly not easy to parent a child who has autism. But when you have the right resources and providers who care about your child as much as you do, it can be much easier to handle.

Contributing caregiver

Emily Morgan, Ph.D., is a psychologist at Providence Pediatrics – Southwest in Portland, Oregon.

Find a doctor

If you want to learn more about the resources Providence provides for families of children with autism, contact the Providence Boyden Family Autism Center. You can also find a provider using our provider directory.

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