Recognizing the Signs of Autism in Toddlers: A Parent’s Guide
Autism spectrum disorder (ASD) can present with early indicators during infancy, but many of the most recognizable and concerning signs become more apparent in toddlers. As children enter the 12–36 month age range, their development accelerates across many domains—communication, play, social skills, and behavior. When progress in these areas is significantly delayed or unusually different, it may signal the need for an autism evaluation.
Learning the signs of autism in toddlers can make the difference between delayed intervention and timely support. Early action can lead to better long-term outcomes, especially when therapies begin during these critical years of brain development.
I think one of the key signs in toddlers is a child’s disinterest in playing with others. There appears to be a total lack of desire to socialize and playing alone is the norm. Sometimes this can get confused with parallel play in children 2 and under, but even typical one year olds will attempt to interact with other kids at some point in time. This could be something as simple as lining up cars without actual car play and getting extremely agitated or upset if someone comes along and changes the direction or location of one of those cars so carefully lined up.
It’s also important to know the behavioral signs for “look alike” disorders, such as sensory processing disorder.
What Is Autism Spectrum Disorder?
Autism is a neurodevelopmental disorder that affects how a child interacts with others, communicates, and engages with the world. It exists on a wide spectrum—some children may be nonverbal and require lifelong support, while others may have mild challenges that improve with early intervention.
ASD is diagnosed based on two core criteria:
- Deficits in social communication and interaction, such as difficulty making eye contact, forming relationships, or using language appropriately.
- Restricted, repetitive behaviors, including unusual movements, fixations, routines, or sensory interests.
These traits can manifest differently in each child, but toddlers often begin showing recognizable patterns by age 18–24 months.
Key Signs of Autism in Toddlers
It’s natural for toddlers to develop at their own pace, but persistent developmental delays or unusual behaviors should be taken seriously. Here are the most commonly observed signs of autism in toddlers:
1. Lack of Social Engagement
- Doesn’t respond to their name by 12–18 months
- Avoids eye contact or seems uninterested in faces
- Rarely smiles or shows facial expressions in response to others
- Prefers playing alone, even in group settings
2. Delayed or Atypical Communication
- No spoken words by 16 months, or only a few
- Does not use gestures like pointing, waving, or nodding
- Repeats words or phrases (echolalia) without understanding
- Doesn’t initiate or respond to social interaction through language
3. Repetitive Behaviors and Routines
- Repeats movements like hand flapping, spinning, or rocking
- Shows intense focus on certain objects or activities
- Plays with toys in unusual ways (e.g., lining them up instead of playing)
- Upset by changes in routine or new environments
4. Sensory Sensitivities
- Overreacts to sounds, lights, or textures
- Fascinated by spinning objects, fans, or flashing lights
- May seek or avoid physical sensations like touch, movement, or temperature
5. Emotional and Behavioral Challenges
- Has frequent meltdowns over minor frustrations
- Difficult to soothe or comfort
- Appears to be “in their own world”
- Doesn’t show interest in what others are doing
How Is This Different From Typical Toddler Behavior?
It’s important to distinguish normal toddler behavior from behaviors that could be signs of autism. For example, parallel play—when toddlers play side-by-side without interacting—is typical for children under age 2. However, a toddler with autism may show no desire to connect with peers, even as they get older.
Similarly, speech delays can happen in many children. But if a toddler shows no interest in communication, doesn’t use gestures, or doesn’t imitate sounds, these could indicate a deeper developmental issue.
How Toddlers with Autism May Respond to Everyday Activities
Recognizing the signs of autism in toddlers can be clearer when observing how your child responds to common social and play-based activities. Here’s a look at what you might expect from a typically developing toddler versus a child who may be on the autism spectrum.
🧸 Activity 1: Peekaboo or Simple Social Games
- Typical Response: Laughs, makes eye contact, anticipates your actions, may try to mimic or initiate the game again.
- Possible Autism Sign: Shows little interest, doesn’t smile or engage, avoids eye contact, or appears confused by the game.
📚 Activity 2: Reading a Picture Book Together
- Typical Response: Points at pictures, turns pages, labels familiar objects or responds when you ask, “Where’s the dog?”
- Possible Autism Sign: Doesn’t respond to questions or gestures, fixates on a specific page, or is completely disinterested in the interaction.
👋 Activity 3: Waving Hello or Goodbye
- Typical Response: Waves back, imitates your movement, or smiles when greeted.
- Possible Autism Sign: Does not wave or acknowledge the gesture, may turn away or act indifferent.
🗣️ Activity 4: Calling Their Name
- Typical Response: Turns head, makes eye contact, may smile or respond verbally.
- Possible Autism Sign: No response after multiple attempts, even when you’re nearby. May appear to ignore you or be in their “own world.”
🧩 Activity 5: Playing with Toys
- Typical Response: Uses toys functionally (feeds doll, rolls car, stacks blocks), experiments with pretend play.
- Possible Autism Sign: Lines up toys repetitively, spins wheels, fixates on parts of the toy, or shows no interest in functional or imaginative play.
🗯️ Activity 6: Engaging in Back-and-Forth Conversation or Babble
- Typical Response: Uses words or gestures to communicate needs, tries to imitate speech sounds, or engages in back-and-forth “chatting.”
- Possible Autism Sign: Limited or no babbling by 18 months, doesn’t imitate sounds, echolalia (repeating words with no understanding), or no attempt to initiate communication.
🎨 Activity 7: Imitating Actions (e.g., clapping, stomping, facial expressions)
- Typical Response: Attempts to copy you, even if imperfectly; enjoys mirroring physical or emotional cues.
- Possible Autism Sign: Doesn’t attempt to mimic you; appears unaware of your actions; may stare blankly or walk away.
🚼 Activity 8: Physical Affection (Hugs, Cuddles, Being Picked Up)
- Typical Response: Seeks comfort, leans in for hugs, reaches up to be picked up.
- Possible Autism Sign: Doesn’t respond to affection, seems uncomfortable with physical contact, or doesn’t reach out to caregivers.
🎵 Activity 9: Singing a Song with Motions (e.g., “If You're Happy and You Know It”)
- Typical Response: Claps hands, imitates motions, laughs, and anticipates parts of the song.
- Possible Autism Sign: Does not engage with song, doesn’t attempt motions, or becomes distressed by the music or group setting.
🚶 Activity 10: Following Simple Directions
- Typical Response: Responds to basic commands like “Come here,” “Give me the ball,” or “Sit down,” even with gestures.
- Possible Autism Sign: Ignores or misunderstands simple directions, even when clearly and repeatedly prompted; may act as if they don't hear you.
Why These Activities Matter
These activities highlight functional communication, joint attention, imitation, and social reciprocity—core developmental milestones that are often affected in toddlers with autism. If your child frequently responds in the ways listed under “possible autism sign,” it’s a good idea to discuss your concerns with a pediatrician or developmental specialist. Early intervention can help build these foundational skills and improve long-term outcomes.
Screening vs. Diagnosis
If you suspect your toddler may show signs of autism, the first step is often a developmental screening. Pediatricians commonly use tools like the Modified Checklist for Autism in Toddlers (M-CHAT) during 18- and 24-month checkups.
However, screenings are just the beginning. A formal diagnosis is typically made by a developmental pediatrician, child psychologist, or neurologist through in-depth behavioral assessments and parent interviews.
How the Signs of Autism in Toddlers Compare to Infants
While infants may show early red flags—such as lack of eye contact or not reacting to their name—many of the hallmark signs become clearer in toddlerhood. This stage is when language, social play, and independence should be emerging. A toddler who doesn't imitate, speak, or interact socially raises more obvious developmental concerns than an infant who simply hasn't reached those milestones yet.
The Infant Sibling Project at the New England Center for Children found that early signs of autism can emerge even before 6 months in high-risk infants. However, for many families, it's during toddlerhood that symptoms become undeniable, prompting evaluation and treatment.
What Should You Do If You See These Signs?
1. Document the Behaviors
Start keeping a journal of your toddler’s behavior. Include what you observe, how often it happens, and under what conditions. This can be incredibly useful during medical evaluations.
2. Use a Checklist
Download and complete a toddler autism checklist to help organize your concerns. Include specific examples of what your child does or does not do in relation to developmental expectations.
3. Speak to Your Pediatrician
Bring your observations and completed checklist to your child’s doctor. If they share your concerns, they may refer you to a specialist for a full evaluation.
Early Treatment Options for Toddlers with Autism
If your child is diagnosed with autism—or even if they’re only showing traits—there’s no need to wait to start treatment. In the U.S., early intervention services are available for children under 3, regardless of diagnosis in many cases.
Evidence-Based Treatments Include:
- Applied Behavior Analysis (ABA): A structured therapy focused on building communication, social, and adaptive skills.
- Speech Therapy: Helps improve expressive and receptive language.
- Occupational Therapy: Supports motor skills, sensory processing, and independence.
- Developmental Therapy: Encourages cognitive and social-emotional growth through guided play and interaction.
Some families also explore dietary approaches, such as gluten-free or casein-free diets, although evidence is mixed. Always consult a pediatrician or nutritionist before making dietary changes.
Moving Forward
Discovering that your toddler may have signs of autism can feel overwhelming. But remember, early recognition opens doors—not closes them. With the right support, many children on the autism spectrum make significant developmental gains, especially when therapy starts early.
The sooner you act, the sooner your child can begin their journey with the tools and support they need to thrive.
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References
1. Autism Symptoms and Early Signs. www.helpguide.org. 10-15-10.