Mental Health & Neurodiversity

What are early signs of autism and when should we screen?

Early Signs of Autism Spectrum Disorder

Every parent watches for those magical milestones—first smiles, first words, first steps. Yet for some children, development unfolds along a different timeline, revealing patterns that don’t fit the typical mold. Recognizing these early differences can be the key to understanding a child’s unique way of thinking, feeling, and interacting with the world. Autism Spectrum Disorder (ASD) represents one of the most important of these developmental variations. The earlier families understand what to look for, the earlier they can access support that empowers both the child and their environment.

Understanding Autism Spectrum Disorder

Autism Spectrum Disorder is a neurodevelopmental difference—not a disease or defect. It describes a wide range of neurological variations that influence how individuals perceive, process, and engage with the world around them. Autism is best understood as a form of neurodiversity: a natural variation in human cognition that shapes how people experience sensory input, language, emotion, and relationships.

The term “spectrum” is key. It reflects both the diversity and individuality of autism. One child may speak fluently but struggle with subtle social cues; another may have minimal speech yet possess extraordinary visual or mathematical abilities. Some children require extensive daily support, while others thrive independently with minimal assistance. This variability means that no two autistic individuals are exactly alike—and why early, individualized assessment is essential for accurate understanding.

While signs of autism usually emerge before age three, many children go undiagnosed until school age, when social and communication demands increase. Early identification enables families to access therapies and learning supports during critical developmental windows, dramatically improving long-term outcomes.

Recognizing Core Early Indicators

Autism manifests through a combination of social communication differences and restricted or repetitive behaviors. These signs vary widely, but parents and caregivers often notice distinct patterns as early as infancy or toddlerhood.

Social Communication and Interaction Differences

Children on the autism spectrum often engage differently in social and emotional exchanges. This might include:

Limited eye contact: The child may avoid or use brief glances rather than sustained eye contact.
Reduced response to name: Even when hearing their name, they may not consistently turn or acknowledge the speaker.
Preference for solitary play: Enjoying independent activities more than group play or shared experiences.
Challenges with social reciprocity: Difficulty in back-and-forth interactions such as games of peekaboo or imitation play.
Language differences: Delays in speech development, unusual intonation, or repetitive language patterns (echolalia).

Parents may also notice differences in nonverbal communication—such as fewer gestures, limited facial expressions, or less pointing and showing objects to share interest. These subtle cues can signal that the child experiences social engagement differently, not that they lack curiosity or care.

Restricted and Repetitive Behaviors

Alongside communication differences, children with autism may exhibit behaviors or interests that appear repetitive, intense, or highly specific:

Repetitive movements: Hand-flapping, spinning, or rocking when excited or stressed.
Rituals and routines: Strong need for predictability and distress at changes to established patterns.
Sensory sensitivities: Overreaction or underreaction to sounds, textures, smells, or lights.
Focused interests: Deep fascination with specific topics or objects (e.g., fans, trains, numbers).
Unusual object use: Lining up toys, spinning wheels, or focusing on parts rather than the whole.

These behaviors are not inherently “problematic.” For many autistic children, repetitive actions serve as comfort, communication, or sensory regulation. The key is understanding the purpose they serve rather than trying to eliminate them.

Understanding the Screening Process

Professional Guidelines

The American Academy of Pediatrics (AAP) recommends universal screening for autism at both 18 and 24 months, integrated into routine well-child visits. Pediatricians may use standardized tools like the Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) to assess social responsiveness, play behaviors, and communication milestones. Additional screening is advised if:

A child shows developmental delays in language or social skills.
Parents or caregivers express consistent concern about communication or behavior.
There is regression—loss of previously acquired speech or social engagement—at any age.

When to Pursue Screening

Parents should seek professional evaluation if they observe the following developmental red flags:

No babbling, pointing, or meaningful gestures by 12 months.
No single words by 16 months or two-word phrases by 24 months.
Loss of language or social abilities at any point.
Limited response to name or environmental cues.
Repetitive play patterns or intense fixation on specific activities.

Early screening does not label a child—it provides information. Even if autism is not diagnosed, screening can reveal other developmental or communication needs that benefit from early support.

The Importance of Early Intervention

Research over the past two decades has made one point clear: early intervention changes trajectories. When children receive therapy and support early, their ability to communicate, learn, and form relationships improves significantly. This period of “brain plasticity” in early childhood is when learning and adaptation occur most rapidly.

Early intervention may include:

Speech and language therapy: Builds communication and comprehension skills, including nonverbal communication.
Occupational therapy: Improves sensory processing, daily living skills, and fine motor coordination.
Applied Behavior Analysis (ABA): Structured techniques that reinforce learning through positive feedback (used selectively and ethically).
Play-based therapies: Such as Floortime or Early Start Denver Model (ESDM), emphasizing social connection and joy.
Parent training programs: Equip caregivers with strategies to support learning and regulation at home.

The goal of early intervention is not to “fix” a child but to empower them to communicate and navigate their world comfortably. These programs also give parents tools to understand and respond effectively to their child’s behaviors, reducing stress and strengthening the parent-child bond.

Embracing Neurodiversity and Individual Strengths

Recognizing autism early allows families to move beyond fear toward understanding. Modern approaches to autism emphasize building on strengths—whether that’s a sharp memory, visual thinking, creativity, or attention to detail. Many autistic individuals excel in fields that value precision, innovation, and persistence once given the right support.

Equally important is reframing language around autism. Instead of “symptoms” or “deficits,” professionals increasingly use terms like “differences” or “traits.” This shift honors autism as a neurotype rather than a disorder to be cured. Acceptance-based frameworks—like the neurodiversity movement—encourage inclusion, accessibility, and dignity in all areas of life.

Supporting Families on the Journey

Discovering that your child might be on the autism spectrum can bring mixed emotions: worry, confusion, relief, or even hope. Remember that seeking evaluation is not an act of labeling—it’s an act of love. It means choosing understanding over uncertainty.

Families benefit greatly from community resources and advocacy networks. Support groups—both local and online—can connect parents with others who share similar experiences. These networks provide practical advice, emotional validation, and recommendations for trusted specialists.

For families beginning the journey, the most important step is staying curious and compassionate. Every small progress—eye contact during play, new words, reduced frustration—is meaningful. Celebrate these moments. Progress is rarely linear, but every step builds connection and confidence.

Moving Forward: Awareness, Advocacy, and Acceptance

Autism is not something to fear or fix—it’s something to understand. Each autistic child brings unique perspectives and strengths that enrich their families and communities. The earlier we recognize and support those differences, the greater the potential for thriving futures built on acceptance rather than conformity.

As society grows in understanding, the focus is shifting from “intervention to make normal” toward “support to empower potential.” Families play the most crucial role in this shift—by choosing empathy, learning, and inclusion as guiding principles.

Key Takeaways for Parents

Trust your instincts—early concerns are valid and worth exploring.
Early screening leads to earlier support and better developmental outcomes.
Intervention works best when it’s individualized and strengths-based.
Autism is lifelong but not limiting; with the right environment, children can flourish.
Your acceptance, advocacy, and patience are the most powerful tools in your child’s development.