Early Signs and Characteristics of ASD

It is widely believed by autism specialists that early intervention is paramount to the best development outcomes for children with ASD. Any parent with concerns about their child’s development should seek professional screening to rule out the possibility of autism. The M-CHAT-R/F (Modified Checklist for Autism in Toddlers) is a free online tool available for parents to complete at home or with your child’s doctor. However, the results need to be evaluated by your pediatrician who will help you decide if further evaluation by an autism expert is needed.

The following “red flags” may indicate your child is at risk for an autism spectrum disorder. Some children exhibit signs during the first few months of life, while others seem to develop normally, then regress some time before 3 years of age. If your child exhibits any of the following, please don’t delay in asking your pediatrician or family doctor for an evaluation.1

By 6 months

  • Few or no big smiles or other warm, joyful and engaging expressions.
  • Limited or no eye contact.

By 9 months

  • Little or no back-and-forth sharing of sounds, smiles or other facial expressions

By 12 months

  • Little or no babbling
  • Little or no back-and-forth gestures such as pointing, showing, reaching or waving
  • Little or no response to name.

By 16 months

  • Very few or no words.

By 24 months

  • Very few or no meaningful, two-word phrases (not including imitating or repeating)

Other Common Characteristics

Children with higher functioning skills and speech may not be recognized as having autism until after they start school or even later. The following are signs to watch for at any age including young children, adolescents and adults.2

Social Skills Deficits

  • Often prefers solitude
  • Has difficulty understanding other people’s feelings or talking about their own feelings
  • Has trouble relating to others or no interest in other people at all
  • Does not play “pretend” games (i.e., feeding a doll, talking on toy phone, eating toy food)
  • Lacks the ability to notice and interpret social cues (i.e., facial expressions, body language, or other nonverbal communication)
  • Has bossy or pedantic way of speaking to peers

Communication Issues

  • No speech or delayed language development (i.e., trouble expressing their needs using typical words or motions)
  • Loss of previously acquired speech, babbling or social skills
  • Persistent repetition of another person’s words or phrases in place of normal language. Repeating a question back to you, rather than answering the question. (echolalia)
  • Does not point at objects to show interest
  • Does not look at objects when another person points at them
  • Appears to be unaware when people talk to them or try to get their attention but responds to other sounds
  • Unusual use of language, (i.e., using only single words, poor sentence structure, misuse of pronouns)
  • Difficulty with the give and take of normal conversation. Dynamic conversation is hard for them to follow.
  • Tendency to talk in monologues on a preferred topic rather than conversing back and forth.

Behavior Related Problems

  • May avoid eye contact
  • Resistant to minor changes in routine or surroundings
  • Restricted interests (desire to watch the same video over and over, has extreme knowledge one subject, like trains or maps or dinosaurs, etc.)
  • Repetitive behaviors (flapping hands, rocking, spinning self or objects, etc.)
  • Unusual and intense reactions to sounds, smells, tastes, textures, lights and/or colors
  • Prefers not to be held or cuddled, or might be overly affectionate
  • Not able to control their own emotions. Engages in outbursts that seem inappropriate to others.
  • Unusual or unnecessary routines, such as needing to touch certain things as they walk by or strictly following a routine, even when some steps aren’t necessary.
  • May lack normal fears (i.e., tries to pet barking dog, jumps into deep water, walks away in a crowd without looking back for parents)

Permission to copy, but not for commercial use.

  1. Learn the Signs  https://www.autismspeaks.org/learn-signs.
  2. Compiled checklist from Learn the Signs  https://www.autismspeaks.org/learn-signs and US Centers for Disease Control and Prevention website (CDC), Basics About ASD https://www.cdc.gov/ncbddd/autism/facts.html.