Early signs and symptoms of autism

The signs of autism can show up early – even during infancy. While some children may have symptoms of autism at 6 months old, others will be symptom free until they are almost 2 years old. Most children with autism begin showing symptoms before the age of three.

Early signs of autism

Patricia Evans, M.D., Ph.D., Neurologist at Children's Health℠ and Professor at UT Southwestern, says parents should watch for signs of autism spectrum disorder.

Autistic behaviors and symptoms may fall into categories such as:

Social difficulties

All children with autism have social difficulties, though they can vary greatly. Signs may include:

• Avoiding eye contact or not looking at people

• Not responding to their name before the age of 1

• Trouble understanding and talking about emotions

• Avoiding cuddling or hugging

• Appearing not to hear when others speak to them

• Not understanding how to interact with others

Dr. Evans says even infants can show social difficulties. “Babies who don’t smile or who aren’t socially smiling show one of the earliest indicators there might be something off,” says Dr. Evans. “Other signs might include when babies don’t like to be cuddled or they can’t be comforted.”

Communication challenges

Along with social difficulties, autistic children often have trouble communicating. Signs of communication challenges can include:

• Delayed speech or language skills

• Repeating the same words over and over

• Not answering questions or giving unrelated answers

• Use of strange tones in their voice such as flat tone or sing-songy tone

• No use of gestures or pointing to communicate

Dr. Evans says many parents receive some misinformation about autism symptoms in boys. “There is a common myth that boys don’t speak as early as little girls,” says Dr. Evans, “but little boys who aren’t speaking should be assessed for hearing, autism and seizures. Any time you have a child not developing language as they should, you have an immediate red flag.”

Unusual behaviors or interests

Children with autism may also have different interests or behaviors, including:

• Obsessive interest in certain objects or items

• Being more interested in objects than people

• Strong reactions to sensations like sounds, smells, tastes or textures

• Getting upset by changes to their routine or environment

• Repetitive movements like flapping their hands or rocking back and forth

Dr. Evans says many autistic children may also show signs of anxiety, especially when faced with new situations. “An autistic child just wants to do the same thing,” says Dr. Evans. "He is just overwhelmed by new things. Anxiety gets worse if you stress out the person with autism."

What do I do if my child shows symptoms of autism?

If you are concerned your child has autism, you should make an appointment with your pediatrician. Autism is diagnosed through watching your child’s behavior. Your pediatrician can identify signs that may mean your child has autism and refer you to a pediatric neurologist who specializes in autism.

Your pediatrician may also identify signs of autism during a well-baby check. Dr. Evans encourages parents to never miss a well-baby check, which can be critical to keeping an eye on your baby’s health, growth and development.

Learn more

The Center for Autism Care is an interdisciplinary program offering comprehensive patient care and translational medicine for individuals with autism and related neurodevelopmental disorders. Learn more about our program and services.

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