Age-Related Signs of Autism – Autism Center – Everyday Health

First giggles, first words, and first steps are exciting milestones for parents and baby. But what if your baby doesn't seem to be reaching them? Are these possible warning signs of autism?

Autism and Missed Milestones

Autism is a developmental disability that typically appears before age 3 and can be diagnosed in children as young as 18 months old. Signs of autism focus on key problem areas including delayed or difficult communication, problems playing and interacting with others, and certain behavioral problems.

Parents and caregivers are most likely to spot the warning symptoms of autism in babies by carefully tracking development and milestones. Of course, no child hits every developmental milestone at exactly the same time. But if you notice delays that are consistent with other signs of autism, your child should be screened.

Here are some developmental milestones, broken down by age, that if missed could signal a concern about autism:

By around age 3 to 4 months, a child should be able to smile, start playing, begin speaking in baby babble, and be able to pay attention to interesting movements and objects. Warning signs of autism at this stage include:

  • No interest in hands or feet — a lack of self-awareness
  • No smiling
  • No babbling or attempt to imitate noises you make
  • No grabbing or gripping objects, poor head support, and difficulty following or focusing on objects
  • No attempt to place objects in the mouth
  • A regression in certain skills

By about 7 months, a child should be very curious about the world around him, using his hands and mouth to check out everything. He should be playful, laughing, and responsive to your emotions. At this stage, your baby should even begin to pick up on verbal communication, including recognizing his name and the word "no." Warning signs of autism at this stage include:

  • Movements that seem too rigid or too loose
  • Not wanting to show physical affection (for example, if you have difficulty getting the baby to cuddle)
  • No response to emotions, physical contact, or sounds
  • Difficulty soothing your baby
  • Physical delays like the inability to roll over, hold up the head, or sit with help from an adult
  • No participation in simple games
  • No babbling
  • A regression in certain skills

By about 12 months old, a child should start to become a bit more emotional — crying when you leave and acting a little uncomfortable around people he doesn't know. He should become more aware of your presence (and the lack of it), play games, and use words and other ways of communicating. Warning signs of autism at this stage include:

  • Physical delays like not standing up with help, no crawling, or crawling with one side of the body dragging
  • Not pointing to things, like a food or a toy he wants
  • Lack of physical communication or gestures, including waving
  • Lack of participation in games like hiding toys; for instance, he doesn't try to look for something you hid
  • Can't say individual words like "dada," "mama," or "cookie"
  • A regression in certain skills

By the time a child is about 2 years old, he should start enjoying the company of and interaction with other kids. Slowly, a toddler will become more independent and maybe a bit feistier as well. Skills like improved verbal communication, recognizing colors and shapes, and being able to play pretend should begin developing. Warning signs of autism at this stage include:

  • Not speaking in phrases (at least two words at a time)
  • Knowing fewer than 15 words
  • Inability to follow basic directions
  • Not imitating others' activities or words
  • Doesn't know what to do with a toothbrush, hairbrush, eating utensils, or a toy phone (can't play with or use them)
  • Physical delays like not walking by 18 months old, or only walking on tiptoes
  • A regression in certain skills

By 3 years old, a child should be able to interact appropriately with other children and enjoy it. He should understand basic concepts of fairness and appropriate social behaviors, like understanding how games work, taking turns, and recognizing other people's property. A child should certainly be a little independent person now, experiencing many different emotions. He should be starting to get the hang of numbers and certain objects, and be able to "pretend" and play. Warning signs of autism at this stage include:

  • Avoiding eye contact with others
  • No interest in "make-believe" or pretend play
  • Not wanting to play with toys or even other children
  • Can't speak even in short phrases
  • Speech that is slurred or difficult to understand, accompanied by frequent drooling
  • Difficulty copying objects; for instance, being unable to draw a shape like a circle
  • Can't work simple toys or objects
  • Severe problems with separation from parent or caregiver
  • A regression in certain skills

Autism: As Your Child Gets Older

The warning signs of autism can be pretty clear by about the age of 3, but you can still see signs as your child gets older. By the time he is 4 or 5, for instance, you should be concerned if he is extremely shy or withdrawn, or very aggressive. Not wanting to play with others and not having creative play alone are other warning signs. Speech is always a good indicator; by age 4 or 5, your child should be able to communicate effectively and use the appropriate person (saying "I" to refer to himself) and verb tense.

Milestones are only guidelines; don't be concerned if your child is a few weeks or months off on a couple of developments. Your child is a unique individual, and that's what you love about him! But if you notice a consistent pattern of delays and that your child is significantly behind others in his age group, it's a good idea to get an evaluation from a doctor.

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