Recognising Signs of Autism in Young Children

Autism spectrum condition (sometimes called autism spectrum disorder or ASD) affects how a person communicates, interacts with others, and experiences the world around them. It's a lifelong condition, but the earlier it's identified, the sooner appropriate support can be put in place — and early support can make a real difference to a child's development and quality of life.

Some parents notice things that concern them that something is different about their child long before they receive any formal diagnosis. Trusting that instinct and seeking advice is always worthwhile, even if it turns out there's nothing to be concerned about.

Early Signs in Babies and Toddlers

Autism can sometimes be spotted in children as young as 12 to 18 months, though many children aren't identified until later — particularly girls, whose presentation often differs from the more widely recognised patterns seen in boys.

In the first year or so of life, some early signs might include:

• Limited or no eye contact

• Not responding to their name being called

• Not pointing at things to share interest (for example, pointing at a dog or an aeroplane)

• Not following a parent's gaze or pointed finger to look at something

• Limited facial expressions or social smiling

• Not waving bye-bye or engaging in other social gestures

It's worth saying that many typically developing children will show one or two of these behaviours at various points. What tends to distinguish autistic children is the combination and persistence of several of these signs together.

Signs in Older Toddlers and Pre-School Children

As children reach the age of two and three, the signs may become more noticeable, particularly as the social demands of life increase. Parents might observe:

Communication differences: Some autistic children are delayed in developing speech, while others develop language on time or even early but use it in unusual ways — repeating phrases from television programmes, for instance, or struggling with the back-and-forth of conversation. Some children lose words they previously had, which is called regression and should always be discussed with a health professional.

Social interaction: Autistic children may seem content to play alone and show little interest in other children. They might not engage in pretend play in the way their peers do — rather than feeding a teddy or playing "shop," they might prefer to line toys up or sort them by colour. They may find it hard to understand other people's feelings or to share their own enjoyment of things with others. Our article on general stages of social development describes what's typically expected at different ages.

Repetitive behaviours and routines: Many autistic children develop strong preferences for particular routines and can become very distressed when these are disrupted. They may engage in repetitive movements such as hand-flapping, spinning, or rocking. Some develop intense, focused interests in specific topics or objects — knowing extraordinary amounts about trains or dinosaurs, for example, but showing little interest in anything else.

Sensory responses: Unusual responses to sensory input are very common in autistic children. They might cover their ears at sounds that don't trouble other children, be extremely selective about food textures, or seek out particular sensory experiences like watching spinning objects or feeling certain fabrics. These sensory differences can have a significant impact on daily life.

What Autism Looks Like in Girls

Research increasingly shows that autism often presents differently in girls, which is one reason why girls tend to be diagnosed later than boys — or missed altogether. Girls are more likely to "mask" their difficulties, copying the social behaviour of their peers to fit in. They may appear to have friends and manage social situations on the surface, while struggling enormously underneath.

Autistic girls' special interests may also look less obviously unusual — focusing intensely on animals, celebrities, or fiction rather than the stereotypical trains or numbers. Their difficulties may only become apparent when social demands increase, often around the transition to secondary school.

Getting an Assessment

If you're concerned about your child's development, your first step should be to speak with your GP or health visitor. They can refer you for a developmental assessment, which is usually carried out by a team of professionals including a paediatrician, speech and language therapist, and clinical psychologist.

Waiting lists for autism assessments can be long in many parts of the UK, which is frustrating for families who want answers. While you're waiting, there are things you can do. Keep a diary of your child's behaviours and any patterns you notice — this will be useful during the assessment. Ask your child's nursery or school for their observations too, as children sometimes behave quite differently in different settings.

You don't need to wait for a diagnosis before seeking support. Many strategies that help autistic children — visual schedules, clear and direct communication, sensory accommodations — are beneficial for all children and can be implemented straight away.

After a Diagnosis

Receiving an autism diagnosis for your child can bring a complicated mix of emotions. Some parents feel relief at finally having an explanation; others feel grief, worry, or uncertainty about the future. All of these responses are valid.

A diagnosis opens the door to specialist support, including speech and language therapy, occupational therapy, and educational adjustments. It also connects you with a community of other parents who understand what you're going through. Organisations like the National Autistic Society offer a wealth of information and support for families.

Every autistic child is different. Some will need significant support throughout their lives; others will go on to live independently, build careers, and form relationships with relatively little extra help. What they all have in common is that they benefit from being understood and accepted for who they are. The more you learn about how your child experiences the world, the better placed you'll be to support them. You might find our article on emotional development in children helpful as additional reading, along with our piece on when to worry about your child's development.

This article is intended to help parents understand some of the early signs that may be associated with autism. It is not a diagnostic guide, and many of these behaviours can be part of typical development. If you have concerns, speak to your GP or health visitor, who can arrange a professional assessment.