What are the signs of autism in toddlers?

Many parents are aware that children develop at their own pace. This can make it difficult to determine whether there is cause for worry if their own child seems to be delayed, or not developing in the same way as others.

It also leads to confusion on whether to be alarmed enough to bring the child to a developmental pediatrician for a check, or to just ‘wait and see’ and hope that the child improves given time.

The website www.autismspeaks.org is an excellent source of further information on this topic. According to their website, the ‘red flags’ that parents should note are:

• No big smiles or other warm, joyful expressions by six months or thereafter
• No back-and-forth sharing of sounds, smiles or other facial expressions by nine months
• No babbling by 12 months
• No back-and-forth gestures such as pointing, showing, reaching or waving by 12 months
• No words by 16 months
• No meaningful, two-word phrases (not including imitating or repeating) by 24 months
• Any loss of speech, babbling or social skills at any age

If your child displays some or all of the above, we suggest that it is time to see a professional / developmental pediatrician to determine next steps.

At what age do toddlers begin to show signs of autism?

Since autism is a spectrum, and there are different ‘types’ that we see among children, there is no one specific answer to the above. Some infants and toddlers show the signs early, for instance, the child does not smile even as early as 6 months.

However, there are some toddlers that develop well initially (ie, they learn words, interact with family, etc like typically developing children), however, they show signs of regression later on (usually between 15 months – 36 months). This type of autism (called regressive autism) can sometimes be confusing to parents and family. It is important to see a professional in this situation.

If my toddler is showing signs of autism, do I need to wait for a diagnosis of autism, or should I seek therapy immediately even without a diagnosis?

An important first step is to see your doctor or developmental pediatrician. He/she can help you with a diagnosis or can guide you towards the next steps for therapy.

The decision to start therapy even prior to a diagnosis is a personal family decision. We are aware of some parents who decide to go for therapy without waiting for a diagnosis because they know that the earlier any intervention is started, the higher the chance of success and improvement for the child.

Clinical data shows that a child that starts ABA therapy before the age of 4 years, and does the therapy with the right amount of intensiveness (number of hours per week), has a much higher chance of improvement.