You cannot diagnose autism at home. A clinician has to make the official diagnosis.
But you spend the most time with your child, and you may notice unusual behaviors that could be signs of autism. Your toddler may not maintain eye contact, or they may not respond when you call their name. Perhaps your child doesn’t engage in imaginative play or engage with other children. Your child might obsess over certain activities or perform repetitive behaviors.
If you notice certain signs of autism in your child, it’s time to talk to a doctor. You can’t make an at-home diagnosis on your own, but you can provide a doctor with valuable information to aid the diagnostic process.
Autism in Children: Understanding Potential Signs
Autism spectrum disorder (ASD), or autism, is a developmental condition. People who are on the autism spectrum communicate differently, understand social cues differently, and experience some behavioral challenges.
Thanks to advances in behavioral psychology and medical diagnoses, more people now know that they are on the autism spectrum, so they can get the help they need. Many of these individuals are adults.
Fortunately, as the medicine advances, more children are receiving early autism diagnoses, so they can work with doctors, therapists, and other professionals to get help as early as possible. With early intervention, these children have the best chances at healthy, balanced lives.
Sometimes, children 18 months old or younger can be diagnosed with ASD, but clearer signs begin appearing around 2 years old. Typically, children do not receive a final diagnosis until much older, usually around elementary school.
A pediatric physician or psychologist will use medical guidelines to diagnose your child, so it’s important to work with a clinician. They will use much of the information you collect at home to make an official diagnosis.
Common Signs of Autism in Your Child
People who have autism may learn, socialize, communicate, and behave in different ways from neurotypical individuals. The autism spectrum highlights that some of these differences may be subtle. For others with ASD, they may be profound. Understanding these differences can help you better care for your child.
Autism usually becomes apparent around 3 years old, but the exact timeline varies from person to person. As a developmental condition, it will continue throughout the person’s life.
Typically, children with autism develop normally for the first portion of their life — usually up until 18 to 24 months. Then, they stop gaining new skills, or they begin to lose skills they had gained as babies. Some studies report that a third of parents with autistic children begin noticing behavioral and mental changes around the child’s first birthday. Between 80 and 90 percent report problems by 24 months old.
- Not reacting to their name by 12 months (1 year old).
- Not pointing at objects of interest, such as an airplane in the sky by 14 months.
- Not playing imaginary or “pretend” games, like setting up scenes with dolls by 18 months.
- Wanting to be alone.
- Avoiding eye contact.
- Difficulty understanding other people’s feelings.
- Trouble verbalizing or expressing their own feelings.
- Delayed speech.
- Echolalia, or repeating words or phrases.
- Unconnected answers to questions.
- Getting upset by minor changes to routines or surroundings.
- Obsessive interests.
- Performing repetitive actions or stimming, like spinning in circles, rocking their body, or flapping their hands.
- Unusual reactions to the way things smell, taste, sound, look, or feel.
These can be very minor or very pronounced. Your child may present with one or two of them, or they may exhibit all of them. If you notice any of these changes, you can work with your pediatrician to get a diagnosis.
Your pediatrician will also be able to guide you on general childhood development. They will use more specific checklists to understand the scope of your child’s autism.
Specific Groups of Autism Signs May Show Up More Than Others
Autism symptoms are often grouped into specific categories.
Your child will show social problems as they get older. These are the most common signs of autism, and they can have serious repercussions on daily life.
Your child may:
- Not respond to their name by 12 months old.
- Only interact with other kids to reach a desired aim.
- Avoid eye contact and social interaction with others, including parents.
- Play alone.
- Not share activities with other kids.
- Have facial expressions that don’t fit the situation.
- Not understand social boundaries or personal space.
- Avoid or resist physical contact.
- Be unable to be consoled by others when feeling upset.
- Have difficulty understanding other people’s feelings or communicating their own feelings.
Communication issues are another common symptom of ASD.
About 40 percent of children with autism do not speak at all. Between 25 and 30 percent of children have some words between 12 and 18 months, but then lose them. Others may speak, but not until later in childhood. Some children speak well and do not experience many, if any, overt communication problems.
Examples of communication issues your child may present with include:
- Delayed speech and language skills.
- Giving unrelated answers to questions.
- Reversing pronouns, such as saying “you” instead of “I.”
- Not pointing at interesting things and not responding to pointing.
- Using few to no gestures, such as not waving goodbye.
- Using a flat, robotic, or sing-song voice.
- Not pretending during play.
- Not comprehending jokes, teasing, playfulness, or sarcasm.
Sometimes, children with autism will use only one word at a time. They may not be able to put words into real sentences.
They may repeat you after you speak. For example, you may ask, “Do you want some juice?” And they may then ask, “Do you want some juice?”
Children who have autism often show unusual interests and behaviors, particularly obsessive interests.
Some of these obsessive symptoms may include:
- Lining up toys or objects.
- Playing with toys the same way every time.
- Liking specific parts of toys, like the wheels.
- Being very organized, even during play.
- Getting upset by minor changes or disruptions.
- Having obsessive interests.
- Following specific routines.
- Stimming, like repeatedly spinning the wheels of a toy car.
There are several other signs that your child may be on the autism spectrum. These signs do not have a specific category, but your pediatrician may ask if you have noticed any of them.
Ungrouped signs of autism include:
- Hyperactivity, including being very physically active.
- Impulsivity, or performing actions without thinking about them.
- A short attention span.
- Self-harming behaviors.
- Extreme emotions that lead to temper tantrums.
- Unusual eating or sleeping habits.
- Odd emotional reactions or mood.
- Either a great deal of unanticipated fear or lacking fear when they should be cautious.
- Unusual reactions to sensory things, like how things smell, taste, look, sound, or feel.
Children with ASD may react unusually to loud noises, or they may underreact to pain. They may chew or eat non-food items like dirt or rocks (PICA), or they may have digestive issues beyond what other children experience. They may have unusual mood reactions, such as laughing or crying at inappropriate times. They may show little fear over harmful events or objects.
Rapid Childhood Development in Some Areas
In addition to the signs and symptoms listed above, which become apparent from 12 months to 3 years old, autistic children may show developmental strengths in areas that their peers do not.
While they may not speak or socialize the same way as a neurotypical toddler, they may be very good at putting a puzzle together, or they may be able to walk or move around faster than neurotypical children their same age. They may be able to read very well at a young age, but they may not be able to speak the sounds of the words on the page.
It can be easy for parents to take pride in their child’s accomplishments while worrying about unusual behaviors that they do not know how to explain. This is where your pediatrician and a specialist come in. You can talk to your pediatrician about any concerns you have, and they can refer you to a specialist as needed.
You can also use some tools at home to help you understand certain behaviors or skills that may appear unusual. All children are individuals and develop a little differently. Whether your child has ASD or not, they may show some unique behaviors, both in positive areas and in areas of concern.
Checklists at Home Prepare You for a Visit With Your Pediatrician
The Centers for Disease Control and Prevention (CDC) has a website with a list of developmental milestones, broken down by age. These start at 2 months old and continue through 5 years old.
Some milestones include:
- Smiling, cooing or gurgling, and paying attention to faces at 2 months old.
- Knowing familiar faces versus strangers’ faces, making basic noises like “bah,” and showing curiosity in others by passing them objects by 6 months old.
- Repeating sounds or actions to get attention, using gestures like waving, and following simple directions like “pick up the toy” by 1 year old.
- Showing defiant behavior, saying sentences with two to four words, and running and kicking balls by 2 years old.
You may also use an online assessment tool, but there isn’t a way to perform an at-home diagnosis of your child. A medical professional has to give the diagnosis.
An online quiz is not definitive, but it asks typical evaluation questions that your pediatrician might answer. You can use it to prepare yourself for an appointment to discuss your concerns. It can give you a form of at-home help that builds the foundation for an official diagnosis from a doctor.
There is no shortage of online assessment tools for autism. Your pediatrician will use similar lists to ask questions so they can understand your child’s behaviors. While you can use these online tools to start the conversation, it is important to get developmental screening with a medical professional if you are concerned about your child.
The American Academy of Pediatrics (AAP) advises that all children get developmental and behavioral screening during specifically timed visits with their pediatrician. These visits happen at:
- 9 months.
- 18 months, for a specific autism screening using the M-CHAT.
- 24 months, for a specific autism screening using the M-CHAT-R/F.
- 30 months.
Additional later tests are recommended if there is a history of autism in the family. The pediatrician will set the frequency of these tests.
If these screenings indicate potential signs of autism spectrum disorder, your pediatrician can refer you and your child for a formal developmental evaluation. This is a medical screening tool with a behavioral professional who can assess your child’s symptoms. They will determine the severity of the condition and help you develop a therapy plan.
With appropriate therapy, like ABA therapy, your child can learn to function well and maximize their potential. Early intervention is key to successful autism treatment, so it’s important to stay on schedule with all developmental and behavioral screenings.
As always, if you notice something that seems amiss with your child, talk to your pediatrician as soon as possible. A medical professional will determine if your child is actually autistic, but the information you provide is invaluable in this process.
- What Is Autism Spectrum Disorder? (March 2020). Centers for Disease Control and Prevention (CDC).
- Autism Spectrum Disorder. (March 2018). National Institute of Mental Health (NIMH).
- Signs and Symptoms of Autism Spectrum Disorders. (August 2019). Centers for Disease Control and Prevention (CDC).
- When Do Children Usually Show Symptoms of Autism? (January 2017). Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHHD), National Institutes of Health (NIH).
- Screening and Diagnosis of Autism Spectrum Disorder. (March 2020). Centers for Disease Control and Prevention (CDC).
- CDC’s Developmental Milestones. (December 2019). Centers for Disease Control and Prevention (CDC).
- Child Autism Test (Self-Assessment). (October 2019). Psycom.