Understanding Autism Evaluation, Part II: Early Signs of Autism in Toddlers and Young Children

This article is Part II of our series on understanding autism evaluation. If you’re just beginning this journey, you may find it helpful to start with Part I: Where to Start if You Think Your Child May Be on the Autism Spectrum

Early Signs of Autism: What Parents Often Notice First

Understanding Early Developmental Differences

Parents are almost always the first to notice when something about their child’s development feels unique. Sometimes these differences are subtle-small variations in how a toddler plays, babbles, or interacts with family members that gradually become more noticeable as they grow.

If you have a feeling that your child is developing a bit differently than their peers, trust your intuition. Research consistently shows that parental concerns are incredibly accurate indicators that a professional evaluation might be helpful. Early identification isn’t about looking for deficits; it’s about understanding your child’s unique brain so you can give them the right support to thrive.

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition that changes how a child experiences, communicates, and interacts with the world around them. Below are the early signs and behavioral patterns clinicians look for in toddlers and younger children.

Differences in Social Connection and Connection Games

In toddlers and young children, early social development is all about “connection games” and shared attention. Autistic kiddos often show a different style of connecting with caregivers and peers:

• Inconsistent Response to Their Name: You might call your child’s name and have them look up only occasionally, or not at all. Parents often tell us they initially wondered if their toddler had hearing loss (even though their hearing tests are perfectly normal).
• Fewer Shared Moments (Joint Attention): Toddlers naturally love to point at a passing airplane, show you a cool rock they found, or look where you are pointing. A child on the spectrum may not naturally look at what you are pointing to, or they may rarely bring objects over just to “show” you or share the joy.
• Unique Eye Contact: Eye contact may be brief, inconsistent, or used differently to communicate. Your child might look at an object they want rather than looking back and forth between the object and your eyes.
• Missing Early Social Gestures: This includes a delay in, or absence of, common early gestures like waving “bye-bye,” clapping, shaking their head “no,” or pointing to communicate a need.

Communication and Language Patterns

Language development varies wildly in early childhood, but there are specific communication patterns that often point toward an autism profile:

• Speech Delays or Pauses: Some children may experience a delay in babbling or spoken words. Others might speak their very first words on time, but then temporarily stop using them (a regression in language).
• Repeating Phrases (Echolalia): Your child might repeat words or entire phrases right after they hear them, or repeat lines from favorite TV shows, movies, or books hours or days later.
• Using Language Structurally: Instead of using words to ask a question, a young child might use “scripts” or speak in a beautifully formal, adult-like tone that feels advanced for their age, but struggle with the casual, back-and-forth flow of a conversation.

The World of Play: Repetition and Focus

Play is a child’s full-time job! How a kiddo plays gives clinicians an incredible window into how their mind processes information. Autistic children often interact with toys in wonderfully focused, systemic ways.

• Focusing on Parts Instead of the Whole: Instead of rolling a toy car across the floor, your child might turn it upside down and focus intensely on spinning the wheels. They might be more fascinated by the hinge of a toy box than the toys inside.
• Lining Up and Organizing: A strong preference for organizing toys by color, shape, or size, or lining them up in precise rows rather than engaging in traditional pretend play (like feeding a doll or pretending a block is a phone).
• Protecting the Order of Play: Becoming deeply upset if an adult or a peer moves a toy out of the line or tries to change the way they have arranged their play space.

Body Movements and “Stimming”

All children move their bodies to express emotion, but autistic children frequently use repetitive physical movements as a vital way to process big feelings, navigate excitement, or calm their nervous system. This is often called stimming:

• Flapping, Rocking, or Spinning: Hand-flapping or finger-flicking next to their eyes when excited; rocking their body while sitting; or loving the sensation of spinning in circles without getting dizzy.
• Toe-Walking: Consistently walking or running on the tiptoes rather than flat feet.
• Visual Fascination: Getting completely transfixed by moving water, ceiling fans, spinning lights, or watching objects drop to the floor.

Sensory Sensitivities and Routines

Autistic children have nervous systems that are highly attuned to their environments, meaning everyday sounds, textures, and sights can feel vastly different to them:

• Big Reactions to Small Changes: A profound need for predictability. Your child might have an intense meltdown if you take a different driving route to daycare, serve breakfast in a different colored bowl, or transition from playtime to bedtime without warning.
• Sensory Overload: Covering their ears at standard household noises (vacuum cleaners, blenders, flushing toilets) or experiencing extreme distress over clothing textures, tags, seams, or messy hands (like wet grass, sand, or paint).
• Sensory Seeking: Intensely craving certain inputs-like needing to crash heavily into pillows, tightly hugging objects, or being highly selective about eating only very crunchy or completely smooth foods.

When to Reach Out for an Evaluation

It is completely normal for typical children to show one or two of these traits from time to time. However, it is incredibly helpful to seek a professional developmental evaluation if you notice a combination of these signs, or if you observe:

• Any loss or regression of speech, babbling, or social skills at any age.
• Persistent difficulty connecting or communicating with family members.
• Sensory sensitivities or behavioral meltdowns that are beginning to make everyday family outings or transitions highly stressful.

An evaluation isn’t something to fear; it is an act of love that provides a clear, compassionate roadmap. It helps us pinpoint exactly how your kiddo learns, communicates, and experiences the world so we can set up an environment where they feel safe, understood, and supported to grow exactly as they are.

This article is part of our series on understanding autism evaluation. In our next post, we will walk you through exactly what an evaluation looks like, what to expect in the clinic, and how we keep the process supportive and stress-free for your little one.

References

• American Academy of Pediatrics. (2020). Identification, Evaluation, and Management of Children with Autism Spectrum Disorder. Pediatrics, 145(1).
• American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., Text Revision). Washington, DC.