Behavior & Social

Worried About Autism - When and How to Screen

Medically reviewed by Dr. Emily Torres, PhD, CCC-SLP · Pediatric Speech-Language Pathologist

Content reviewed against published AAP, CDC, NIH guidelines

Editorial policy

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Behavioral development varies greatly from child to child. If you have noticed worried about autism - when and how to screen, here is what you need to know.

The short answer

The AAP recommends autism screening at 18 and 24 months for all children, using the M-CHAT-R/F questionnaire. If you have concerns before these ages, you can request screening earlier. Early signs of autism may include limited eye contact, no pointing by 12 months, no words by 16 months, no pretend play by 18 months, or loss of any previously acquired skills. Trust your instincts as a parent and raise concerns with your pediatrician.

Key takeaways

  • The AAP recommends autism screening at 18 and 24 months for all children, using the M-CHAT-R/F questionnaire. If you have concerns before these ages, you can request screening earlier. Early signs of autism may include limited eye contact, no pointing by 12 months, no words by 16 months, no pretend play by 18 months, or loss of any previously acquired skills. Trust your instincts as a parent and raise concerns with your pediatrician.
  • Usually normal when: Your baby makes eye contact, responds to their name, and engages socially even if quieter than peers
  • Call your doctor if: Your child has lost previously acquired skills like words, social smiling, or babbling
  • Varies by age — see the age-by-age breakdown below

This is one of the most common questions parents ask. Searching for answers means you care.

What Parents Should Know

According to AAP, CDC, NIH guidelines, the AAP recommends autism screening at 18 and 24 months for all children, using the M-CHAT-R/F questionnaire. If you have concerns before these ages, you can request screening earlier. Early signs of autism may include limited eye contact, no pointing by 12 months, no words by 16 months, no pretend play by 18 months, or loss of any previously acquired skills. Trust your instincts as a parent and raise concerns with your pediatrician. At 0-6 months, autism cannot be reliably diagnosed at this age, but some early signs may include reduced eye contact, limited social smiling, and reduced response to familiar voices. These signs overlap with many other conditions and with normal variation. It is generally considered normal when your baby makes eye contact, responds to their name, and engages socially even if quieter than peers. However, you should contact your pediatrician promptly if your child has lost previously acquired skills like words, social smiling, or babbling.

Sources: [1], [2], [3]

Normal vs. Concerning

Usually Normal
Worth Discussing
Your baby makes eye contact, responds to their name, and engages socially even if quieter than peers
Your child has lost previously acquired skills like words, social smiling, or babbling
Your toddler has some quirks but is developing social communication skills on track
Your child shows no social engagement, no communication, and no joint attention by 18 months
Your child plays pretend, points to share, and shows interest in other people
You have a gut feeling that your child's social development is different

By Age

What to expect by age

0-6 months

Autism cannot be reliably diagnosed at this age, but some early signs may include reduced eye contact, limited social smiling, and reduced response to familiar voices. These signs overlap with many other conditions and with normal variation.

6-12 months

Possible early indicators include limited babbling, absent pointing, lack of response to name, reduced social engagement, and no back-and-forth gestures. These should be monitored but are not diagnostic at this age.

12-18 months

Autism screening can begin. Key concerns include no words by 16 months, no pointing by 12 months, no showing or waving, limited eye contact, and loss of any previously acquired skills.

18-24 months

Universal screening with M-CHAT-R/F is recommended at 18 and 24 months. This brief questionnaire identifies children who should be referred for comprehensive evaluation. Early identification leads to earlier intervention.

24-36 months

Autism can be reliably diagnosed by age 2 in many cases. If you have concerns, request a developmental evaluation. The diagnostic process typically includes observation, parent interviews, and standardized testing.

What to Tell Your Pediatrician

  • Describe when you first noticed worried about autism - when and how to screen and how it has changed over time.
  • Note your baby's current age and which age-specific patterns you are seeing.
  • Mention if you have a gut feeling that your child's social development is different.
  • Mention if your child shows several early signs like limited eye contact, absent pointing, and no words.
  • Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
  • Bring a list of any questions or observations you want to discuss at the appointment.

What Should You Do?

When to take action

Probably normal when...
  • Your baby makes eye contact, responds to their name, and engages socially even if quieter than peers
  • Your toddler has some quirks but is developing social communication skills on track
  • Your child plays pretend, points to share, and shows interest in other people
Mention at your next visit when...
  • You have a gut feeling that your child's social development is different
  • Your child shows several early signs like limited eye contact, absent pointing, and no words
  • There is a family history of autism and you want proactive screening
Act now when...
  • Your child has lost previously acquired skills like words, social smiling, or babbling
  • Your child shows no social engagement, no communication, and no joint attention by 18 months

What You Can Do at Home

  • Keep track of when you notice worried about autism - when and how to screen — noting the time of day, duration, and any triggers can help your pediatrician.
  • Remember that your baby makes eye contact, responds to their name, and engages socially even if quieter than peers — this is generally within the range of normal.
  • At 0-6 months, focus on observation rather than intervention unless your pediatrician advises otherwise.
  • Respond consistently and calmly to your baby's behavior. Maintain predictable daily routines.
  • While monitoring at home, seek immediate care if your child has lost previously acquired skills like words, social smiling, or babbling.

Early Signs of Autism in Babies and Toddlers

Autism spectrum disorder (ASD) can sometimes be identified as early as 12-18 months, though most children are not diagnosed until age 2-3. Early signs include limited eye contact, not responding to their name, lack of pointing or showing, limited social smiling, and absence of pretend play. Having one or two of these signs does not mean your child has autism - many typically developing children share individual traits. However, a pattern of multiple social communication differences warrants evaluation. Early intervention, regardless of eventual diagnosis, consistently leads to the best outcomes.

My Toddler Failed the M-CHAT Autism Screening

Failing the M-CHAT (Modified Checklist for Autism in Toddlers) does not mean your child has autism. It means additional evaluation is recommended. Many children who fail the initial M-CHAT screen do not receive an autism diagnosis after comprehensive evaluation. The important next step is to complete the follow-up interview (M-CHAT-R/F) with your pediatrician and, if indicated, pursue a developmental evaluation.

What Happens During an Autism Evaluation?

An autism evaluation typically involves multiple professionals including a developmental pediatrician, psychologist, or multidisciplinary team. The process includes parent interviews about developmental history, standardized observation tools like the ADOS-2, cognitive and language assessments, and review of development. The evaluation usually takes several hours and may be split across multiple sessions. Results lead to a clear diagnostic conclusion and recommendations.

Milestone

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When to Call the Doctor

General guide on when to call the pediatrician, visit urgent care, or go to the ER.

Frequently asked questions

Is worried about autism - when and how to screen normal?
The AAP recommends autism screening at 18 and 24 months for all children, using the M-CHAT-R/F questionnaire. If you have concerns before these ages, you can request screening earlier. Early signs of autism may include limited eye contact, no pointing by 12 months, no words by 16 months, no pretend play by 18 months, or loss of any previously acquired skills. Trust your instincts as a parent and raise concerns with your pediatrician.
When should I call the doctor about worried about autism - when and how to screen?
Your child has lost previously acquired skills like words, social smiling, or babbling Your child shows no social engagement, no communication, and no joint attention by 18 months
When is worried about autism - when and how to screen normal?
Your baby makes eye contact, responds to their name, and engages socially even if quieter than peers Your toddler has some quirks but is developing social communication skills on track Your child plays pretend, points to share, and shows interest in other people
What causes worried about autism - when and how to screen?
The AAP recommends autism screening at 18 and 24 months for all children, using the M-CHAT-R/F questionnaire. If you have concerns before these ages, you can request screening earlier. Early signs of autism may include limited eye contact, no pointing by 12 months, no words by 16 months, no pretend play by 18 months, or loss of any previously acquired skills. Trust your instincts as a parent and raise concerns with your pediatrician. Common explanations include: Your baby makes eye contact, responds to their name, and engages socially even if quieter than peers. Your toddler has some quirks but is developing social communication skills on track.
What should I mention to my pediatrician about worried about autism - when and how to screen?
You should mention worried about autism - when and how to screen at your next visit if: You have a gut feeling that your child's social development is different. Your child shows several early signs like limited eye contact, absent pointing, and no words. There is a family history of autism and you want proactive screening.
Is worried about autism - when and how to screen normal at 0-6 months?
Autism cannot be reliably diagnosed at this age, but some early signs may include reduced eye contact, limited social smiling, and reduced response to familiar voices. These signs overlap with many other conditions and with normal variation.
Is worried about autism - when and how to screen normal at 6-12 months?
Possible early indicators include limited babbling, absent pointing, lack of response to name, reduced social engagement, and no back-and-forth gestures. These should be monitored but are not diagnostic at this age.
Should I go to the ER for worried about autism - when and how to screen?
Seek emergency care if your child has lost previously acquired skills like words, social smiling, or babbling, or if your child shows no social engagement, no communication, and no joint attention by 18 months. When in doubt, call your pediatrician's after-hours line for guidance.
Does worried about autism - when and how to screen go away on its own?
In many cases, worried about autism - when and how to screen resolves on its own, especially when your baby makes eye contact, responds to their name, and engages socially even if quieter than peers. By 24-36 months, autism can be reliably diagnosed by age 2 in many cases. If you have concerns, request a developmental evaluation. The diagnostic process typically includes observation, parent interviews, and standardized testing.
AAPCDCNIH

References

  1. [1]American Academy of Pediatrics. Identification, Evaluation, and Management of Children with ASD. AAP
  2. [2]Centers for Disease Control and Prevention. Screening and Diagnosis of Autism Spectrum Disorder. CDC
  3. [3]National Institute of Mental Health. Autism Spectrum Disorder. NIH

Doctor Visit Checklist

Bring this checklist to your next pediatrician visit to discuss Worried About Autism - When and How to Screen.

Things to mention

  • Describe when you first noticed worried about autism - when and how to screen and how it has changed over time.
  • Note your baby's current age and which age-specific patterns you are seeing.
  • Mention if you have a gut feeling that your child's social development is different.
  • Mention if your child shows several early signs like limited eye contact, absent pointing, and no words.
  • Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
  • Bring a list of any questions or observations you want to discuss at the appointment.

Observations to share

  • You have a gut feeling that your child's social development is different
  • Your child shows several early signs like limited eye contact, absent pointing, and no words
  • There is a family history of autism and you want proactive screening

Urgent signs to report immediately

  • Your child has lost previously acquired skills like words, social smiling, or babbling
  • Your child shows no social engagement, no communication, and no joint attention by 18 months

My notes

From ismybabyalright.com — free, evidence-based baby health guides

All content follows our editorial policy and is reviewed against published clinical guidelines.

2,705 evidence-based guides6 authoritative medical sources5 medical advisory board members

Related Resources

Ear Infection TriageMilestone ChecklistsEarly Intervention DirectoryScreen Time GuideBaby Tracker

Bottom line

Most cases of worried about autism - when and how to screen are normal. Talk to your pediatrician if your child has lost previously acquired skills like words, social smiling, or babbling.

Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.

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Autism spectrum disorder (ASD) can sometimes be identified as early as 12-18 months, though most children are not diagnosed until age 2-3. Early signs include limited eye contact, not responding to their name, lack of pointing or showing, limited social smiling, and absence of pretend play. Having one or two of these signs does not mean your child has autism - many typically developing children share individual traits. However, a pattern of multiple social communication differences warrants evaluation. Early intervention, regardless of eventual diagnosis, consistently leads to the best outcomes.

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What Happens During an Autism Evaluation?

An autism evaluation typically involves multiple professionals including a developmental pediatrician, psychologist, or multidisciplinary team. The process includes parent interviews about developmental history, standardized observation tools like the ADOS-2, cognitive and language assessments, and review of development. The evaluation usually takes several hours and may be split across multiple sessions. Results lead to a clear diagnostic conclusion and recommendations.

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