Behavior & Social

Early Signs of Autism in Babies and Toddlers

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

Content reviewed against published CDC, AAP, NIH, AAP guidelines

Editorial policy

Last reviewed:

Behavioral development varies greatly from child to child. If you have noticed early signs of autism in babies and toddlers, here is what you need to know.

The short answer

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.

Key takeaways

  • 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.
  • Usually normal when: Your baby is shy or slow to warm up in new situations but engages well with familiar people at home
  • Call your doctor if: Your child has lost words, babbling, or social skills they previously had - any regression in development warrants urgent evaluation
  • Varies by age — see the age-by-age breakdown below

Parents everywhere have the same worry. You are doing the right thing by looking into it.

What Parents Should Know

According to CDC, AAP, NIH guidelines, 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. At 0-6 months, at this age, autism is very difficult to identify because social development is still emerging. What to watch for is the development of social engagement: your baby should be making eye contact, smiling socially (not just reflex smiling), and showing interest in faces by 2-3 months. A baby who rarely looks at faces, does not smile back when you smile at them, or seems indifferent to social interaction may benefit from monitoring. However, many babies who are later diagnosed with autism appear typically developing in these early months. It is generally considered normal when your baby is shy or slow to warm up in new situations but engages well with familiar people at home. However, you should contact your pediatrician promptly if your child has lost words, babbling, or social skills they previously had - any regression in development warrants urgent evaluation.

Sources: [1], [2], [3], [4]

Normal vs. Concerning

Usually Normal
Worth Discussing
Your baby is shy or slow to warm up in new situations but engages well with familiar people at home
Your child has lost words, babbling, or social skills they previously had - any regression in development warrants urgent evaluation
Your baby is a late talker but points, gestures, makes eye contact, and shows things to you
Your child has no babbling, no gestures, no eye contact, and no social engagement by 12 months - request a comprehensive developmental evaluation
Your toddler has one or two quirky behaviors (like lining up cars sometimes) but is otherwise socially engaged
Your baby is not consistently responding to their name by 12 months
Your bilingual child has fewer words in each language but a combined vocabulary that is on track
Your baby is not pointing to share interest (not just to request) by 14 months

By Age

What to expect by age

0-6 months

At this age, autism is very difficult to identify because social development is still emerging. What to watch for is the development of social engagement: your baby should be making eye contact, smiling socially (not just reflex smiling), and showing interest in faces by 2-3 months. A baby who rarely looks at faces, does not smile back when you smile at them, or seems indifferent to social interaction may benefit from monitoring. However, many babies who are later diagnosed with autism appear typically developing in these early months.

6-12 months

Between 6 and 12 months, social communication skills develop rapidly. Key milestones to watch include responding to their name (consistently by 9-10 months), babbling with consonant sounds, sharing enjoyment by smiling and looking at you, and showing interest in social games like peek-a-boo. Differences that may emerge include not looking when you point at something, limited babbling, reduced interest in interactive games, and not using gestures like reaching to be picked up.

12-18 months

This is when some early signs become more apparent. The AAP recommends formal autism screening with the M-CHAT at 18 months and again at 24 months. Signs to discuss with your pediatrician include: not pointing to show you things (not just to request), no words by 16 months, limited pretend play, not following your pointing gesture, loss of any previously acquired skills (regression), and limited back-and-forth social games. Remember that late talking alone, without other social differences, is more commonly a language delay than autism.

18-24 months

By 18-24 months, the signs that may suggest autism become more distinct from typical variation. Children with ASD may not combine words by 24 months, may have difficulty with back-and-forth conversation-like babbling, may line up toys rather than play with them imaginatively, may be very focused on parts of objects (spinning wheels rather than driving the car), and may have strong reactions to sensory input (covering ears, avoiding textures). If the M-CHAT or your own observations raise concerns, request an evaluation.

2-3 years

Many children receive their autism diagnosis during this period. By age 2-3, social differences become clearer: limited interest in peers, difficulty with back-and-forth play, echolalia (repeating phrases without communicative intent), restricted interests, and rigid insistence on routines. An evaluation by a developmental pediatrician, child psychologist, or multidisciplinary team can provide a formal diagnosis and connect you with early intervention services. Research consistently shows that earlier intervention leads to better long-term outcomes.

What to Tell Your Pediatrician

  • Describe when you first noticed early signs of autism in babies and toddlers and how it has changed over time.
  • Note your baby's current age and which age-specific patterns you are seeing.
  • Mention if your baby is not consistently responding to their name by 12 months.
  • Mention if your baby is not pointing to share interest (not just to request) by 14 months.
  • 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 is shy or slow to warm up in new situations but engages well with familiar people at home
  • Your baby is a late talker but points, gestures, makes eye contact, and shows things to you
  • Your toddler has one or two quirky behaviors (like lining up cars sometimes) but is otherwise socially engaged
  • Your bilingual child has fewer words in each language but a combined vocabulary that is on track
  • Your child flaps their hands briefly when excited but is otherwise socially connected and communicative
Mention at your next visit when...
  • Your baby is not consistently responding to their name by 12 months
  • Your baby is not pointing to share interest (not just to request) by 14 months
  • Your child has no words by 16 months or no two-word phrases by 24 months
  • Your child has limited pretend play, does not imitate actions, or seems to prefer objects over people
Act now when...
  • Your child has lost words, babbling, or social skills they previously had - any regression in development warrants urgent evaluation
  • Your child has no babbling, no gestures, no eye contact, and no social engagement by 12 months - request a comprehensive developmental evaluation

What You Can Do at Home

  • Keep track of when you notice early signs of autism in babies and toddlers — noting the time of day, duration, and any triggers can help your pediatrician.
  • Remember that your baby is shy or slow to warm up in new situations but engages well with familiar people at home — 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 words, babbling, or social skills they previously had - any regression in development warrants urgent evaluation.

Not Making Eye Contact

Eye contact develops gradually over the first few months of life, and newborns can only focus on objects about 8-12 inches away. Most babies are making consistent eye contact and tracking faces by 2-3 months, so very young babies who seem to look past you are usually developing normally.

My Baby Isn't Responding to Their Name

Babies typically begin responding to their name consistently between 9 and 12 months. Before that, responses can be hit-or-miss, especially when your baby is focused on something interesting. The first step is always to check hearing, because hearing issues are common, treatable, and can look a lot like other concerns.

My Baby Isn't Pointing

Pointing typically develops between 12 and 14 months and is considered one of the most important social communication milestones. It shows your baby wants to share their world with you. If your baby isn't pointing by 18 months, a developmental evaluation is recommended - but there are lots of other ways babies start communicating that are worth noticing too.

Baby Hand Flapping - Normal or Concern?

Hand and arm flapping when excited, happy, or frustrated is extremely common in babies and toddlers and is usually a normal way of expressing big emotions before they have the words to do so. Most babies flap their arms at some point, typically between 6-24 months. Hand flapping becomes a concern only when it is very frequent, occurs outside the context of emotions, is accompanied by other developmental differences (limited eye contact, no pointing, no social engagement), or persists as the primary way of expressing emotion well past age 2.

Milestone

Milestone Checklists by Age

Track your baby's developmental milestones from birth to 5 years with age-specific checklists.

Milestone

Month-by-Month Development

Detailed monthly development guides from birth through 24 months.

Guide

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 early signs of autism in babies and toddlers normal?
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.
When should I call the doctor about early signs of autism in babies and toddlers?
Your child has lost words, babbling, or social skills they previously had - any regression in development warrants urgent evaluation Your child has no babbling, no gestures, no eye contact, and no social engagement by 12 months - request a comprehensive developmental evaluation
When is early signs of autism in babies and toddlers normal?
Your baby is shy or slow to warm up in new situations but engages well with familiar people at home Your baby is a late talker but points, gestures, makes eye contact, and shows things to you Your toddler has one or two quirky behaviors (like lining up cars sometimes) but is otherwise socially engaged
What causes 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. Common explanations include: Your baby is shy or slow to warm up in new situations but engages well with familiar people at home. Your baby is a late talker but points, gestures, makes eye contact, and shows things to you.
What should I mention to my pediatrician about early signs of autism in babies and toddlers?
You should mention early signs of autism in babies and toddlers at your next visit if: Your baby is not consistently responding to their name by 12 months. Your baby is not pointing to share interest (not just to request) by 14 months. Your child has no words by 16 months or no two-word phrases by 24 months.
Is early signs of autism in babies and toddlers normal at 0-6 months?
At this age, autism is very difficult to identify because social development is still emerging. What to watch for is the development of social engagement: your baby should be making eye contact, smiling socially (not just reflex smiling), and showing interest in faces by 2-3 months. A baby who rarely looks at faces, does not smile back when you smile at them, or seems indifferent to social interaction may benefit from monitoring. However, many babies who are later diagnosed with autism appear typically developing in these early months.
Is early signs of autism in babies and toddlers normal at 6-12 months?
Between 6 and 12 months, social communication skills develop rapidly. Key milestones to watch include responding to their name (consistently by 9-10 months), babbling with consonant sounds, sharing enjoyment by smiling and looking at you, and showing interest in social games like peek-a-boo. Differences that may emerge include not looking when you point at something, limited babbling, reduced interest in interactive games, and not using gestures like reaching to be picked up.
Should I go to the ER for early signs of autism in babies and toddlers?
Seek emergency care if your child has lost words, babbling, or social skills they previously had - any regression in development warrants urgent evaluation, or if your child has no babbling, no gestures, no eye contact, and no social engagement by 12 months - request a comprehensive developmental evaluation. When in doubt, call your pediatrician's after-hours line for guidance.
Does early signs of autism in babies and toddlers go away on its own?
In many cases, early signs of autism in babies and toddlers resolves on its own, especially when your baby is shy or slow to warm up in new situations but engages well with familiar people at home. By 2-3 years, many children receive their autism diagnosis during this period. By age 2-3, social differences become clearer: limited interest in peers, difficulty with back-and-forth play, echolalia (repeating phrases without communicative intent), restricted interests, and rigid insistence on routines. An evaluation by a developmental pediatrician, child psychologist, or multidisciplinary team can provide a formal diagnosis and connect you with early intervention services. Research consistently shows that earlier intervention leads to better long-term outcomes.
CDCAAPNIHAAP

References

  1. [1]Centers for Disease Control and Prevention. Signs and Symptoms of Autism Spectrum Disorder. CDC
  2. [2]American Academy of Pediatrics. Autism Spectrum Disorder. HealthyChildren.org. AAP
  3. [3]National Institute of Mental Health. Autism Spectrum Disorder. NIH
  4. [4]Hyman SL, et al. Identification, Evaluation, and Management of Children With Autism Spectrum Disorder. Pediatrics. 2020;145(1):e20193447. AAP

Doctor Visit Checklist

Bring this checklist to your next pediatrician visit to discuss Early Signs of Autism in Babies and Toddlers.

Things to mention

  • Describe when you first noticed early signs of autism in babies and toddlers and how it has changed over time.
  • Note your baby's current age and which age-specific patterns you are seeing.
  • Mention if your baby is not consistently responding to their name by 12 months.
  • Mention if your baby is not pointing to share interest (not just to request) by 14 months.
  • 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

  • Your baby is not consistently responding to their name by 12 months
  • Your baby is not pointing to share interest (not just to request) by 14 months
  • Your child has no words by 16 months or no two-word phrases by 24 months

Urgent signs to report immediately

  • Your child has lost words, babbling, or social skills they previously had - any regression in development warrants urgent evaluation
  • Your child has no babbling, no gestures, no eye contact, and no social engagement by 12 months - request a comprehensive developmental evaluation

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 TriageEye Discharge TriageMilestone ChecklistsEarly Intervention DirectoryBaby Sign Language GuideScreen Time GuideBaby Tracker

Bottom line

Most cases of early signs of autism in babies and toddlers are normal. Talk to your pediatrician if your child has lost words, babbling, or social skills they previously had - any regression in development warrants urgent evaluation.

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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Related Behavior Concerns

Not Making Eye Contact

Eye contact develops gradually over the first few months of life, and newborns can only focus on objects about 8-12 inches away. Most babies are making consistent eye contact and tracking faces by 2-3 months, so very young babies who seem to look past you are usually developing normally.

My Baby Isn't Responding to Their Name

Babies typically begin responding to their name consistently between 9 and 12 months. Before that, responses can be hit-or-miss, especially when your baby is focused on something interesting. The first step is always to check hearing, because hearing issues are common, treatable, and can look a lot like other concerns.

My Baby Isn't Pointing

Pointing typically develops between 12 and 14 months and is considered one of the most important social communication milestones. It shows your baby wants to share their world with you. If your baby isn't pointing by 18 months, a developmental evaluation is recommended - but there are lots of other ways babies start communicating that are worth noticing too.

Baby Hand Flapping - Normal or Concern?

Hand and arm flapping when excited, happy, or frustrated is extremely common in babies and toddlers and is usually a normal way of expressing big emotions before they have the words to do so. Most babies flap their arms at some point, typically between 6-24 months. Hand flapping becomes a concern only when it is very frequent, occurs outside the context of emotions, is accompanied by other developmental differences (limited eye contact, no pointing, no social engagement), or persists as the primary way of expressing emotion well past age 2.

Baby Not Sharing Attention (No Joint Attention)

Joint attention - the ability to share focus on something with another person - is one of the most important social-communication skills that develops between 9 and 14 months. It includes following someone's point or gaze, pointing to show you something interesting, and looking back and forth between you and an object. This skill is the foundation for language learning and social development.

My Baby Isn't Talking

First words typically appear between 10 and 14 months, but there's enormous variation in what's normal. What matters most at first is whether your baby is communicating - pointing, gesturing, making eye contact, and babbling with different sounds - even if actual words haven't arrived yet.