Parents and caregivers are the most important observers of their child’s development, and noting symptoms of what could be autism spectrum disorder early on can get them the sort of intervention that sets them up for success. While according to the World Health Organisation, only about one in 100 children is autistic, recent well-controlled studies suggest the number could be quite a bit higher. Your toddler is unlikely to be diagnosed during the toddler years; most children are not diagnosed before age three, but signs can show much earlier and staying mindful of any potential symptoms and making a note of any that appear to progress could be very useful to their healthcare team. There is a higher incidence of autism in children where a family history exists, so knowing about any cases among your relatives or those of the other parents can also help. However, even if your child displays three or more of the symptoms below, it is also important to remember that each child is different and developing at their own pace. Unless a potential symptom is causing your child problems in everyday life, it’s best not to worry too much at this stage.

What are the features of autism spectrum disorder (ASD)?

The core features of autism spectrum disorder are differences in social communication and social interaction (from what is considered neurotypical at your child’s age), as well as restricted, repetitive patterns of behaviour, interests, or activities. By age two, you may see some clear communicative or behavioural red flags to include in any notes you share with your child’s doctor.

Signs of autism in toddlers around the age of two can include:

They don’t respond when their name is called.
They don’t draw your attention to things by pointing.
They might not return your smiles or eye contact.
They do not talk as much as other children, and/or they often repeat phrases or words (echolalia).
They demonstrate repetitive behaviour, such as flapping their hands or rocking.
Rarely shares interests or objects.
A failure to coordinate non-verbal and verbal communication, e.g., looking at a snack they want while naming the food.
Frequent falling or difficulty with stairs.
They rarely copy the actions of older family members, e.g., attempting to comb their hair when you comb yours.
Speech regression, including becoming nonverbal after signs of speech emerge, can be a sign.
Difficulty understanding simple, one-step instructions, e.g., “Give me the toy.”

In addition, some genetic disorders are strongly associated with autism, and autism can be inherited, so your child’s medical history and the family medical histories of both parents will be very useful to your child’s doctor.

What should I do if I suspect my toddler has autism?

Your child’s GP or paediatrician should be your first point of contact and should be helpful in referring you to the right specialist if necessary. Try to avoid comparing your child with other people’s children or engaging with social media contents about childhood autism that may worry you unnecessarily. Even if your toddler does have ASD, their case will be unique, and so will the treatment required to progress them into a confident, anxiety-free child. Keep a diary of potential symptoms, including the regularity and severity with which they occur if possible. Changes—especially regressions—should be reported. We must stress that while a delay in hitting developmental milestones may be a sign of autism, there is a broad range of what’s considered normal with these, and your paediatrician may not feel that having your child hit them late is in itself a cause for concern.

How does autism diagnosis in early childhood happen?

This depends on the symptoms your child is showing but will usually involve observation and testing. Autistic children, like neurotypical children, can present themselves differently in different environments and may also mask behaviours in unfamiliar company, so a diagnosis can take some time, as well as good communication between you and your healthcare team.

Can autism be cured?

No, autism cannot be cured. It is not a disease but occurs as a result of how the brain develops. It is diagnosed based on the observation of symptoms, and there is no one-size-fits-all approach to treatment. However, with timely intervention and the right support, symptoms can be greatly reduced, and a toddler with autism’s life is then made very similar to that of a neurotypical child.

If I have more children, could they also be autistic?

Autism does run in families. Having an autistic child increases your chance of having another by around twenty percent. This chance is further increased if you have two children with ASD.

For more information on supporting your toddler’s health and development, check out Unii’s Toddler Health and Development Journey video course with Dr. Nisha Patel.

What are some signs of autism in toddlers?

Unii looks at potential red flags for ASD in early childhood.