Early Signs of Autism in Babies and Toddlers

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By 6 Months:

• Reacting unexpectedly to new faces.

• Rarely smiling in social situations.

• Making little or no eye contact.

• Difficulty following objects with their eyes.

• Lack of response to their name.

• Limited reaction to loud sounds or not turning their head to locate sounds.

• Overreacting to some sounds.

• Lack of interest in interactive games like peekaboo.

• Dislikes being touched or cuddled, or not reaching out when about to be picked up.

• Displaying unusual or repetitive body movements.

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By 9 Months: 

• Little or no back-and-forth chattering.

• Limited or no babbling.

• Limited gestures such as pointing at an object or waving back at others.

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By 12 Months:

• Little or no use of back-and-forth gestures (e.g., pointing, showing, reaching, or waving).

• Little or no response to their name.

• Difficulty imitating actions or sounds, affecting learning and social interaction.

 

 

By 16 Months:

• Very few or no words.

• Limited imitation of movements (e.g., clapping, waving).

• Intense focus on specific objects or activities, potentially ignoring social interactions.

 

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By 24 Months:

• Very few or no meaningful two-word phrases (excluding imitation or repetition).

• Difficulty using words to express needs or emotions, leading to frustration and behavioral issues.

• Limited or no speech.

• Difficulty following simple verbal instructions.

• Gestures and imitation of others’ actions are limited.

• Intense interest in specific objects or activities, potentially excluding others.

• Engagement in repetitive actions (e.g., lining up or spinning objects, watching moving objects, flicking light switches).

 

 

By 36 Months:

• Little interest in other children.

• Preference for routines and distress when routines are disrupted.

• Extreme sensitivity to sensory experiences (e.g., sight, sound, smell, taste).

• Limited sensitivity to other sensory experiences (e.g., heat, cold, touch, hunger).

• Fixation on specific toys, activities, or actions.

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Signs of Autism at Any Age

 

• Loss of previously acquired speech, babbling, or social skills.

• Avoidance of eye contact.

• Persistent preference for solitude.

• Difficulty understanding or showing understanding of others' feelings.

• Delayed language development.

• Persistent repetition of words or phrases (echolalia).

• Resistance to minor changes in routine or surroundings.

• Restricted interests and repetitive behaviors (e.g., flapping, rocking, spinning).

• Unusual and intense reactions to sensory stimuli (e.g., sounds, smells, tastes, textures, lights).

• Difficulty with transitions or adapting to new situations, potentially resulting in severe anxiety or meltdowns.

 

 

Social Interaction and Communication:

 

• Not consistently use eye contact to gain attention (e.g., not looking at you and then at a snack).

• Rarely point to or hold up objects to show interest (e.g., not pointing to a dog or dropping a toy).

• Not consistently respond to their name.

• Struggle to use gestures independently (e.g., not waving bye-bye or clapping without prompting).

• Not consistently smile back at familiar people.

• Rarely imitate others’ actions (e.g., not mimicking your actions like combing hair).

• Not engage in conversation-like babbling or may not babble at all.

• Have difficulty understanding simple, one-step instructions (e.g., ‘Give me the block’).

• Struggle with understanding non-verbal cues or facial expressions, affecting reciprocal communication

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​Relationships and Play:

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• Show little interest in other children (e.g., not looking towards them or trying to get their attention).

• Rarely initiate games like peekaboo or round the garden.

• Avoid pretend play (e.g., not pretending to feed a teddy bear).

• Have difficulty with joint attention, affecting their ability to participate in group activities or cooperative play.

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Behavioral Patterns and Interests

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Repetitive Behavior and Special Interests:

 

• Exhibit strong interests in specific objects or toys (e.g., cars, dolls).

• Display repetitive behaviors (e.g., spinning toy wheels or arranging objects).

• Interact with toys in unusual ways (e.g., lining up objects or creating piles).

• Become upset if unable to engage in preferred activities (e.g., watching the same TV show repeatedly).

• Follow specific routines or rituals during play.

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Routines:

 

• Be easily upset by changes and show a preference for routines (e.g., following the same route to child care).

 

 

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Repetitive Movements:

 

• Engage in repetitive body movements or unusual postures (e.g., arching backs, flapping hands, walking on toes).

• Perform self-stimulatory behaviors (stimming) like hand-flapping or rocking for sensory feedback.

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Sensory Sensitivities:

 

• Be highly sensitive to environmental stimuli (e.g., noise or bright lights).

• Prefer consistency in their environment (e.g., eating only certain textures or wearing the same clothes).

• Seek out sensory experiences (e.g., rubbing objects on their lips or faces).

• Show overreaction or underreaction to sensory inputs, such as extreme sensitivity to textures or high pain tolerance.

 

 

 

Biological Changes and Developmental Differences

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Sleep Patterns: Variations in sleep behaviors and issues commonly observed in individuals with autism:

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• Disturbances: Problems such as difficulty falling asleep, frequent night awakenings, and irregular sleep patterns. These disturbances can affect overall sleep quality and duration, impacting daily functioning and behavior.

• Delayed Sleep Onset: Extended time taken to fall asleep, which may be due to difficulties in winding down or heightened anxiety.

• Night Wakings: Frequent awakenings during the night, which can disrupt sleep cycles and contribute to sleep fragmentation.

• Irregular Sleep Schedules: Unpredictable or inconsistent sleep patterns, such as varying bedtimes and wake times, that may not align with typical sleep routines.

• Difficulty Staying Asleep: Challenges in maintaining sleep throughout the night, leading to multiple awakenings or early morning risings.

 

 

Growth Patterns:

 

• Head Size: Accelerated head growth during infancy, which can be an early indicator of atypical neurological development. Increased head circumference compared to typical growth charts may be observed.

• Height and Weight: Variability in growth patterns, including deviations from expected height and weight trajectories. This can include rapid or slowed growth rates compared to typical developmental norms.

 

 

Gastrointestinal Issues:

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• Digestive Problems: Issues such as constipation, diarrhea, and abdominal pain.

• Food Sensitivities: Reactions to specific foods, including allergies and intolerances.

• Gastroesophageal Reflux Disease (GERD): Frequent acid reflux or heartburn.

• Irritable Bowel Syndrome (IBS): Symptoms such as cramping, bloating, and changes in bowel habits.

• Altered Gut Microbiome: Imbalance in the composition of gut bacteria.

• Nutritional Deficiencies: Issues related to poor absorption or restricted diets.

• Feeding Difficulties: Aversion to certain textures or preferences for limited types of food

 

 

Neurological Differences:

 

• Atypical Brain Connectivity: Differences in the connectivity between various brain regions, such as altered connections in the default mode network or between sensory and motor areas.

• Altered Brain Volume: Differences in the size or volume of specific brain regions, such as increased or decreased volumes in the amygdala, hippocampus, or cerebellum.

• Abnormal EEG Patterns: Irregularities in brainwave activity, including atypical patterns such as excessive theta waves or reduced alpha activity.

• Delayed Neurodevelopmental Milestones: Variations in reaching developmental milestones, such as delays in motor skills, language acquisition, or cognitive development.

• Abnormal Cortical Thickness: Differences in the thickness of the cortical areas, which can reflect atypical brain development.

• Altered White Matter Integrity: Changes in the integrity of white matter tracts, affecting the efficiency of communication between different brain regions.

• Sensory Processing Abnormalities: Neurological differences in how sensory information is processed, leading to either hypersensitivity or hyposensitivity to sensory stimuli:​​

  • Over-Sensitivity: Heightened sensitivity to sensory inputs, such as touch, sound, or light. This can result in discomfort or distress in response to stimuli that may be tolerable to others.

  • Under-Sensitivity: Decreased sensitivity to sensory inputs, such as reduced response to pain or diminished awareness of tactile sensations. This can lead to seeking out intense sensory experiences.

  • Sensory Integration Issues: Difficulty in processing and integrating multiple sensory inputs simultaneously. This can affect balance, coordination, and overall sensory perception, leading to challenges in responding appropriately to the environment

• Motor Skill Impairments: Differences in motor coordination, which may include clumsiness, difficulties with fine or gross motor tasks, and atypical movement patterns:

  • Fine Motor Skills: Challenges with tasks requiring precision, such as using utensils, buttoning clothes, or other activities involving detailed hand-eye coordination.

  • Gross Motor Skills: Delays or difficulties with larger movement skills, such as crawling, walking, jumping, or exhibiting an atypical gait.

• Reduced Synaptic Density: Changes in the density of synapses in certain brain areas, which may impact information processing and connectivity.

• Abnormalities in Brain Asymmetry: Differences in the symmetry of brain structures, which can affect cognitive and motor functions.

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Biological Changes:

 

• Genetic Variants: Specific genetic mutations linked to increased autism risk.

• Immune System Responses: Altered immune functioning and inflammatory responses.

• Metabolic Differences: Variations in metabolic pathways and metabolites.

• Biochemical Imbalances: Abnormal neurotransmitter levels and oxidative stress.

• Neuroanatomical Differences: Structural and connectivity differences in the brain.

• Epigenetic Factors: Gene expression changes influenced by environmental factors.

• Prenatal Factors: Maternal infections, toxins, or complications affecting brain development.

• Hormonal Differences: Variations in stress and sex hormone levels.

• Microbiome Differences: Alterations in gut bacteria composition.

• Neurochemical Imbalances: Imbalances in neuropeptides and other brain chemicals.

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Additional Behavioral and Emotional Indicators

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• Hyperactivity: Excessive activity levels.

• Impulsivity: Difficulty controlling impulses.

• Short Attention Span: Trouble focusing on tasks.

• Aggression: Aggressive behaviors towards others.

• Self-Injury: Behaviors causing self-harm.

• Meltdowns: Intense emotional outbursts.

• Unusual Eating and Sleeping Habits: Extreme food preferences and irregular sleep patterns.

• Unusual Emotional Reactions: Disproportionate or atypical emotional responses.

• Lack of Fear or Excessive Fear: Unusual responses to danger, either excessive fear or lack of it.

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