What Are the Early Signs of Autism in Children?

How Is Autism Identified?

Autism is diagnosed through a comprehensive developmental evaluation rather than a single laboratory or medical test. Clinicians consider a child's social communication and interaction, along with restricted or repetitive behaviors and other aspects of development. The two core areas are:

• Social communication and social interaction — how a child connects, shares attention, and communicates with others.
• Restricted or repetitive behaviors, interests, or activities — repeated movements, strong preferences for sameness, or intense, narrow interests.

A child does not need to show every behavior listed below, and showing one or two of these behaviors does not mean a child is autistic either — many of these behaviors can also occur in typically developing children. What matters clinically is the overall pattern of behaviors, their persistence, and how they fit the child's broader development.

Early signs by approximate age

A note before you read this list: no single item on it diagnoses autism, and children develop at very different rates. The signs below are meaningful when they form part of a broader, persistent pattern — not when they appear once or in isolation. Some typically developing children will show one or two of these behaviors as a passing phase. That's a normal reason to keep watching, not a reason to assume a diagnosis.

These ages are approximate developmental reference points, not diagnostic cutoffs. Children develop at different rates, and autism can present differently from child to child. The age-specific examples below are based on developmental milestones and autism-related signs described by the CDC. These behaviors are developmental signs that may warrant further evaluation when they occur as part of a broader pattern; none of them alone means that a child has autism.

Social communication and interaction

• Avoids or doesn't keep eye contact
• Doesn't respond to their name by 9 months
• Doesn't show facial expressions like happy, sad, angry, or surprised by 9 months
• Doesn't play simple interactive games like pat-a-cake by 12 months
• Uses few or no gestures (like waving goodbye) by 12 months
• Doesn't share interests with others — for example, showing you an object they like — by 15 months
• Doesn't point to show you something interesting by 18 months
• Doesn't notice when others are hurt or upset by 24 months
• Doesn't notice other children or join them in play by 36 months
• Doesn't engage in pretend play, like being a teacher or superhero, by 48 months
• Doesn't sing, dance, or act for you by 60 months

Restricted or repetitive behaviors, interests, or activities (these aren't tied to specific ages the way the signs above are)

• Lines up toys or objects and gets upset if the order changes
• Repeats words or phrases over and over (echolalia)
• Plays with toys the same way every time
• Focuses intensely on parts of objects, like the wheels on a toy car
• Insists on following certain routines and gets upset by even minor changes to them
• Has intense, narrow interests
• Flaps hands, rocks their body, or spins in circles
• Has unusual reactions to how things sound, smell, taste, look, or feel

Again, none of these behaviors alone points to autism — many typically developing children have strong preferences for routine or intense interests at some point. What clinicians look at is whether these traits are persistent, occur alongside the social-communication signs above, and noticeably affect the child's daily functioning.

Limited spoken language or delays in communication can also be worth flagging, especially when they occur alongside the social-communication differences above — but language delay by itself isn't specific to autism and has many other possible causes. If a child has delayed language, isn't responding consistently to sounds, or doesn't reliably respond to their name, a hearing evaluation is often recommended alongside developmental screening, since hearing difficulties can produce communication concerns that look similar on the surface.

Other features that can occur alongside autism

Autism is diagnosed based on the two core areas above — social communication differences and restricted or repetitive behaviors — not on the features below. But autistic children sometimes also experience differences in other areas of development, including:

• Language, motor, or cognitive development
• Attention or hyperactivity
• Sleep or eating difficulties
• Gastrointestinal problems
• Anxiety or unusual fears
• Seizures or epilepsy

These are associated features that a clinician may ask about during an evaluation, not signs that confirm or point to a diagnosis on their own. Many children who have some of these features are not autistic, and many autistic children don't have them at all.

Losing skills a child once had

One pattern worth knowing about specifically: some children appear to develop as expected at first and later show a plateau or loss of previously acquired skills — for example, they stop using words they used to say, or stop making eye contact they used to make. This is different from the gradual signs listed above. Regression can occur in some children with autism, but it can also have other causes — either way, a noticeable loss of previously acquired language, social, or other developmental skills should be discussed promptly with a healthcare professional.

What these signs don't mean

• A single sign isn't diagnostic. Plenty of typically developing toddlers go through phases of limited eye contact, picky play preferences, or slower talking.
• Every autistic child is different. Some autistic children are highly verbal; others are minimally verbal. Some seek out social interaction in their own way; others avoid it. The "spectrum" in autism spectrum disorder reflects genuinely wide variation, not a single fixed presentation.
• Autism isn't caused by parenting. Differences like reduced eye contact or delayed language are traits of how a child's brain processes the world, not a response to how they've been raised.
• A formal diagnosis requires professional evaluation. A comprehensive evaluation by qualified healthcare professionals may include developmental history, observation, and standardized assessment tools. No online checklist or quiz can diagnose autism.

From concern to diagnosis: what the process actually looks like

It helps to know that "noticing a sign" and "getting a diagnosis" are separated by a few distinct steps, and they aren't the same thing:

• Developmental monitoring happens continuously — parents, caregivers, and healthcare professionals observe how a child is growing, learning, communicating, and developing over time.
• Developmental screening is a more formal check, using specific tools or questionnaires at set ages, to flag whether a child's development looks different enough from peers to warrant a closer look. A screening result is not a diagnosis — it's a signal that further evaluation may be worthwhile.
• A formal diagnostic evaluation is a comprehensive assessment by a qualified specialist (such as a developmental pediatrician, child psychologist, or psychiatrist), which may include structured observation, developmental history, and standardized diagnostic tools. This is the step that actually confirms or rules out an autism diagnosis.

A child can move from a "flagged" screening to "no diagnosis" after a full evaluation, and that's a normal, expected outcome of the process — not a sign the screening failed.

When and how to get help

In Dubai, developmental concerns can be raised with your child's pediatrician or another qualified healthcare professional as a first step, as part of routine well-child and developmental checks. Dubai Health offers specialist pediatric neurodevelopmental services that assess and support children with neurodevelopmental conditions, including autism spectrum disorder — but this is specialist care, not a general walk-in screening service, and a medical referral is required before a child can be seen. If your pediatrician has concerns after an initial check or screening, they can refer you on to specialist assessment.

Parents in Dubai who are exploring additional support for children with developmental concerns can also learn about services offered by Dr Tang Acupuncture Clinic, established in 2000. Dr. Shuangshuang Tang is a licensed Traditional Chinese Medicine practitioner and acupuncturist with experience in paediatric acupuncture, including work with children with autism, cerebral palsy, and developmental delays. The clinic provides Traditional Chinese Medicine and acupuncture-based care as a complementary approach. Such services should not replace recommended developmental assessment, diagnosis, or evidence-based interventions, and parents should discuss complementary treatments with their child's healthcare professional. Families can learn more about Dr Tang Acupuncture Clinic’s autism-related services in Dubai, including complementary Traditional Chinese Medicine and acupuncture support.

More broadly, the American Academy of Pediatrics also recommends developmental screening at 9, 18, and 30 months, with autism-specific screening at 18 and 24 months.

Practical next steps:

• Talk to your healthcare professional. Describe specific things you've noticed, ideally with examples or even video, rather than general impressions. Ask directly about developmental or autism screening.
• Ask about early intervention. Depending on the child's needs and local services, developmental support may be recommended while a diagnostic evaluation is underway.
• Track milestones over time, rather than relying on memory. The CDC's "Learn the Signs. Act Early." checklists can help with this.
• Don't wait to "see if they grow out of it" if concerns persist. Signs can sometimes be detected as early as 18 months, and a diagnosis by an experienced specialist can be considered reliable from around age 2, although the timing varies from child to child and many children aren't diagnosed until later. Identifying developmental needs early can help children and families access appropriate support sooner — though it's never too late for support to help.

FAQs

At what age can autism first be noticed?

Some early developmental differences can be noticed during the first year, while other signs become clearer during the toddler and preschool years. Signs can sometimes be detected as early as 18 months, and a diagnosis by an experienced specialist can be considered reliable from around age 2, although the timing varies by child. Other children develop as expected at first and show signs later, including through skill regression around 18–24 months.

Can autism be diagnosed in a baby?

Autism can be difficult to diagnose confidently in infancy because development is still changing rapidly. Autism-specific screening is commonly performed during the toddler years, while developmental concerns in infancy can still be evaluated by a healthcare professional. Monitoring or early support does not need to wait for a formal autism diagnosis.

Is it normal for toddlers to avoid eye contact sometimes?

Yes, occasional or situational reduced eye contact is common in typically developing toddlers. It becomes a horizontal sign when it's persistent, occurs alongside other social-communication differences, and doesn't improve with familiarity.

Does late talking always mean autism?

No. Language delay has many possible causes, including hearing issues, other developmental conditions, or simply individual variation, and plenty of late talkers are not autistic. It's still worth mentioning to your pediatrician, who may recommend a hearing evaluation alongside developmental screening to help narrow down the cause.

What should I do if my child's daycare or teacher raises a concern?

Take it seriously — teachers and childcare providers may notice developmental or social differences in a child. If they raise a concern, ask them to describe the specific behaviors they've observed, and discuss those observations with your child's healthcare professional.

Final Thoughts

This article provides general information and isn't a substitute for professional evaluation. If you have concerns about your child's development, talk to your pediatrician or a qualified developmental specialist.

Sources

• Dubai Health — Pediatric Neurodevelopmental Disabilities — specialist assessment and support for neurodevelopmental conditions including autism spectrum disorder; referral required.
• CDC — Signs and Symptoms of Autism Spectrum Disorder — the specific milestone ages and behavior examples used throughout this article.
• CDC — Screening for Autism Spectrum Disorder — autism-specific screening guidance and the distinction between early detection (as young as 18 months) and reliable diagnosis (by age 2).
• American Academy of Pediatrics — Promoting Optimal Development: Identifying Infants and Young Children With Developmental Disorders — developmental surveillance and autism-specific screening recommendations.
• American Academy of Pediatrics — Identification, Evaluation, and Management of Children With Autism Spectrum Disorder — clinical guidance on diagnostic evaluation, the two core diagnostic domains, and diagnosis reliability from age 2.