Early Autism Signs: Behaviors Parents Write Off as ‘Just a Phase’

1. Limited Eye Contact

One of the earliest and most commonly overlooked signs of autism is limited or absent eye contact. While it’s natural for infants to occasionally avert their gaze, typically developing babies begin seeking out eye contact within the first few months of life. This visual connection serves as a foundation for early social and emotional development, helping babies bond with caregivers and learn from facial expressions.

Parents might mistake a child’s minimal eye contact for shyness or an independent personality, but there is a key difference. Shy children may avoid eye contact in unfamiliar situations yet maintain it with trusted family members. Children with autism, by contrast, often display a consistent lack of eye engagement—even with parents or siblings.

This subtle sign can emerge as early as six months of age. If a child rarely meets your gaze, doesn’t follow where you look, or doesn’t smile back when you make eye contact, it may be time to discuss these observations with a pediatrician. Early evaluation is important because interventions that target social-communication skills are most effective when started young (Eunice Kennedy Shriver National Institute of Child Health and Human Development).

2. Not Responding to Name

A baby’s response to their name is more than a cute milestone—it’s a sign of social and neurological development. By 6 to 12 months, most infants will turn or look toward a caregiver when their name is called, demonstrating that the brain is processing social cues and distinguishing familiar sounds from background noise. In children with autism, the neural networks responsible for attention and social awareness may function differently, leading to a lack of response (Autism Speaks).

Parents sometimes chalk up missed responses to distractions or possible hearing issues. However, there’s an important distinction: children with hearing loss will typically not respond to any sounds, while children with autism may react to other noises—like a favorite toy or music—but ignore their name being called. This selective response highlights a difference in social processing rather than auditory function.

If your child regularly does not respond to their name by 12 months, especially when you call from a close distance and without other distractions, it’s time to bring it up with a healthcare provider. Early, consistent lack of response can be an early signal of autism, and addressing it can open doors to timely intervention and support.

3. Delayed Babbling or Speech

Babbling is a crucial early milestone in language development, usually emerging between 4 and 6 months of age. Typical babies experiment with sounds like “ba-ba” or “da-da,” which gradually evolve into words and meaningful speech. A lack of babbling or a significant delay in speech milestones can be an early sign of autism spectrum disorder, signaling differences in the brain’s language centers (CDC: Signs and Symptoms of Autism Spectrum Disorders).

While some children may simply develop language skills at their own pace, consistent absence of babbling, cooing, or word attempts by 12 months often warrants attention. For example, if a child is not making repetitive consonant-vowel sounds or doesn’t respond to speech with their own vocalizations, it could indicate a need for further evaluation.

Parents might attribute these delays to personality or “quietness,” but it’s important to look for the presence of other communication signs. If your toddler isn’t using single words by 16 months or simple phrases by 24 months, consult a speech-language pathologist or developmental specialist. Early support can dramatically improve communication outcomes for children with autism and related challenges.

4. Rarely Sharing Interests

A key component of early social development is joint attention—the ability to share interests or experiences with another person. This typically begins in infancy, when a baby points to a toy, looks between the object and a caregiver, or brings something to show. These simple acts lay the groundwork for empathy, language, and social learning, reflecting healthy maturation of the social brain (Autism Speaks: Joint Attention and Autism).

Children with autism may rarely, if ever, attempt to direct others’ attention to interesting sights or objects. Rather than engaging a parent to “look at this!” or seeking shared enjoyment, they may play alone and not involve others, even with favorite toys. This can be subtly different from independent or introverted behavior: neurotypical children will still seek to share discoveries or experiences, even if they are quiet or reserved.

If your toddler seldom points to objects, doesn’t bring items to show you, or rarely checks to see if you are watching, it’s worth discussing with your pediatrician. Consistent lack of shared attention after 12 months may indicate autism or other developmental differences, rather than simply an independent streak.

5. Unusual Reactions to Sounds

Many children with autism spectrum disorder experience differences in sensory processing, which includes heightened or reduced sensitivity to sounds. The brain’s interpretation of auditory input may be either overstimulated or under-responsive, leading to distinct reactions. For example, a child might cover their ears during everyday noises, such as a vacuum cleaner, hair dryer, or even the flush of a toilet. Others may seem oblivious to loud events that would startle most children (National Autistic Society: Sensory Differences).

These behaviors differ from typical startle responses or a dislike of certain sounds. Extreme sound sensitivities may cause distress, meltdowns, or attempts to escape environments with triggering noises. Conversely, some children might seek out specific sounds, humming or banging objects repeatedly to stimulate their senses.

It’s important to monitor whether these reactions are persistent and significantly impact daily activities. If your child consistently overreacts or underreacts to common sounds—far beyond what’s typical for their age—raise these concerns with your healthcare provider. Persistent or extreme sound sensitivities are a red flag for sensory differences often associated with autism.

6. Repetitive Movements

Many children with autism display repetitive movements or behaviors, often called “stimming” (self-stimulatory behavior). These stereotyped movements can include hand-flapping, rocking, spinning, finger-flicking, or repetitive tapping. While all children fidget or repeat actions occasionally—such as spinning in circles or tapping their feet—the frequency and intensity of these behaviors in autism can set them apart (Autism Speaks: Repetitive Behaviors and Autism).

Typical fidgeting is usually situational, serving as a way to burn off energy or cope with temporary excitement or boredom. In contrast, autistic stimming is often persistent and may occur in a variety of situations, sometimes interfering with learning or daily routines. These movements can be soothing for the child, helping them manage overwhelming sensory input or emotions.

If your child displays repetitive behaviors that are intense, frequent, and seem unrelated to their environment—or if these actions interfere with play, social interaction, or learning—it’s wise to seek an evaluation. Persistent, stereotyped movements, especially when combined with other signs, are a hallmark of autism spectrum disorder and can benefit from professional guidance and support.

7. Lack of Gestures

Gestures are a fundamental aspect of early communication, helping children express needs and connect with others before they develop spoken language. Examples of early gestures include waving “bye-bye,” pointing to request or share interest, reaching up to be picked up, or shaking the head for “no.” These nonverbal cues typically emerge between 9 and 12 months and are closely linked with the development of social and language skills (American Speech-Language-Hearing Association: Communication Development).

Children with autism may use fewer gestures or may not gesture at all, relying instead on other means—or not communicating their needs. The absence of gestures can make it harder for caregivers to understand what a child wants or feels, leading to frustration for both child and parent.

If your child is not using gestures such as pointing, waving, or reaching by 12 months, or if they do not use gestures to share experiences (like pointing out a bird in the sky), it may signal an underlying developmental difference. A lack of these early communicative tools—especially when combined with limited eye contact or delayed speech—should prompt a conversation with your pediatrician or a developmental specialist.

8. Trouble with Social Smiling

Social smiling is one of the earliest forms of nonverbal communication, typically appearing by two months of age. This type of smile is more than a reflex; it’s a way for babies to engage, bond, and share positive emotions with caregivers. For most infants, a smile becomes a tool to attract attention, respond to playful faces, and participate in joyful exchanges (Zero to Three: Your Baby’s Smiles).

Children on the autism spectrum may smile less frequently, or their smiles may not be directed at people in a social context. For instance, a child might smile while playing alone but rarely respond with a smile when a caregiver tries to engage. These differences become more noticeable when a child doesn’t reciprocate a parent’s animated expressions or fails to “light up” during familiar routines, such as peekaboo or singing.

If your baby or toddler seldom responds to your smiles, laughter, or playful attempts to connect, or their smiles appear disconnected from social interaction, it may be a red flag. Consistent absence of social smiling by six months should be discussed with a pediatrician, as it can indicate an underlying difference in social development.

9. Fixation on Objects

Many children with autism display a strong fixation on objects, showing intense or unusual interest in specific items. This might look like endless spinning of wheels on a toy car, lining up blocks with precision, or staring at lights and patterns for long periods. While all young children are naturally curious and may temporarily focus on new or exciting objects, the intensity and persistence of these fixations set autism apart (National Autistic Society: Repetitive and Restricted Behaviour).

Neurotypical children typically move quickly from one toy or activity to another, exploring their environment broadly. In contrast, a child with autism may become deeply absorbed in a single part of a toy (such as the wheels, buttons, or tags), ignoring the intended use and the people around them. This can also include becoming upset if the object is removed or if play is interrupted.

If your child’s play is narrowly focused on certain objects, or if their interest in these items seems to limit their ability to interact, explore, or participate in other activities, it’s important to bring this up with your pediatrician. These intense fixations, especially when paired with other early signs, may be an indicator of autism.

10. Insistence on Sameness

A pronounced insistence on sameness is another early sign often observed in children with autism. This goes beyond the typical toddler preference for favorite foods, shows, or bedtime routines. Children on the autism spectrum may become extremely distressed by even minor changes in their environment or daily schedule, such as a new route to daycare or a different cup at breakfast (Autism Speaks: Repetitive Behaviors and Autism).

While most young children thrive on predictability and may protest changes, neurotypical children are generally able to adapt with some reassurance. For children with autism, however, inflexibility can be so profound that it disrupts family routines or causes intense meltdowns. They may insist on lining up toys in a specific order, following an exact sequence of actions, or repeating the same phrase or question multiple times.

If your child’s need for routine is rigid to the point where it interferes with daily functioning or limits participation in new experiences, it’s time to consult with a specialist. This level of inflexibility—especially when combined with other signs—can signal underlying differences in neurodevelopment and is a core feature of autism spectrum disorder.

11. Absence of Pretend Play

Pretend play is a vital milestone in early childhood, reflecting the development of imagination, empathy, and social understanding. By 18 to 24 months, most children begin to imitate everyday activities—feeding a doll, pretending to talk on the phone, or making a toy car “drive.” This type of play helps children learn about emotions, relationships, and problem-solving (CDC: Important Milestones for 2-Year-Olds).

Children with autism often show little interest in pretend or imaginative play. Instead of pretending a block is a car or hosting a tea party with stuffed animals, they may line up objects, repeat the same action, or focus on sensory aspects of toys (like spinning wheels or flipping pages). Their play can appear rigid, repetitive, or lacking in creativity.

If your child does not engage in basic pretend games by age two, or if their play remains limited to repetitive actions rather than imaginative scenarios, consider discussing this with your pediatrician or a developmental expert. Limited or absent pretend play—especially alongside other early communication and social differences—may be an early indicator of autism spectrum disorder.

12. Unusual Attachment to Objects

It’s common for young children to have a favorite blanket, stuffed animal, or toy that provides comfort, especially during transitions or bedtime. However, children with autism may develop unusual attachments to objects that go beyond typical comfort items. These attachments can involve everyday items like keys, bottle caps, or even household objects—often carried everywhere, sometimes replacing social interaction (National Autistic Society: Repetitive and Restricted Behaviour).

While neurotypical children may cycle through different favorite items and form emotional bonds with toys or blankets, autistic children might fixate intensely on one specific object for a long time. For example, a child might insist on always holding a spoon, become deeply distressed if it’s lost, or ignore peers in favor of manipulating a single item. This form of attachment is less about comfort and more about routine, ritual, or sensory appeal.

If your child’s attachment to objects is extreme, interferes with daily activities, or limits their willingness to engage with people or new experiences, it could be a sign worth discussing with a healthcare provider. Such unusual and persistent attachments—especially when paired with other developmental differences—may indicate autism.

13. Atypical Walking or Posture

Motor development can also be affected in children with autism, leading to atypical walking patterns or postures. One common example is persistent toe-walking—where a child walks on the balls of their feet rather than using a typical heel-to-toe motion. While many toddlers briefly experiment with toe-walking, consistent use beyond the age of two or three can signal underlying neurological or sensory differences (Kennedy Krieger Institute: Toe-Walking and Autism).

Other postural differences might include awkward gait, clumsiness, unusual ways of sitting, or difficulty with balance and coordination. Some children may hold their bodies stiffly, walk with arms flapping, or struggle to master skills like running, jumping, or climbing stairs. These challenges often relate to differences in proprioception (body awareness) and motor planning.

If you notice your child consistently toe-walking, displaying odd postures, or struggling with basic motor milestones well past the usual age range, it’s a good idea to consult a pediatrician. An evaluation can help determine whether these differences are part of typical development, a sensory issue, or potentially related to autism spectrum disorder.

14. Hyper- or Hypo-reactivity to Touch

Children with autism often experience atypical responses to touch—either hyper-reactivity (being overly sensitive) or hypo-reactivity (under-reacting) to tactile experiences. A child who is hypersensitive may recoil from hugs, dislike being held, or react strongly to certain clothing textures, tags, or seams. Even a gentle pat or a light breeze might trigger discomfort or distress (STAR Institute for Sensory Processing).

Conversely, some children display a muted response to touch, appearing unaware of pain, cold, or dirt on their skin. They might seek out intense sensory input, pressing their bodies against objects, or not notice when they are injured. These responses can impact everyday life—leading to struggles with grooming, dressing, play, or social interactions.

While some sensitivity to touch is normal, especially in toddlers, persistent or extreme reactions that interfere with daily activities or cause distress are worth noting. If your child consistently avoids or craves touch, or has strong preferences for or against certain textures, monitor these behaviors and discuss them with a healthcare provider. Abnormal touch sensitivity—when paired with other differences—can be an early sign of autism.

15. Lack of Pointing

Pointing is a vital developmental milestone that typically appears between 9 and 14 months of age. When children point, they aren’t just reaching for an object—they’re also inviting others to share their interest or attention. This simple gesture helps build the foundation for language, learning, and social interaction by connecting a child’s inner world with those around them (CDC: Important Milestones for 1-Year-Olds).

Babies usually point to ask for something (“I want that toy!”), to share excitement (“Look at the dog!”), or to direct a parent’s gaze. Children with autism, however, often do not point at all or may only use an adult’s hand as a tool to get what they want—without making eye contact or sharing interest.

If your child is not pointing by 14 months—or isn’t using gestures to direct your attention or share discoveries—this can be a red flag for a social-communication difference. While the absence of pointing can occasionally be seen in shy or quiet children, it’s a strong early indicator of autism when combined with other delays in communication or social engagement. If concerned, discuss these signs with your pediatrician for further evaluation.

16. Monotone or Odd Speech Patterns

Speech isn’t just about words—it also involves prosody, the melody and rhythm that give language emotion and meaning. Children with autism may develop speech, but their vocal tone can sound flat, robotic, or sing-song, lacking the usual inflections that convey excitement, curiosity, or warmth. This difference in speech prosody can make it harder for listeners to interpret feelings or intentions (Autism Speaks: Speech, Language and Communication Disorders).

For example, a child might recite questions or statements in a monotone, speak very loudly or softly, or use an unusual rhythm—pausing at odd places or stressing unexpected words. Some children may echo phrases with an exact pitch or pattern, while others may sound overly formal or use language that seems out of context for their age.

While developing unique speech quirks is normal for young children, persistent monotone or unusual patterns—especially when paired with social and communication differences—should prompt further assessment. If you notice your child’s speech sounds markedly different from peers, or if they struggle to use expressive tone and rhythm, consult a speech-language pathologist or developmental specialist for evaluation.

17. Difficulty Understanding Emotions

Recognizing and responding to emotions is a cornerstone of social development. By their first birthday, most children begin to notice and respond to caregivers’ facial expressions and tones of voice. Children with autism, however, may have difficulty reading and interpreting emotions—both in themselves and others. This can lead to missed cues, awkward responses, or challenges forming close relationships (Raising Children Network: Nonverbal Communication and Autism).

For instance, a neurotypical child might comfort a crying friend or giggle when someone smiles, showing empathy and understanding. A child with autism may not notice when someone is upset, or they may laugh, cry, or react in ways that seem out of place for the situation. These differences can stem from challenges processing facial expressions, body language, or vocal cues.

If you notice your child consistently struggles to connect with others’ feelings, doesn’t show concern when someone is hurt, or reacts oddly to emotional situations, it may be time to seek guidance. Persistent challenges in emotional recognition—especially when combined with other early behavioral signs—are worth discussing with a pediatrician or developmental specialist.

18. Lining Up Toys or Objects

A distinctive, often overlooked sign of autism is the repeated lining up of toys or objects in precise, orderly rows. While all young children enjoy sorting and organizing their playthings from time to time, children with autism may become intensely focused on this repetitive organization. They might line up cars, blocks, or even household items and insist that no one disturb their arrangement (National Autistic Society: Repetitive and Restricted Behaviour).

In typical development, lining up toys is usually part of a larger creative or imaginative play—building a city or preparing a parade, for example. Children with autism, however, may not use the items for pretend play at all, instead deriving satisfaction from the order itself. They may become upset if their rows are moved or disrupted, and return to this behavior repeatedly, sometimes for extended periods.

If you observe your child persistently lining up toys or objects in the same way, far more than what’s typical for their age, or showing distress when the order is changed, consider monitoring for other patterns. This repetitive, non-functional play—especially when combined with social or communication delays—warrants discussion with your pediatrician.

19. Limited Use of Facial Expressions

Facial expressions are a core part of how humans communicate feelings and connect socially—even before children can talk. Most babies and toddlers naturally use a wide range of expressions—smiling, frowning, raising eyebrows, or showing surprise—to engage others and respond to the world. Children with autism, however, may display a limited range of facial expressions or have what’s known as a “flat affect” (Autism Speaks: Social Challenges and Autism).

For example, a neurotypical child might flash a big grin when happy, pout when upset, or widen their eyes in awe. A child with autism might not mirror these behaviors, instead keeping the same neutral or blank expression regardless of the situation. This limited expressiveness can make it more difficult for others to understand their feelings or intentions, sometimes leading to misunderstandings or missed social opportunities.

If your child rarely smiles, frowns, or uses other facial expressions to communicate—especially during social interactions or play—it’s worth noting. A persistent flat affect, particularly when coupled with other communication or social delays, should be discussed with a pediatrician or developmental specialist as it may be an early sign of autism.

20. Unusual Gaze Patterns

Visual attention is a subtle yet powerful way children connect with their surroundings. Children with autism may display unusual gaze patterns, such as avoiding eye contact, staring at objects for long periods, or watching things from odd angles. These differences aren’t just about shyness—they reflect unique ways the brain processes social and sensory information (National Institutes of Health: Eye Tracking in Autism Spectrum Disorder).

For instance, a child might frequently look out of the corners of their eyes, fixate on spinning objects, or focus intensely on a moving ceiling fan rather than people’s faces. Some children may track people briefly but quickly shift their gaze away, making social interactions feel disconnected or fleeting. Others may avoid looking at faces altogether, missing out on important nonverbal cues.

If you notice that your child’s gaze rarely meets yours, is often drawn to lights, patterns, or moving objects, or seems different from peers, it’s important to observe this behavior over time. Persistent unusual gaze patterns—especially when combined with other early signs—warrant a conversation with your pediatrician or a developmental specialist.

21. Excessive Tantrums Over Small Changes

All toddlers experience frustration and may throw tantrums when routines are disrupted or desires are unmet. However, children with autism often have an extreme resistance to change that goes far beyond typical toddler behavior. Even small adjustments—like moving a favorite toy, taking a different route to the store, or switching seats at the table—can trigger intense, prolonged meltdowns (Autism Speaks: Behavioral Health Treatment).

Whereas most children can be distracted or soothed with reassurance and time, a child with autism may remain inconsolable and display aggressive or self-injurious behaviors. Their reaction is not about being stubborn or spoiled; it is often rooted in a need for predictability and difficulty processing unpredictable sensory or social input.

If your child’s tantrums are frequent, last much longer than their peers’, or seem wildly disproportionate to the trigger—especially when the change is small or routine—it’s important to take note. Extreme emotional distress over minor changes, especially when observed alongside other early signs of autism, is a strong indicator that a developmental evaluation may be needed.

22. Echoing Words or Phrases (Echolalia)

A common, yet often misunderstood early sign of autism is echolalia—the repetition of words, phrases, or sentences heard from others. While it’s normal for toddlers to echo language as they learn to talk, children with autism may repeat what they hear far more frequently and in a way that doesn’t fit the context of conversation (American Speech-Language-Hearing Association: Autism Spectrum Disorder).

For example, a child might repeatedly echo a question (“Do you want juice?”) instead of answering, or recite lines from favorite television shows or commercials throughout the day. Sometimes, the echoed speech is immediate—repeating right after hearing it—or delayed, occurring hours or even days later. Unlike typical language practice, echolalia in autism may not serve a communicative purpose, making it harder for caregivers to have meaningful interactions.

If your child’s language consists mostly of repeated words or phrases, or if the repetition persists past the expected age for typical language development, this could be a sign of a communication difference. Persistent echolalia—especially with limited spontaneous speech—should prompt consultation with a speech-language pathologist or developmental specialist.

23. Difficulty with Transitions

Many children with autism experience pronounced difficulty with transitions—moving from one activity, place, or routine to another. While it’s common for young children to resist leaving a favorite game or ending screen time, children on the autism spectrum often react with intense distress, confusion, or anxiety when faced with even minor changes (Autism Speaks: Transition Tips).

For example, a child might have a meltdown when it’s time to stop playing and get ready for bed, or become inconsolable when asked to leave the park. Some children may freeze, refuse to move, or become highly agitated, even with advance warning or visual cues. These reactions are usually disproportionate to the situation and can disrupt daily routines for the entire family.

If your child consistently struggles with transitions between activities, needs elaborate rituals to move from one task to another, or reacts far more strongly than their peers, this could indicate an underlying difficulty with flexibility and adaptation. When these challenges are persistent and interfere with everyday functioning, they may be a sign of autism and should be discussed with a pediatrician or developmental specialist.

24. Unusual Feeding Habits

Feeding challenges are common in early childhood, but children with autism often display unusual feeding habits that go beyond typical picky eating. These eating issues are frequently rooted in sensory sensitivities—certain tastes, textures, smells, or even food colors may be overwhelming or aversive. As a result, children may eat only a very limited range of foods, refuse entire food groups, or insist on specific preparation and presentation (Autism Speaks: Feeding and Nutrition).

Examples include eating only white foods (like bread, pasta, or milk), refusing foods with mixed textures (such as casseroles), or gagging at the sight or smell of certain items. Some children may hold food in their mouths for extended periods, pocketing it in their cheeks, or avoid chewing altogether. Others may crave crunchy or bland foods exclusively.

If your child’s food selectivity is extreme, persists beyond the toddler years, results in nutritional gaps, or causes significant family stress, it’s worth seeking support. A feeding evaluation by a pediatrician, occupational therapist, or nutritionist familiar with autism can help identify underlying issues and develop strategies to expand your child’s diet safely and gradually.

25. Not Bringing Objects to Show Adults

A major milestone in early social development is the desire to share attention and interests with caregivers. Most toddlers naturally bring toys, books, or interesting objects to adults—not just to request help, but to share excitement or invite engagement. For example, a child might proudly carry over a favorite block creation, a flower from the yard, or a picture from daycare, seeking an adult’s reaction and shared enjoyment (CDC: Important Milestones for 2-Year-Olds).

Children with autism, however, may rarely or never engage in this “show and share” behavior. Instead, they might play with objects in isolation, without seeking to involve parents, siblings, or peers. The absence of this behavior is more than shyness or independence—it reflects difficulty with joint attention, a foundational skill for later communication and social connection.

If your child does not bring you items to look at, share, or celebrate by 18 to 24 months, or if they seem uninterested in involving others in their discoveries, this could be a sign of autism. Persistent lack of shared attention—especially when seen with other early signs—should prompt discussion with your pediatrician or a developmental specialist.

26. Lack of Interest in Peers

Social motivation usually emerges early, with most toddlers showing curiosity about other children and seeking out opportunities to play together. For children with autism, however, there may be a noticeable lack of interest in peers. Instead of joining group activities or imitating others, they may prefer solitary play—engaging with toys or objects alone, even in social settings like playgrounds or preschools (Autism Speaks: Social Challenges and Autism).

Real-life examples include a child happily stacking blocks by themselves while classmates play nearby, or ignoring invitations to join group games. These children may seem indifferent to the presence of peers, showing little desire to make friends or participate in turn-taking and sharing. Their play often lacks the back-and-forth interaction that characterizes typical early friendships.

While some children are naturally more reserved, persistent lack of interest in other children—especially after age two—should be monitored. If your child rarely watches, imitates, or seeks out peers for play or conversation, discuss these observations with your pediatrician. Early identification and support can help nurture social skills and build meaningful connections.

27. Unusual Play with Toys

Children with autism often engage in restricted or repetitive play that differs from the imaginative play seen in their peers. Rather than using toys for pretend scenarios—like feeding a doll, driving cars on imaginary roads, or creating stories—these children may focus on repeating the same action, such as spinning wheels, opening and closing doors, or lining up blocks in a specific pattern (National Autistic Society: Repetitive and Restricted Behaviour).

This type of play is usually rigid and lacks variety. For example, a child might spend long periods flipping the light switch on and off, or repeatedly stacking and knocking down the same tower. While all children enjoy repetition as they learn new skills, the persistence, intensity, and narrow focus of repetitive play in autism are more pronounced and less likely to evolve into creative or social games.

If your child consistently uses toys in nontraditional ways, seems uninterested in make-believe, or returns to the same repetitive play patterns regardless of the setting, it’s important to take note. Such behaviors, especially when combined with other early signs, may be a reason to consult a pediatrician or developmental specialist for further assessment.

28. Over- or Under-Sensitivity to Pain

Children with autism may show atypical responses to pain, either seeming unusually sensitive (over-reactive) or almost oblivious (under-reactive) to injuries or discomfort. This altered pain perception is linked to differences in how the brain processes sensory input, and it can be confusing for parents and caregivers (Autism Speaks: Sensory Issues).

For example, an over-sensitive child might react dramatically to a minor bump or brush, crying intensely over something that wouldn’t faze most children. Conversely, a child with under-sensitivity might not notice a scraped knee, fail to respond to a bee sting, or keep playing after a fall that would typically result in tears. This lack of expected reaction can delay awareness of injuries or illnesses and complicate medical care.

While individual pain tolerance varies, persistent and marked differences in pain response—either extreme sensitivity or seeming insensitivity—warrant attention, especially when seen alongside other early behavioral signs of autism. If you’re concerned about your child’s reactions to pain, discuss them with your pediatrician, who can help determine if further evaluation or support is needed.

29. Unusual Body Movements

Beyond classic repetitive motions like hand-flapping or rocking, children with autism may display a variety of unusual body movements that are less commonly recognized. These can include finger flicking, twisting hair, walking on tiptoes, spinning in circles, or repeatedly tapping objects or surfaces with different parts of the body (National Autistic Society: Repetitive and Restricted Behaviour).

Some children might arch their backs, contort their bodies in unique ways, or rhythmically bounce while sitting or standing. These movements often occur when a child is excited, anxious, tired, or seeking sensory input, and may appear odd or out of place in social settings. In some cases, children will engage in these behaviors for long stretches of time, seemingly unaware of their surroundings.

While occasional fidgeting or self-soothing movements are normal for all children, persistent, intense, or highly unusual body movements—especially when they interrupt learning or social interaction—should prompt a conversation with a pediatrician or developmental specialist. Early recognition and intervention can help address underlying sensory or regulatory needs and support healthy development.

30. Difficulty Imitating Actions

Imitation is a core aspect of early learning and social development. Most babies and toddlers naturally copy the actions, sounds, and facial expressions of those around them—clapping hands, waving, making funny faces, or repeating words. Through imitation, children learn social norms, language, play skills, and how to interact with others (CDC: Important Milestones for 1-Year-Olds).

Children with autism often struggle with these foundational copying skills. They may not mimic simple gestures, sounds, or actions, even when shown repeatedly or encouraged through play. For example, a parent might clap hands or make a silly face, and the child remains unresponsive or uninterested. This lack of imitation affects their ability to learn new words, participate in group activities, and develop peer relationships.

While some hesitance to imitate is normal in shy or reserved children, persistent difficulty copying others—especially beyond 18 months—can signal a developmental difference. If your child rarely or never imitates actions, gestures, or words, discuss these observations with your pediatrician or a developmental specialist. Early support can make a meaningful difference in communication and social growth.

31. Limited Use of Words for Needs

Functional communication—using words or gestures to express needs and wants—is a significant milestone in early language development. By around 18 months, many children begin to use simple words like “more,” “milk,” or “up” to communicate with caregivers. Children with autism, however, may struggle to use language purposefully, relying instead on nonverbal cues such as pulling a parent’s hand, crying, or leading adults to objects (American Speech-Language-Hearing Association: Autism Spectrum Disorder).

For example, instead of asking for a snack, a child might simply point, whine, or take an adult to the kitchen without saying a word. They may use words they know inconsistently or only repeat phrases rather than initiating requests. This limited use of language for practical purposes can lead to frustration, tantrums, and missed opportunities for social learning.

While some delays in expressive language are common, especially in bilingual homes or among shy children, persistent difficulties using words to get needs met—beyond age two—should raise concern. If your child rarely uses language functionally or seems unable to ask for help or items, consult a speech-language pathologist or developmental specialist to explore supportive strategies and early intervention.

32. Inconsistent Social Responses

Children with autism often show inconsistent social responses, reacting unpredictably to people and situations. For example, a child may enthusiastically greet a neighbor one day but ignore them the next, or sometimes respond to their name and other times seem completely unaware. These unpredictable patterns can make it difficult for caregivers and peers to understand how to engage with the child (National Autistic Society: Social Communication).

Common scenarios include a child laughing inappropriately during a quiet moment, not responding to a parent’s hug, or suddenly withdrawing from activities they usually enjoy. While all children have “off days,” the social responses in autism are often strikingly variable, lacking the reliable patterns seen in typical development. This inconsistency may stem from sensory overload, difficulties processing social cues, or fluctuating attention and motivation.

If your child’s social behaviors seem erratic or disconnected—sometimes engaging warmly and other times completely aloof, without obvious reason—it’s important to note these patterns. Consistent unpredictability in social responses, especially alongside other early signs, should prompt a discussion with your pediatrician or a developmental specialist for further evaluation.

33. Strong Reactions to Specific Smells

Olfactory sensitivity, or heightened or diminished reactions to smells, is a sensory difference often seen in children with autism. The brain may process scents more intensely, causing certain odors—pleasant or unpleasant—to feel overwhelming or even distressing. As a result, children may have strong aversions or unusually keen interest in specific smells (National Autistic Society: Sensory Differences).

For example, a child might gag or cover their nose at the scent of cleaning products, perfumes, or certain foods, refusing to enter rooms where those smells linger. Conversely, some children may repeatedly sniff objects, clothing, or people, appearing fascinated by everyday odors others barely notice. Food aversions and feeding difficulties can also be linked to heightened sense of smell.

While all children have preferences, persistent or extreme reactions to smells—either avoidance or seeking—are worth monitoring. If your child’s response to scents interferes with daily activities, limits their participation in routines, or causes significant distress, discuss these patterns with your pediatrician. Strong olfactory sensitivities, especially when combined with other signs, may indicate underlying sensory processing differences related to autism.

34. Not Following Pointed Directions

A foundational aspect of early social development is joint attention—the shared focus between a child and caregiver on the same object or event. One way this develops is through following visual cues, such as an adult pointing to a toy, animal, or picture and the child turning to look where indicated. Children with autism often have difficulty responding to these nonverbal prompts, which can affect language acquisition and learning (CDC: Important Milestones for 2-Year-Olds).

For example, a parent might say, “Look at the airplane!” while pointing to the sky, but the child doesn’t shift their gaze or acknowledge the gesture. This difference isn’t due to vision or hearing issues, but rather a unique way of processing social and visual information. Children with autism may miss out on shared experiences and opportunities to learn from others simply because they do not follow these cues.

If your child rarely or never follows your pointed directions by 14 to 18 months—especially when combined with other social or communication delays—it’s a sign to seek further evaluation. Early interventions can help strengthen joint attention and support communication development if challenges are identified.

35. Unusual Interest in Lights or Patterns

Many children are naturally drawn to bright lights, moving objects, or bold patterns, but for some children with autism, this fascination can become an intense fixation on visual stimuli. They may spend long periods staring at ceiling fans, sunlight reflections, spinning wheels, or repetitive designs on fabrics and wallpapers. This behavior is linked to the way the autistic brain processes sensory input, often seeking out or becoming absorbed by specific visual experiences (National Autistic Society: Repetitive and Restricted Behaviour).

Unlike typical curiosity, which is usually brief and shifts easily from one object to another, children with autism may become upset if interrupted or prevented from watching their chosen lights or patterns. They may ignore people or activities in favor of fixating on visual details, missing out on social interaction or learning opportunities.

If your child’s interest in lights, spinning objects, or patterns is so strong that it interferes with play, learning, or social engagement, consider monitoring the frequency and intensity of this behavior. Bring these observations to the attention of your pediatrician if the fixation is persistent and seems to limit broader exploration or interaction.

36. Does Not Show Empathy

Empathy—the ability to recognize and respond to the feelings of others—is a foundational aspect of social-emotional development. By age two, most children will offer comfort to a crying friend, show concern if someone is hurt, or imitate the emotional tone of those around them. Children with autism, however, may struggle with social-emotional reciprocity, appearing indifferent or unresponsive when those nearby are upset (Raising Children Network: Nonverbal Communication and Autism).

For example, a child might not react when a sibling falls and cries, or may fail to notice a parent’s distress after a long day. They might laugh during sad moments or continue with their routine, unaware of the emotional cues from those around them. This isn’t due to a lack of caring, but rather differences in recognizing and interpreting others’ emotions.

If your child rarely offers comfort, ignores others’ feelings, or seems unaffected by emotional events, it’s important to observe these patterns over time. Persistent absence of empathy—especially alongside other communication or social differences—should be discussed with your pediatrician. Early identification can help support social-emotional skills and foster more meaningful relationships.

37. Difficulty with Back-and-Forth Conversation

Conversational reciprocity—the give-and-take of dialogue—is a key marker of social communication. Most young children, even with limited vocabularies, begin to master the rhythm of conversation: asking questions, responding to comments, and taking turns speaking. Children with autism, however, may struggle with back-and-forth exchanges, often dominating the conversation, echoing phrases, or providing unrelated answers (American Speech-Language-Hearing Association: Autism Spectrum Disorder).

For instance, a child may talk at length about a favorite topic without pausing for input, or fail to answer simple questions like “How are you?” or “What did you do today?” They might repeat a question instead of responding, or abruptly change the subject, making interactions feel one-sided or disconnected.

While all children are learning to navigate conversation, persistent difficulty with turn-taking, topic maintenance, or responding appropriately should raise concern—especially if these challenges remain after age three. If your child rarely engages in true back-and-forth conversation, or if interactions feel like monologues, consult a speech-language pathologist or developmental specialist for evaluation and support.

38. Excessive Interest in One Topic

A hallmark of autism spectrum disorder is the presence of restricted and highly focused interests. While many children develop favorite toys or topics, those on the autism spectrum may display an intense, almost obsessive fascination with a specific subject—such as trains, dinosaurs, or numbers—that dominates their play and conversations (Autism Speaks: Symptoms).

For example, a child might spend hours memorizing train schedules, reciting dinosaur names, or collecting facts about space, often to the exclusion of other activities or social engagement. They may steer every conversation back to their preferred topic, share lengthy monologues, or become upset if interrupted or redirected. These interests can be impressive but also isolating if they prevent broader participation in play or learning.

While deep curiosity is a strength, excessive preoccupation with a single subject—especially if it interferes with daily routines, relationships, or the ability to explore new activities—should prompt further observation. If your child’s focus on one topic is persistent, intense, and limits other experiences, discuss these patterns with your pediatrician or a developmental specialist for possible evaluation and support.

39. Unusual Sleeping Patterns

Sleep disturbances are common among children with autism, affecting both the child and their family’s overall well-being. These unusual sleeping patterns may include difficulty falling asleep, frequent night wakings, or waking very early in the morning and being unable to return to sleep (Autism Speaks: Sleep).

Some children may wander the house at night, resist bedtime routines, or experience night terrors. Others might only sleep for a few hours at a time or require very specific conditions—such as complete darkness or a certain blanket—to fall and stay asleep. Disrupted sleep can worsen daytime behaviors, increase irritability, and make it harder for children to learn and interact.

While occasional sleep challenges are normal in early childhood, persistent and severe sleep issues—especially when paired with other developmental differences—should be discussed with your pediatrician. A healthcare provider can help identify underlying causes, offer behavioral strategies, or refer to a sleep specialist if needed. Addressing sleep problems early improves quality of life for the whole family and can support healthy development in children with autism.

40. Not Engaging in Turn-Taking Games

Turn-taking is a foundational skill for both play and communication, beginning with simple games like rolling a ball back and forth or playing peekaboo. These early social games teach children about reciprocity, patience, and shared enjoyment. Most toddlers will eagerly participate, laughing and looking to their play partner for cues to continue. However, children with autism may struggle to engage in turn-taking games or show little interest in the back-and-forth dynamic (CDC: Important Milestones for 2-Year-Olds).

For example, a child might ignore attempts to initiate a simple game, take multiple turns in a row without waiting, or become frustrated when asked to share or wait. They may instead focus on playing alone, repeating the same action, or using toys in a solitary manner.

While all children develop social skills at their own pace, persistent avoidance or difficulty with turn-taking—especially after age two—should be monitored. If your child rarely engages in or enjoys these games, or struggles to understand the rules of sharing and waiting, bring these observations to your pediatrician. Early support can help foster social participation and communication growth.

41. Unusual Vocalizations

Children with autism may produce unusual vocalizations—sounds or noises that stand out from typical babbling or speech development. These can include high-pitched squeals, repetitive humming, grunting, throat clearing, or making animal-like sounds. Some children create rhythmic noises, click their tongues, or repeat nonsensical syllables throughout the day (Autism Speaks: Speech, Language, and Communication Disorders).

While all young children experiment with sound as they learn to talk, the vocalizations seen in autism are often persistent, contextually inappropriate, or unrelated to attempts at communication. A child might hum loudly in quiet settings, make unusual noises during play, or produce sounds for sensory stimulation rather than social interaction.

If your child consistently uses atypical vocalizations long after peers have moved on to words and sentences, or if the noises interfere with play, learning, or social participation, it’s important to observe these behaviors over time. If the vocalizations are persistent and do not evolve into typical speech, consult a speech-language pathologist or developmental specialist for further assessment and support.

42. Lack of Curiosity About Others

Most young children are naturally curious about people around them. They will watch adults, observe other children, and ask questions about what others are doing or feeling. This social curiosity drives learning, friendship-building, and the development of empathy. In contrast, children with autism may show a marked lack of interest in others, rarely observing, imitating, or inquiring about those around them (Autism Speaks: Social Challenges and Autism).

For example, a neurotypical child might notice a new visitor and ask, “Who is that?” or watch closely as an older sibling plays a new game. A child with autism may be indifferent to new people, show little interest in joining activities, or remain focused on their own play regardless of what’s happening nearby.

While some shyness or independence is normal, persistent lack of curiosity about others—especially after age two—can be a sign of social-communication differences. If your child rarely observes, imitates, or engages with people in their environment, it’s wise to bring this up with your pediatrician. Early input can help identify support strategies to encourage social interest and development.

43. Difficulty with Physical Coordination

Children with autism frequently experience challenges in motor planning and physical coordination, which can affect both gross and fine motor skills. This may become apparent when a child struggles with activities such as running, climbing, catching a ball, or using utensils and crayons. Unlike typical developmental variations, these difficulties often persist and can stand out in group settings like playgrounds or preschool classes (Autism Speaks: Motor Skills and Autism).

Examples include tripping frequently, bumping into objects, having trouble learning to pedal a tricycle, or showing awkward or stiff movements. Fine motor challenges may appear as difficulty stacking blocks, buttoning clothes, or using scissors. These issues are not simply a result of lack of practice; they can stem from differences in how the brain processes movement and spatial awareness.

If your child consistently struggles with physical coordination or seems noticeably less skilled than peers in age-appropriate motor tasks, consider mentioning these observations to your pediatrician or occupational therapist. Early intervention can help children develop motor skills and confidence, supporting overall independence and participation in daily life.

44. Not Comforted by Social Touch

Social touch—like hugs, cuddles, or pats on the back—is a primary way young children seek and receive comfort from caregivers. Most babies and toddlers instinctively reach for a parent when upset or tired, and are soothed by being held or rocked. However, children with autism may not seek or respond to comfort through touch in the typical way, sometimes pulling away or appearing unaffected by cuddles (National Autistic Society: Sensory Differences).

For example, a child might not lift their arms to be picked up after a fall, resist holding hands, or become stiff or irritable when hugged. Some children may prefer being alone, soothe themselves through repetitive motions, or seek comfort in a favorite object rather than through physical closeness.

While every child has unique preferences, persistent lack of response to social touch—or clear discomfort with being comforted physically—should be observed closely, especially if combined with other early social or communication differences. If your child does not seek comfort from you or seems indifferent to physical affection, mention these concerns to your pediatrician for further guidance and support.

45. Unusual Laughing or Crying

Emotional expression in children with autism can sometimes appear atypical or out of context. This might include laughing or giggling at moments that seem inappropriate, such as during quiet or sad situations, or crying suddenly without an obvious trigger. These responses can be confusing for caregivers and may lead to misunderstandings with peers and adults (National Autistic Society: Emotions).

For example, a child might burst into laughter when someone is hurt, or cry intensely when nothing appears to be wrong. Their emotional responses may not match the social cues or events around them, and they may be difficult to comfort or redirect. Sometimes, these reactions are related to sensory overload, anxiety, or difficulty interpreting and expressing emotions.

While emotional ups and downs are part of normal childhood, persistent or extreme emotional expressions that do not fit the situation—or are hard to soothe—warrant close observation. If your child often laughs or cries in ways that seem disconnected from context, or struggles to regulate emotions, talk with your pediatrician or a developmental specialist for evaluation and support.

46. Not Seeking Help or Comfort

Most young children instinctively seek help or comfort from caregivers when faced with challenges, discomfort, or distress. This may include holding up their arms to be picked up, bringing a broken toy to an adult, or seeking hugs and reassurance after a fall. Children with autism, however, may not display these help-seeking behaviors, instead remaining silent, withdrawn, or attempting to solve problems alone (CDC: Important Milestones for 2-Year-Olds).

For example, a child might struggle to open a container without asking for assistance, or continue to cry after an injury without approaching a parent. Others may not look for comfort when scared or upset, choosing instead to self-soothe through repetitive behaviors or seeking comfort in objects.

While some independence is normal, persistent absence of help-seeking or comfort-seeking—especially after age two—should be noted. If your child rarely comes to you or another adult for help or reassurance, or seems indifferent to your presence during distress, it may indicate a social-communication difference. Discuss these behaviors with your pediatrician to ensure your child receives the support and guidance they need.

47. Difficulty Understanding Simple Instructions

Receptive language—the ability to understand and process spoken words—is a key part of early communication development. Children with autism may have difficulty understanding simple instructions, even if they appear to hear well. This can show up as not following basic requests like “come here,” “give me the ball,” or “sit down,” despite repeated prompts or gestures (American Speech-Language-Hearing Association: Autism Spectrum Disorder).

For example, a child might ignore directions to clean up, or seem confused by multi-step commands such as “pick up your shoes and put them by the door.” Sometimes, children may rely on routines or visual cues rather than truly understanding the words, making comprehension delays less obvious in structured environments.

While all children occasionally ignore instructions or become distracted, consistent trouble understanding and acting on age-appropriate requests—especially after age two—should be closely monitored. If your child often seems lost or unresponsive to simple directions, this may signal receptive language difficulties associated with autism. Early evaluation and intervention by a speech-language pathologist can help strengthen comprehension skills and support overall development.

48. Unusual Interest in Parts of Objects

A classic early sign of autism is an unusual preoccupation with specific parts of objects rather than the whole. While most children experiment with toys in a variety of ways—pretending, building, or exploring different functions—children with autism may become fixated on a single feature, such as spinning wheels, flipping switches, or examining patterns and textures in detail (National Autistic Society: Repetitive and Restricted Behaviour).

For example, a child might spend long stretches watching the wheels of a toy car spin, repeatedly opening and closing a door on a dollhouse, or lining up puzzle pieces without attempting to complete the puzzle. These behaviors often provide sensory feedback or visual stimulation, but limit broader engagement with the toy or with peers.

While it’s normal for all children to explore how things work, persistent, intense focus on parts rather than the whole—especially if it interferes with play, learning, or socialization—should be monitored. If your child’s play is narrowly centered on specific details and lacks variety, mention these observations to your pediatrician for further evaluation and support.

49. Poor Eye-Hand Coordination

Visual-motor integration, or eye-hand coordination, is crucial for many everyday childhood activities. It involves the ability to use visual input to guide hand movements, allowing for tasks like stacking blocks, feeding oneself, drawing, or catching a ball. Children with autism may display persistent difficulties in these areas, struggling to coordinate what they see with how they move (Autism Speaks: Motor Skills and Autism).

Common examples include dropping objects frequently, having trouble fitting puzzle pieces together, or avoiding toys that require coordinated movement. Fine motor challenges might manifest as awkward pencil grip, difficulty using utensils, or slow progress with dressing skills like buttoning or zipping. Gross motor issues can appear as clumsy catching or frequent spilling when pouring or transferring items.

While some clumsiness is typical as skills develop, ongoing, pronounced struggles with eye-hand coordination—particularly compared to peers—should be monitored. If your child consistently avoids or becomes frustrated by activities requiring precise movements, an occupational therapy evaluation can help identify underlying issues and provide strategies to build confidence and ability.

50. Regression in Skills

One of the most concerning early signs of autism is regression in developmental skills. This means a child who previously met milestones—such as using words, waving, making eye contact, or playing social games—suddenly loses these abilities. Such regression often occurs between 15 and 30 months of age, and is an urgent red flag for evaluation (CDC: Signs and Symptoms of Autism Spectrum Disorders).

Real-life stories include children who once greeted family members with “hi” or “bye” but stop speaking altogether, or toddlers who used to point at airplanes or bring toys to show adults but no longer do so. Parents might notice a child withdrawing, becoming less responsive to their name, or losing interest in favorite activities.

Unlike gradual changes in interest or personality, true regression is a sudden or noticeable loss of skills that were solidly established for weeks or months. If you observe your child losing language, social, or motor milestones, seek immediate evaluation by your pediatrician or a developmental specialist. Prompt intervention can make a significant difference in outcomes and access to support.

Conclusion

Early detection of autism is crucial for maximizing a child’s potential and accessing timely interventions. By watching for the subtle signs described above—many of which are easily mistaken for “just a phase”—parents can make a profound difference in their child’s developmental path. If you have any concerns, trust your instincts and speak with your pediatrician. Free, evidence-based screening tools like the M-CHAT-R/F can help families identify early red flags. Remember, seeking support is never premature; early action can open doors to resources, therapies, and a community of understanding. Your attentiveness and advocacy are the first steps to ensuring every child gets the best start possible.

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