What Parents Wish They’d Noticed Earlier About Autism

1. Delayed Speech Milestones

One of the earliest and most noticeable signs that may indicate autism spectrum disorder is a delay in speech and language development. According to the Centers for Disease Control and Prevention, children typically begin to babble by 12 months and say single words by 16 months. However, many children with autism show significant delays in reaching these milestones. For example, a toddler who is 18 months old and still does not say basic words like “mama” or “dada,” or who shows little interest in communicating, may be exhibiting a red flag for underlying neurological differences.

Language delays are not always a guarantee of autism, but they are a common early indicator that the brain is processing communication differently. Parents might initially attribute these delays to personality or family traits, but research underscores the importance of early evaluation. If a child is not meeting speech milestones or has lost previously acquired language skills, it’s advisable to seek a developmental assessment from a pediatrician or speech-language pathologist. Early identification provides the best chance for effective intervention and support (Autism Speaks).

2. Limited Eye Contact

Eye contact is a fundamental part of early social communication, helping infants and young children connect emotionally with caregivers and learn about social cues. Typically developing children begin to make eye contact as early as a few weeks old, and this behavior strengthens as they grow, supporting the development of relationships and social understanding (Raising Children Network). In contrast, children on the autism spectrum may avoid or make less frequent eye contact. This difference is not due to rudeness or defiance, but rather a neurological difference in how social information is processed.

Parents often recall, in retrospect, that their child seemed “distant” or uninterested in faces, or that the child looked away when spoken to or smiled at. Some children might glance at a person’s face but quickly look elsewhere, or seem more focused on objects than on people. It’s important to monitor for these subtle signs, especially if they persist beyond infancy. If a child rarely seeks eye contact, or seems uninterested in sharing attention with others, it may be time to discuss these observations with a healthcare provider (National Autistic Society).

3. Lack of Pointing or Gesturing

Gestures such as pointing, waving, and reaching are crucial parts of early communication, typically emerging between 9 and 14 months of age. These nonverbal behaviors allow infants to show interest, share experiences, and direct the attention of others long before they master words. In neurotypical development, a baby might point to a favorite toy, wave goodbye, or reach up to be picked up, signaling their intentions and desires clearly to caregivers (American Academy of Pediatrics).

Children with autism often show a noticeable absence or delay in these gestures. For example, a toddler may not point to indicate something interesting or may fail to wave when prompted. Instead, they might use an adult’s hand as a tool to obtain objects, without making eye contact or sharing in the moment. Parents should watch for the consistent use of gestures such as pointing to request or show, waving, or nodding. If these behaviors are minimal or missing beyond the first year, it could signal a need for developmental evaluation. Recognizing and acting on these signs can help ensure earlier support (CDC).

4. Unusual Response to Name

An early sign that can indicate autism spectrum disorder is an unusual or inconsistent response to one’s own name. While most infants begin to recognize and react to their name by 6 to 9 months of age, children with autism may not turn, smile, or show acknowledgment when called. This behavior is not necessarily a sign of hearing loss, but rather reflects differences in how the brain processes auditory and social information (Autism Speaks).

Many parents later recall calling their child’s name repeatedly without a response, sometimes suspecting hearing difficulties. For example, a parent might notice that their toddler responds to other sounds, such as the jingle of a favorite toy or music, but does not react when spoken to directly. This selective response can be confusing and is often dismissed as stubbornness or distraction. However, it may be an early marker of autism-related social communication challenges. If a child consistently fails to respond to their name by 12 months, or if parents observe a regression in responsiveness, it is wise to seek a developmental screening. Early assessment can help clarify the underlying cause and support timely intervention (CDC).

5. Intense Repetitive Behaviors

Many children engage in occasional repetitive actions, but intense or prolonged repetitive behaviors—often called “stimming”—are a core characteristic of autism spectrum disorder. These actions can include hand-flapping, rocking, spinning, finger flicking, or lining up objects in a precise order. Such behaviors serve as a way for autistic individuals to self-soothe, manage sensory overload, or express excitement (Autism Speaks).

For example, a child might repeatedly wave their hands in front of their face when excited, or rock back and forth for long periods, seemingly unaware of their surroundings. While repetitive play—such as stacking blocks or enjoying the same song—is common in young children, behaviors that are unusually intense, persistent, or interfere with daily activities may signal a deeper difference. Parents should take note if their child’s repetitive actions are difficult to interrupt, limit social interaction, or seem to arise in response to stress or changes in routine. Recognizing the difference between typical childhood habits and concerning repetitive behaviors can guide parents toward seeking an expert opinion. Early awareness and consultation with a healthcare provider are vital for understanding and supporting a child’s unique needs (CDC).

6. Hyperfocus on Specific Interests

Restricted or highly focused interests are another hallmark of autism spectrum disorder. While many children develop favorite toys or hobbies, those on the autism spectrum may become intensely preoccupied with a specific topic, object, or activity, sometimes to the exclusion of everything else. This hyperfocus can manifest early, presenting as an all-consuming fascination with things like trains, dinosaurs, maps, or numbers (National Autistic Society).

For example, a young child might spend hours lining up toy trains in a precise order, memorizing their names and routes, and insisting on discussing trains with anyone who will listen. While a strong interest is not inherently problematic, the intensity and rigidity of these fixations can sometimes impact social interactions and flexibility. Parents often wonder whether to nurture these passions or seek further evaluation. It’s important to encourage a child’s enthusiasm while also observing whether the interest restricts their willingness to engage in other activities or makes it difficult for them to relate to peers. If a child’s fascination seems unusually intense, exclusive, or interferes with daily life, it may be time to consult a professional for assessment and guidance (CDC).

7. Sensory Sensitivities

Sensory sensitivities are common in children with autism and can present as either hypersensitivity (over-reactivity) or hyposensitivity (under-reactivity) to sensory input such as light, sound, touch, taste, or smell. These differences in sensory processing can make everyday experiences overwhelming or, conversely, leave a child seemingly indifferent to stimuli that typically attract attention (Autism Speaks).

In daily life, a child with hypersensitivity might cover their ears at the sound of a vacuum cleaner, squint or avoid brightly lit rooms, or become distressed by the feeling of certain fabrics. On the other hand, a child with hyposensitivity may not notice when their hands are dirty, seek strong hugs or pressure, or seem oblivious to loud noises. Sensory issues can also affect eating habits and tolerance for grooming routines, such as haircuts or tooth brushing.

Parents can recognize sensory sensitivities by observing patterns: Does the child consistently avoid or seek out certain sensations? Are meltdowns triggered by specific environments or textures? Noticing these behaviors and their contexts can help families communicate concerns to professionals and access tailored support (Raising Children Network).

8. Unusual Tone or Rhythm in Speech

Children with autism often experience challenges with prosody, which is the natural melody, intonation, and rhythm of speech. Prosody gives spoken language its emotional tone and helps convey meaning beyond the words themselves. In typical development, children’s speech is varied—rising and falling to express excitement, curiosity, or a question. However, children on the autism spectrum may speak in a monotone, use an unusual pitch, or have a sing-song or robotic quality to their voice (Autism Speaks).

Parents might notice that their child’s speech sounds flat, lacks emphasis, or seems oddly exaggerated for the context. For example, a child might ask questions with a rising inflection even when not seeking information, or their speech might lack the typical pauses and stresses found in conversation. These differences can make it difficult for others to interpret the child’s feelings or intentions, sometimes leading to misunderstandings.

If a child consistently speaks with an unusual tone, rhythm, or volume, or if their speech seems out of sync with their emotions or the situation, it’s advisable to consult a speech-language pathologist or developmental specialist. Early evaluation can help identify underlying communication challenges and guide appropriate intervention (CDC).

9. Difficulty with Pretend Play

Imaginative or pretend play is a key part of early childhood development, fostering creativity, language skills, and social understanding. By age two or three, most children begin to engage in activities such as pretending a block is a car, feeding a doll, or enacting simple stories with toys. These playful scenarios help children practice roles, experiment with emotions, and connect with peers (CDC Developmental Milestones).

Children on the autism spectrum, however, may show limited interest in or ability to engage in pretend play. For instance, while a neurotypical child might create a tea party for stuffed animals, a child with autism might line up the cups without enacting a story or use toys in repetitive, non-imaginative ways. Some parents notice their child prefers to explore how toys work—such as spinning wheels or opening doors—rather than using them as props for make-believe.

If a child consistently avoids or struggles with imaginative play by age three, it’s a good idea to discuss concerns with educators or a pediatric therapist. Early intervention can support the development of play skills and foster social growth (Autism Speaks).

10. Resistance to Change

A strong preference for routines and predictability is a common trait among children with autism spectrum disorder. Many autistic children rely on structure to feel secure and may experience significant distress when faced with unexpected changes or disruptions to their usual schedule. While all children benefit from routine, those on the autism spectrum often exhibit intense anxiety, frustration, or behavioral outbursts if their day does not unfold as expected (National Autistic Society).

For example, a child might become extremely upset if a favorite television show is canceled, if dinner is served later than usual, or if the route to school is altered. Even small changes—such as moving furniture or introducing a new teacher—can result in agitation or withdrawal. These reactions stem from a neurological need for sameness and difficulty adapting to novelty.

Families can help by providing advance warnings of changes, using visual schedules, and keeping routines as consistent as possible. However, if a child’s reaction to change is extreme or interferes with daily functioning, it may warrant further evaluation by a developmental specialist. Early recognition allows families to access strategies and support tailored to their child’s needs (CDC).

11. Limited Peer Interaction

One of the core challenges for children with autism is difficulty forming and sustaining interactions with peers. While neurotypical children often seek out playmates, join group games, and learn to take turns through social play, children on the autism spectrum may struggle in these areas. They might prefer solitary activities, have trouble initiating or responding to social overtures, or seem uninterested in the activities of other children (National Autistic Society).

For example, in a preschool group, a neurotypical child might eagerly join a pretend game or share toys, whereas a child with autism may watch from a distance, engage in parallel play without interacting, or focus intensely on a personal interest. Parents and caregivers might notice a lack of back-and-forth play, difficulty understanding social rules, or apparent indifference to invitations from peers.

Signs of concern include persistent avoidance of group activities, limited eye contact during play, or difficulty interpreting the emotions and intentions of others. If these patterns are evident, especially as the child grows older and social expectations increase, it’s advisable to consult with teachers or a developmental specialist to explore supportive interventions (CDC).

12. Unusual Attachment to Objects

While many young children develop attachments to comfort items like blankets or stuffed animals, autistic children may form particularly intense or unusual bonds with specific objects. These can include items not typically regarded as toys, such as household utensils, pieces of string, or even packaging materials. The attachment may go beyond comfort, becoming a central focus in the child’s daily activities and a source of distress if the object is misplaced (National Autistic Society).

For example, a child might insist on carrying a kitchen spatula everywhere, or show extreme anxiety if separated from a favorite shoelace. Unlike the transitional objects commonly seen in neurotypical development, these attachments can be more rigid and may interfere with social activities or learning. The object may also be used in repetitive ways, such as spinning, tapping, or lining it up with other items.

Parents should consider whether their child’s attachment is unusually intense, inflexible, or focused on items not generally used for comfort. If the bond seems to dominate play and daily routines, or if it leads to meltdowns when the object is unavailable, it may be helpful to seek guidance from a developmental professional (CDC).

13. Lack of Social Smiling

Social smiling—a baby’s way of smiling in response to another person’s face or voice—is an important milestone that typically emerges by two months of age. This early exchange helps foster emotional bonding, communication, and social learning, as infants use smiles to connect with caregivers and signal pleasure or interest (CDC Developmental Milestones). In neurotypical development, babies often smile back when someone smiles at them, showing a clear awareness of social interaction.

Children on the autism spectrum, however, may show a noticeable lack of social smiling. Parents might observe that their baby rarely smiles in response to familiar faces, or seems less interested in engaging socially through facial expressions. Instead, smiles may appear less often, seem unrelated to social cues, or be directed at objects rather than people. This can make early bonding and communication feel more challenging for families.

If a child consistently does not return smiles, appears indifferent to playful interactions, or seems unusually reserved in early infancy, it is worth discussing these observations with a pediatrician. Early attention to social smiling can help guide appropriate screening and support (Autism Speaks).

14. Difficulty Understanding Feelings

Many children with autism spectrum disorder have difficulty interpreting and responding to the emotions of others. This challenge, often called “mindblindness” or difficulties with emotional literacy, can affect a child’s ability to recognize facial expressions, tone of voice, or body language, making social interactions and friendships more complex (National Autistic Society).

For example, in a classroom setting, a child with autism might not notice when a peer is upset or may fail to comfort a friend who is crying. They may appear unaware of sarcasm, jokes, or subtle cues that signal how someone else is feeling. Teachers often observe that these children struggle with group activities requiring empathy, such as sharing or taking turns, and may seem disconnected from the emotional climate of the room.

Parents and educators can support emotional literacy by using visual aids, stories, and explicit discussions about feelings. Resources such as social stories and emotion cards are helpful tools (Autism Speaks: Social Skills and Autism). If difficulties with understanding feelings persist, consulting a speech-language pathologist or social skills therapist can provide targeted strategies to build empathy and social awareness.

15. Repetition of Words or Phrases (Echolalia)

Echolalia is a language characteristic often observed in children with autism spectrum disorder. It involves the repetition of words, phrases, or sentences spoken by others, sometimes immediately after hearing them (immediate echolalia) or later on (delayed echolalia). While some repetition is a normal part of language development—especially in toddlers learning to speak—persistent or unusual echolalia may signal differences in how a child processes and uses language (National Autistic Society).

For example, a child might repeat a phrase from a favorite TV show, such as “It’s time for adventure!” in various situations, regardless of context. Others may echo questions instead of answering them, such as responding to “Do you want juice?” by repeating “Do you want juice?” instead of giving a yes or no answer. While echolalia can serve as a developmental step for some children, helping them practice speech and communication, it often persists longer in children with autism.

If a child’s use of echolalia is frequent, contextually inappropriate, or continues beyond the early preschool years, parents should discuss these patterns with a speech-language pathologist. Early intervention can help support more functional communication (CDC).

16. Unusual Gait or Motor Patterns

Children with autism spectrum disorder often experience challenges with motor planning and coordination, which can manifest as unusual gait or distinctive movement patterns. These motor differences are sometimes subtle but may become more noticeable as children grow. Common observations include persistent toe-walking, awkward or clumsy movements, difficulty running or jumping, or problems with balance and posture (Autism Speaks: Motor Skills and Autism).

For instance, a child may primarily walk on their toes well beyond the toddler years, stumble frequently, or display a “floppy” or unusually stiff posture. These patterns may be accompanied by challenges with tasks requiring fine motor skills, such as holding a pencil, using scissors, or fastening buttons. While many children experience occasional clumsiness, persistent or pronounced motor difficulties may signal underlying neurological differences common in autism.

If a parent or caregiver observes ongoing toe-walking, difficulties with coordination, or other unusual movement patterns, it is advisable to bring these concerns to a pediatrician or physical therapist. Early assessment and intervention can help address motor skill challenges and support overall development (CDC).

17. Extreme Food Preferences

Selective eating and extreme food preferences are frequently observed in children with autism spectrum disorder, often rooted in sensory sensitivities to taste, texture, smell, or even the appearance of food. These preferences can go beyond typical childhood pickiness, sometimes resulting in a highly restricted diet limited to just a few foods (Autism Speaks: Feeding and Nutrition).

For example, some children may only eat foods of a certain color, like white bread and plain pasta, or may refuse anything crunchy, sticky, or mixed together. Real-life stories often include parents preparing multiple separate meals or children gagging at the sight or smell of unfamiliar foods. One parent might recall their child accepting only chicken nuggets and applesauce for months, and having meltdowns if presented with anything else. These intense aversions are usually not about willful defiance, but rather a genuine discomfort or distress triggered by sensory processing differences.

If selective eating is so pronounced that it impacts growth, nutrition, or family life, parents should consult a pediatrician or registered dietitian. Early intervention can address nutritional gaps and provide strategies for expanding food acceptance (CDC).

18. Sleep Difficulties

Sleep disturbances are highly prevalent among children with autism spectrum disorder, often manifesting as trouble falling asleep, frequent night wakings, or early morning awakenings. Research suggests that between 50% and 80% of autistic children experience significant sleep problems, compared to 20%-30% of their neurotypical peers (Autism Speaks: Sleep). These difficulties can arise from differences in melatonin production, heightened anxiety, sensory sensitivities, or irregular bedtime routines.

Parents may observe that their child resists bedtime, takes an unusually long time to settle, or wakes multiple times during the night. Some children are highly sensitive to changes in lighting or noise, which can disrupt their sleep, while others may become active or restless instead of drowsy. Unlike typical sleep regressions seen in early childhood, these patterns often persist and can affect daytime mood, attention, and learning.

If sleep issues are ongoing, severe, or impact the child’s or family’s wellbeing, it is important to consult a pediatrician or sleep specialist familiar with autism. Professional guidance can help identify contributing factors and develop a tailored plan to improve sleep quality (CDC).

19. Unusual Reaction to Pain or Temperature

Children with autism spectrum disorder may display atypical responses to pain or temperature, ranging from a high pain threshold to extreme sensitivity. These altered sensations are related to differences in the way the nervous system processes sensory input. For instance, some autistic children might not react to bumps, cuts, or bruises that would typically cause distress, while others may seem overly sensitive to minor discomforts or changes in temperature (Autism Speaks: Sensory Issues).

Parents often observe unusual scenarios, such as a child not crying after a fall that results in scrapes, or failing to notice a burn from touching something hot. Conversely, a child might react strongly to the feeling of cold water, a gentle tap, or even changes in the weather. These differences can sometimes make it challenging to identify when a child is hurt or in need of comfort, as their reactions may not match the severity of the situation.

If a child consistently shows little response to injury or temperature extremes, or exhibits strong aversions to mild sensations, parents should discuss these patterns with a healthcare provider. Awareness of these differences can improve safety and inform strategies for support (CDC).

20. Lack of Interest in Group Activities

A preference for solitary play and a lack of interest in group activities are common among children with autism spectrum disorder. While many young children enjoy parallel play, by preschool age, neurotypical children increasingly seek out collaborative games, team sports, or group projects. In contrast, autistic children may consistently choose to play alone, showing little enthusiasm for joining classmates or siblings in group activities (National Autistic Society: Social Communication).

Teachers and parents may notice that a child with autism prefers individual tasks, avoids group games during recess, or becomes overwhelmed and withdraws during circle time or class discussions. The child might seem content with their own activities, such as puzzles or drawing, and may resist invitations to participate in team efforts. This can sometimes be misinterpreted as shyness or stubbornness, but often reflects social communication differences or sensory sensitivities that make group settings challenging.

To encourage social involvement, adults can offer gentle invitations, set up structured activities with clear rules, and pair the child with empathetic peers. If solitary play persists and limits social development, consulting a teacher or social skills therapist can help tailor support to the child’s needs (CDC).

21. Difficulty Following Instructions

Children with autism spectrum disorder often face challenges with processing spoken language, which can make it difficult for them to follow instructions—especially if they are multi-step or abstract. These difficulties are not always due to defiance or inattention, but may instead stem from differences in receptive language skills or auditory processing (National Autistic Society: Understanding Language).

In a school setting, a teacher might notice that a child struggles to follow directions like “Put your crayons away, get your coat, and line up at the door.” The child may only complete part of the task, become confused, or require repeated prompts. Parents may observe similar challenges at home, such as difficulty following instructions during routines or games. Visual supports, such as picture schedules or step-by-step checklists, can sometimes help bridge the gap for these children.

If a child consistently has trouble understanding or remembering instructions—especially when language is age-appropriate in other areas—it is wise to seek an evaluation from a speech-language pathologist. Early assessment can identify specific needs and guide interventions that improve communication and independence (CDC).

22. Absence of Babbling by 12 Months

Babbling is a crucial milestone in early speech and language development, typically emerging between 4 and 6 months of age. By 12 months, most infants produce a variety of sounds, combining consonants and vowels—such as “ba-ba,” “da-da,” or “ma-ma”—in repetitive strings. This early vocal play lays the foundation for later language, helping babies practice the mouth movements and sound patterns needed for speech (CDC Developmental Milestones: 1 Year).

The absence of babbling or limited vocalization by the first birthday is considered a significant clinical red flag for developmental differences, including autism spectrum disorder. Pediatricians and speech-language pathologists use babbling as a key benchmark when screening for communication delays. For example, a baby who is quiet, rarely coos, or does not experiment with sounds may be signaling an underlying neurological difference.

If a child is not babbling by 12 months or shows very limited sound play, parents should raise these concerns with their pediatrician as soon as possible. Early evaluation can help determine if further assessment is needed and connect families with interventions that support communication development (Autism Speaks).

23. Difficulty Sharing Enjoyment or Interests

Joint attention—the ability to share focus or enjoyment about an object or event with another person—is a key social skill that develops in early childhood. Children typically show joint attention by pointing to something interesting, looking back and forth between an object and a caregiver, or bringing toys to share during play. This behavior helps build language, empathy, and social connections (CDC: Autism Screening).

Children on the autism spectrum often have difficulty with joint attention. For example, during a playdate, a neurotypical child might excitedly show a new toy to a friend or parent, seeking to share the experience. In contrast, a child with autism may play quietly on their own, not looking up to include others, or may not respond when someone else tries to share an interest. Parents may notice that their child rarely brings items over to “show” or does not seek approval, smiles, or shared excitement from others.

If a child consistently seems uninterested in sharing experiences, objects, or achievements with others, it’s important to discuss these observations with a pediatrician or developmental specialist. Early support can help foster joint attention and social communication skills (Autism Speaks).

24. Unusual Laughter or Giggles

Children with autism spectrum disorder may exhibit laughter or giggles that seem out of context or occur without an obvious trigger. Emotional expression in autism can be different from typical patterns, with some children laughing at times when others might not, or displaying bursts of giggling that appear unrelated to the surrounding environment or conversation (National Autistic Society: Behaviour Challenges).

Parents often recall moments when their child laughed vigorously in a quiet room, during serious moments, or while alone, leading to confusion or concern. For example, a child might giggle while looking at spinning ceiling fans, during repetitive play, or even in response to internal thoughts or sensations that are not apparent to others. While laughter is generally a healthy emotional response, persistent giggling that seems disconnected from social interactions or emotional cues may indicate differences in sensory processing or social understanding.

If a child frequently laughs or giggles in situations where it seems inappropriate, unrelated, or disruptive, it’s a good idea to track patterns and consult a pediatrician or developmental specialist. Early evaluation can help determine if this behavior is linked to autism or other developmental differences (CDC).

25. Strong Aversion to Being Touched

Tactile defensiveness, or a strong aversion to being touched, is a common sensory characteristic in children with autism spectrum disorder. These children may react negatively to physical contact that most peers find comforting or neutral, such as hugs, pats on the back, or holding hands (National Autistic Society: Touch Sensitivities). This sensitivity can affect daily routines and relationships, sometimes leading to misunderstandings between children and caregivers.

For example, a child might recoil or become distressed during hair brushing, resist cuddling, or avoid crowded spaces where accidental bumps are likely. Some children may dislike wearing certain fabrics, tags, or seams in clothing, or may protest activities like bathing or applying lotion. These aversions are not about willful opposition but reflect genuine discomfort or overwhelm caused by tactile input.

To support children with tactile defensiveness, parents and caregivers can offer gentle introductions to touch, using slow, predictable movements and allowing the child to initiate contact when possible. Providing advance notice before touching, respecting boundaries, and seeking guidance from occupational therapists can help make daily interactions less stressful (CDC).

26. Overwhelmed by Crowds or Noisy Spaces

Sensory overload is a frequent experience for many children on the autism spectrum. Crowded or noisy environments—such as shopping malls, birthday parties, or school assemblies—can quickly become overwhelming due to heightened sensitivity to sounds, lights, movements, and even smells (Autism Speaks: Sensory Issues). The barrage of sensory input in these settings may lead to distress, anxiety, or meltdowns.

Parents often notice that their child covers their ears, hides under tables, or becomes agitated and withdrawn during visits to busy stores or family gatherings. Some children might refuse to enter crowded places altogether or insist on leaving soon after arriving. Even routine outings, like grocery shopping, can be fraught with challenges if sensory sensitivities are intense. These reactions are not simply behavioral issues but are rooted in the child’s neurological differences in processing sensory stimuli.

If a child consistently struggles or feels distressed in noisy or crowded environments, it is valuable to keep a log of triggers and speak with a pediatrician or occupational therapist. A sensory evaluation can help identify specific sensitivities and guide strategies to make outings more manageable (CDC).

27. Difficulty Transitioning Between Activities

Children with autism spectrum disorder often have a strong need for predictability and may struggle significantly when asked to switch from one activity to another. Transitions—such as moving from playtime to mealtime, or from recess to classroom work—can be especially challenging, leading to resistance, anxiety, or meltdowns (National Autistic Society: Routines).

In the school environment, teachers may observe a child becoming upset when it is time to clean up and start a new lesson, or needing extra time and support to leave the playground and return indoors. At home, similar difficulties might arise when ending a favorite TV show for bedtime or transitioning from one daily routine to another. These reactions are not just about stubbornness but reflect a neurological preference for sameness and the comfort it brings.

To ease transitions, parents and educators can use visual schedules, countdown timers, and verbal warnings (e.g., “In five minutes, we will pack up the toys”). Offering choices about the next activity, providing consistent routines, and using positive reinforcement can make changes less abrupt and more manageable (CDC).

28. Flat or Unusual Facial Expressions

Children with autism spectrum disorder often display facial expressions that are less varied or do not match the social context, a difference known as atypical affect display. While neurotypical children use a range of facial expressions to convey interest, excitement, confusion, or empathy, autistic children may appear to have a “flat” affect or may show expressions that seem out of sync with the situation (National Autistic Society: Nonverbal Communication).

In classroom settings, a teacher may notice a child listening intently but showing little or no change in facial expression, even when something funny or surprising happens. Family members might observe that the child does not smile in response to jokes, or that their face looks neutral during both happy and sad events. In other cases, a child may display smiles or other expressions at unexpected times, making it difficult for peers and adults to interpret their feelings or needs.

If a child consistently exhibits flat or unusual facial expressions that hinder communication or social connection, it is helpful to discuss these observations with a pediatrician or specialist. Early evaluation can identify underlying challenges and guide interventions to support nonverbal communication (CDC).

29. Unusual Posture or Body Movements

Motor differences, including unusual postures or repetitive body movements, are frequently observed in children with autism spectrum disorder. These behaviors can range from subtle to pronounced and often serve as a means of self-regulation or sensory stimulation. Examples include finger posturing (holding fingers in odd positions), walking on tiptoes, holding the body at unusual angles, or repetitive movements such as flapping, twisting, or spinning (Autism Speaks: Motor Skills and Autism).

Parents may notice their child standing with arms held stiffly at their sides, arching their back in specific situations, or making intricate movements with their fingers while watching lights or patterns. In group settings, these behaviors might stand out more, especially if the child appears unaware of how their body movements differ from peers. While some children use these motions to cope with excitement or anxiety, persistent or intense posturing can interfere with functional movement and social participation.

If a child consistently exhibits unusual posture or repetitive body movements beyond what is typical for their age, it is advisable to consult with an occupational therapist or developmental specialist. Early intervention can help address motor planning and support participation in daily activities (CDC).

30. Frequent Meltdowns or Tantrums

Emotional regulation is often more challenging for children with autism spectrum disorder than for their neurotypical peers. Meltdowns—intense emotional outbursts—may occur frequently and can be triggered by sensory overload, unexpected changes, or frustration with communication. Unlike typical tantrums, which are generally goal-driven and may subside when a child gets what they want, meltdowns are involuntary and reflect an overwhelmed nervous system (National Autistic Society: Meltdowns).

For example, a child might scream, cry, or drop to the floor when confronted with a noisy environment or a change in routine, regardless of reassurance or redirection. These episodes can last longer than typical tantrums and may not be soothed by comfort or distraction. Parents may notice that meltdowns seem unpredictable or are triggered by seemingly minor events, such as a tag in clothing or an unexpected sound.

If a child experiences frequent, intense meltdowns that interfere with daily life or social participation, it’s important to seek guidance from a pediatrician, psychologist, or behavioral therapist. Professional support can help families understand triggers, teach coping strategies, and foster emotional self-regulation (CDC).

31. Not Responding to Social Cues

Social communication involves understanding and appropriately responding to subtle signals from others—such as facial expressions, gestures, tone of voice, and body language. Children with autism spectrum disorder often have difficulty picking up on these social cues, which can impact their ability to connect with peers and adults (National Autistic Society: Social Communication).

For example, a child may not notice when a friend wants to join a game, fails to recognize when someone is upset, or does not understand when it is their turn to speak in conversation. During playdates or classroom activities, they might continue talking about their own interests without awareness that others have lost interest, or may not react to someone’s smile, frown, or other facial cues. These challenges can make social interactions confusing and may lead to misunderstandings or social isolation.

If a child persistently struggles to interpret or respond to social cues, especially as compared to peers, it is important to observe these patterns over time and in different settings. Consulting with a pediatrician, speech-language pathologist, or developmental specialist can help clarify concerns and identify ways to support social learning (CDC).

32. Avoiding Physical Contact

Avoidance of physical contact is a behavior commonly seen in children with autism spectrum disorder, but it is important to distinguish this from typical shyness. While shy children may initially hesitate but gradually warm up to hugs, hand-holding, or friendly touches, autistic children often have a persistent sensory aversion to physical contact that can cause distress or discomfort (National Autistic Society: Touch Sensitivities).

Parents sometimes recall their child pulling away from cuddles, resisting being held, or disliking physical affection even from familiar people. For example, one parent might describe how their child stiffens or cries when picked up, or avoids sitting close during storytime. In social settings, these children may avoid group hugs, high-fives, or even casual touches from peers. Such reactions are rooted in sensory processing differences rather than a lack of attachment or emotion.

If a child’s aversion to physical contact is consistent, intense, and interferes with daily routines or relationships, it’s advisable to discuss these observations with a pediatrician or occupational therapist. Early advice and support can help families adapt routines and foster positive sensory experiences (CDC).

33. Difficulty with Toilet Training

Toilet training can be particularly challenging for children with autism spectrum disorder, often taking longer than for neurotypical peers. While most children begin to show readiness for toilet training between 18 months and 3 years, autistic children may experience delays due to sensory sensitivities, communication differences, or difficulties with understanding routines (Autism Speaks: Toilet Training).

Common struggles include resistance to sitting on the toilet, fear of flushing sounds, trouble recognizing bodily signals, or difficulty generalizing toilet use across different environments. Some children may become anxious about the texture or temperature of toilet seats or the loudness of automatic hand dryers. Parents frequently describe frequent accidents, strong opposition to trying the toilet, or confusion around bathroom routines. These challenges can cause stress for families and may impact a child’s participation in preschool or daycare.

If a child is significantly delayed in toilet training or shows ongoing distress or confusion about bathroom routines, parents should consult their pediatrician or a behavioral therapist. Resources and structured approaches—such as visual schedules, social stories, and gradual desensitization—can help guide families through the process (CDC: Toilet Training).

34. Prefers Routine Routes or Rituals

Insistence on sameness—preferring specific routines, routes, or rituals—is a notable trait among children with autism spectrum disorder. This need for predictability often manifests in daily habits, such as taking the same path to school, following a precise bedtime routine, or arranging toys in a particular order every day (National Autistic Society: Routines). Even minor changes to these routines can provoke anxiety, frustration, or meltdowns.

For example, a child might insist on walking the same route to the playground, eating foods in a specific sequence, or lining up shoes exactly before leaving the house. Parents may notice their child becomes upset if the order is changed, a step is skipped, or a familiar object is moved. These rituals often provide comfort and a sense of control amidst a world that can feel unpredictable or overwhelming due to sensory and social processing differences.

While routines are helpful for all children, intense rigidity or distress over small changes can be a red flag for autism, especially if accompanied by other developmental differences. If these preferences interfere with daily life, flexibility, or social engagement, it is prudent to consult a pediatrician or developmental specialist (CDC).

35. Unusual Play with Toys

Atypical play with toys is a hallmark sign of autism spectrum disorder, often distinguished by repetitive or unconventional use of objects. Instead of engaging in pretend scenarios or interactive games, autistic children may line up cars, spin the wheels of a truck, or repeatedly open and close a dollhouse door. These repetitive patterns often provide sensory satisfaction or a sense of control, but may limit opportunities for imaginative or social play (National Autistic Society: Repetitive and Restrictive Behaviour).

Parents might observe their child spending long periods organizing crayons by color, stacking blocks in the same order, or spinning tops for extended periods. The focus is typically on the physical properties or movements of the toys, rather than their intended purpose. For instance, a child may not “drive” toy cars in a make-believe race, but instead arrange them in perfectly straight lines or study them from unusual angles.

While all children sometimes play repetitively, frequent and persistent unusual play—especially when it replaces pretend play or limits peer interaction—should prompt further observation. If these patterns are accompanied by other social or communication differences, consider seeking guidance from a developmental specialist (CDC).

36. Lack of Imitation

Imitation is a foundational skill in early childhood development, enabling children to learn new behaviors, social cues, and language by observing and copying others. Through imitation, children pick up gestures, facial expressions, sounds, and daily routines from caregivers and peers (CDC: Developmental Milestones – 1 Year). A lack of imitation is often noticeable in children with autism spectrum disorder and can signal differences in how they process and engage with the social world.

For example, during a game of “pat-a-cake” or “peekaboo,” a neurotypical toddler will usually mimic clapping hands or covering eyes. In contrast, an autistic child may watch without copying the actions, or may not respond at all. Parents might notice their child does not imitate waving, blowing kisses, or copying simple household tasks like sweeping or stirring. This absence of imitation can impact language development, play skills, and the ability to learn through observation.

If a child rarely or never imitates gestures, sounds, or actions by 12 to 18 months, especially in interactive play or daily routines, it is important to raise concerns with a pediatrician or developmental specialist. Early identification and intervention can help support the development of social and communication skills (Autism Speaks).

37. Avoiding Looking at Faces

Children with autism spectrum disorder often exhibit differences in how they process and respond to faces. While neurotypical infants and toddlers are naturally drawn to look at faces—especially those of caregivers—autistic children may avoid or minimize eye contact and facial observation (National Autistic Society: Nonverbal Communication). This avoidance can affect their ability to interpret social cues, such as emotions, intentions, and responses from others.

In social contexts, a child might look away when spoken to, focus on objects instead of people’s faces, or seem uninterested in interactive games that involve facial expressions, like making funny faces or playing peekaboo. During family gatherings, they may not seek out familiar faces or respond with smiles and engagement as expected. Over time, these patterns can contribute to difficulties with forming relationships and participating in group activities.

While occasional avoidance of eye contact is not uncommon in all children, consistent reluctance to look at faces—especially in combination with other social or communication challenges—should be discussed with a pediatrician or developmental specialist. Early evaluation can help determine if further assessment or support is needed (CDC).

38. Unusual Attachment to Routines

An unusual attachment to daily routines is a common characteristic of autism spectrum disorder. While most children benefit from some predictability, autistic children often display a heightened need for sameness and may become extremely distressed if routines or rituals are disrupted (National Autistic Society: Routines). These rituals can involve precise sequences for getting dressed, mealtime behaviors, or bedtime routines, and often extend to the way toys are arranged or tasks are performed.

For example, a child may insist on eating meals in a specific order, lining up items before leaving the house, or following an exact sequence for brushing teeth and washing hands. Even minor changes—like moving furniture, altering the order of morning activities, or introducing a new brand of cereal—may prompt anxiety, resistance, or meltdowns. Unlike typical habits, these rituals are marked by their intensity and the emotional reaction they provoke if altered.

If a child’s attachment to routines is so rigid that it interferes with flexibility, family life, or social participation, it can be a red flag for autism. Parents should monitor for distress or behavioral disruption related to changes and consult with a pediatrician or developmental specialist if concerns arise (CDC).

39. Disinterest in Playing with Others

A marked preference for solitary play over interactive games with peers is common among children with autism spectrum disorder. While all children enjoy alone time, autistic children may consistently choose independent activities and show little interest in joining group games or forming friendships, even in social settings like daycare or preschool (CDC: Signs of Autism Spectrum Disorder).

Daycare providers often observe that a child with autism may play quietly in a corner, focusing on puzzles or lining up toys, while other children engage in pretend games or share activities. These children might not respond to invitations to play, may walk away when approached, or seem unaware of what others are doing around them. Parents sometimes describe their child as being “in their own world,” preferring to interact with objects rather than people.

While occasional solitary play is normal, persistent disinterest in playing with others—especially when coupled with other social or communication differences—warrants further attention. If a child rarely seeks out or responds to social engagement opportunities, it’s important to consult a developmental specialist to assess for underlying differences and to access supportive interventions (Autism Speaks: Signs of Autism).

40. Difficulty Making Friends

Children with autism spectrum disorder often face significant challenges with the social skills needed to make and sustain friendships. These difficulties can include trouble initiating conversations, understanding social rules, interpreting body language, or responding appropriately to peers’ emotions (CDC: Signs of Autism Spectrum Disorder). As a result, autistic children may be isolated on the playground, struggle to join group activities, or be misunderstood by classmates.

For example, a teacher might notice that a student remains on the sidelines during recess, avoids group work, or has difficulty resolving conflicts with others. These challenges may lead to loneliness or frustration, and can sometimes make the child vulnerable to bullying or exclusion. Parents may also observe that their child has few or no close friends, or that their attempts to interact are awkward or one-sided.

Early intervention is crucial for supporting social development. Social skills groups, speech-language therapy, and inclusive classroom strategies can help children build confidence and learn the nuances of friendship. If persistent difficulty making friends is observed, families should consult with educators or developmental specialists to access targeted support (Autism Speaks: Social Skills and Autism).

41. Unusual Interest in Parts of Objects

A distinct characteristic often seen in children with autism spectrum disorder is a heightened or unusual interest in specific parts of objects, rather than the object as a whole. This focus might manifest as an intense fascination with wheels, buttons, tags, or the spinning blades of a fan, rather than engaging in typical play with the complete toy or device (CDC: Signs of Autism Spectrum Disorder).

During playtime, a child may spend long periods spinning the wheels of a toy car instead of “driving” it around, repeatedly flipping the light switch rather than using the room for pretend games, or fixating on the zipper of a jacket instead of wearing it. Parents frequently notice their child running their fingers along the edges of books, staring at reflections, or examining the stitching on a stuffed animal. These behaviors can be soothing or captivating to the child, but may limit their engagement in more imaginative or interactive play.

Observation tips include noting if a child consistently seeks out parts of objects over time, appears disengaged from group play, or becomes upset if unable to access a favorite part. If these patterns persist, consider consulting a developmental specialist for guidance (Autism Speaks: Signs of Autism).

42. Not Using Gestures to Communicate

Gestures such as pointing, waving, nodding, or shaking the head are fundamental to early communication and typically emerge alongside babbling and first words. By 12 months, most children use gestures to indicate needs, share discoveries, or direct others’ attention (CDC: 1 Year Milestones). Children with autism spectrum disorder, however, may show a marked absence or limited use of these communicative gestures.

For example, a child might not point to objects they want, wave goodbye, or reach up to be picked up. Instead, they may rely solely on crying, leading a parent by the hand, or using physical actions to obtain what they desire without making eye contact or sharing attention. This lack of gesture can make it difficult for others to understand the child’s needs and may delay the development of more complex language and social skills.

If a child is not using gestures to communicate by 12 to 15 months, or their gestures are significantly less frequent than those of peers, it is a reason to seek assessment by a pediatrician or a speech-language pathologist. Early intervention can provide valuable support for language and social development (Autism Speaks: Signs of Autism).

43. Preference for Adult Company

Some children with autism spectrum disorder consistently seek out the company of adults rather than engaging with peers. This gravitation toward adults may be due to the predictability, understanding, or structured interactions that adults provide, which can feel less overwhelming than the spontaneous and sometimes confusing play of other children (CDC: Signs of Autism Spectrum Disorder).

For example, parents and teachers may notice that a child consistently talks with teachers during free play, seeks out adult attention for conversation or help, or prefers to shadow grown-ups during group activities instead of joining classmates. Anecdotes often include children who are comfortable in adult company, can carry on lengthy conversations about their interests, or follow adults around the playground but rarely attempt to join peer games or build friendships with children their age.

While some children naturally have an affinity for older individuals, a pronounced and persistent preference for adult company—especially if accompanied by difficulty with peer relationships or limited social play—is worth monitoring. Families should discuss these patterns with a pediatrician or developmental specialist if they notice persistent social differences, as early support can foster age-appropriate social skills (Autism Speaks: Signs of Autism).

44. Unusual Voice Quality

Children with autism spectrum disorder often exhibit differences in vocal tone, pitch, or overall voice quality, a trait sometimes referred to as atypical prosody. Their speech may sound unusually flat, high-pitched, sing-song, robotic, or monotone compared to their peers. These differences can affect how their emotions, intentions, or urgency are conveyed and understood by others (Autism Speaks: What is Autism?).

For example, a child might speak in a consistently high-pitched voice, use exaggerated intonation on certain words, or deliver sentences with little variation in tone regardless of the topic. Others may speak too loudly or softly, or sound emotionless even when discussing exciting or sad events. Parents and teachers may recall that the child’s way of speaking stands out, sometimes making it difficult for listeners to interpret feelings or follow the conversation’s flow.

If a child’s voice quality is persistently unusual—whether flat, robotic, overly dramatic, or otherwise different from typical speech—it is advisable to consult with a speech-language pathologist. Early evaluation can help identify underlying communication challenges and guide interventions for more natural and effective speech patterns (CDC: Signs of Autism).

45. Difficulty Expressing Needs

Children with autism spectrum disorder often face significant barriers when it comes to expressing their basic needs and desires. These challenges can stem from delays in speech and language development, limited use of gestures, or difficulty forming sentences. As a result, a child may struggle to ask for food when hungry, request to use the bathroom, or communicate discomfort, leading to frustration and even meltdowns (CDC: Signs of Autism Spectrum Disorder).

Families frequently share stories of guessing games at mealtimes, where a child might cry or become agitated instead of saying “juice” or pointing to a snack. In other cases, a child may not signal the need to go to the bathroom, resulting in accidents. These barriers can also affect social interactions, as children may not ask for help, request a turn, or let others know when they’re upset or tired.

When communication difficulties persist, parents should consider augmentative and alternative communication (AAC) methods, such as picture cards, communication boards, or speech-generating devices. Working with a speech-language pathologist can help families find the best strategies to ensure the child’s needs are understood and met (Autism Speaks: Augmentative Communication).

46. Overly Formal or Adult-Like Speech

Some children with autism spectrum disorder display an unusual pattern of communication known as overly formal or adult-like speech. These children may use advanced vocabulary, complex sentence structures, or uncommon expressions that are atypical for their age group. While a strong vocabulary is generally a positive trait, in autism, this formal speech often lacks the nuances of casual conversation and can appear out of place in peer interactions (Autism Speaks: What is Autism?).

For instance, teachers may notice a young student using phrases such as “I would prefer not to participate in this activity,” or referring to classmates as “my peers” rather than “friends.” In classroom discussions, these children might discuss interests or facts in a lecture-like manner, missing opportunities for back-and-forth dialogue. Parents sometimes describe their child as sounding like a “little professor,” reciting information or using expressions that mimic adult speech patterns.

While advanced language skills can be a strength, it’s important to monitor how children use language in context. If speech consistently feels formal, stilted, or disconnected from typical social interactions, consider consulting a speech-language pathologist. Targeted support can help foster more natural communication and peer relationships (CDC: Signs of Autism).

47. Difficulty Understanding Jokes or Sarcasm

Children with autism spectrum disorder often struggle to understand figurative language, including jokes, sarcasm, idioms, and metaphors. Their language comprehension tends to be literal, making it challenging to interpret humor or recognize when someone is being playful or ironic (Autism Speaks: Social Skills and Autism). This can lead to confusion or awkwardness during conversations with peers or adults.

For example, at home, a parent might say, “It’s raining cats and dogs,” only to be met with a puzzled look or a question about animals falling from the sky. In school, a teacher’s sarcastic remark—such as, “Thanks for cleaning up so quickly!” when a child is slow—may be taken at face value. These misunderstandings can sometimes cause frustration, embarrassment, or even social isolation, as the child may feel left out of group laughter or not realize when others are joking.

To support understanding, parents and educators can use social stories, visual cues, or explicit explanations of common jokes and expressions. If a child consistently struggles with nonliteral language, a speech-language pathologist can offer targeted interventions to build social communication skills (CDC: Signs of Autism).

48. Not Seeking Comfort When Upset

A typical response for most young children when they experience distress, fear, or pain is to seek comfort or reassurance from a trusted caregiver. Children with autism spectrum disorder, however, may not instinctively look to parents or adults for soothing when upset. This difference often arises from challenges with social connection and emotional expression, rather than a lack of attachment (CDC: Signs of Autism Spectrum Disorder).

For example, a child might fall and scrape their knee but walk away silently, or remain in a corner crying without calling for help. Others may become visibly upset by loud noises or changes in routine, yet not seek a hug, eye contact, or verbal reassurance. Parents sometimes describe feeling helpless or confused when their child seems to “shut down” emotionally, or when they are unable to provide comfort in traditional ways.

While some independence is normal, a consistent lack of seeking comfort during times of emotional distress can be a red flag for social or attachment differences. If these patterns persist, especially alongside other communication or social challenges, it is important to consult a pediatrician or developmental specialist for evaluation and support (Autism Speaks: Signs of Autism).

49. Unusual Reactions to Smells, Textures, or Tastes

Children with autism spectrum disorder frequently experience heightened or reduced sensitivity to sensory input, leading to unusual reactions to smells, textures, or tastes. These sensory processing differences can impact daily routines, such as eating, dressing, or personal hygiene (Autism Speaks: Sensory Issues).

At mealtimes, a child may gag at the smell of certain foods, refuse to eat anything with a specific texture (like mushy or crunchy foods), or insist on eating only bland or familiar tastes. Similarly, clothing choices may be dictated by a strong aversion to tags, seams, or particular fabrics, leading to meltdowns or refusal to get dressed. Some children might sniff objects obsessively or react strongly to the scent of cleaning products, perfumes, or even people. These behaviors are not simply picky preferences, but rather intense sensory experiences that can cause distress or discomfort.

If a child displays persistent, strong reactions to everyday sensory experiences that interfere with eating, dressing, or participation in typical routines, a sensory evaluation by an occupational therapist can be beneficial. Professional guidance can help identify triggers and develop strategies for managing sensory challenges (CDC: Signs of Autism).

50. Regression in Skills

One of the most concerning signs of autism spectrum disorder is regression—the loss of previously acquired language, social, or play skills. This can occur suddenly or gradually, often between the ages of 15 and 30 months. Parents might notice that a child who once spoke several words, responded to their name, or engaged in pretend play suddenly stops talking, avoids eye contact, or withdraws from social interaction (CDC: Signs of Autism Spectrum Disorder).

A clinical example is a toddler who, at 18 months, could say “mama,” “dada,” and “ball,” wave goodbye, and play peekaboo, but by age two, stops using words, no longer waves, and seems uninterested in social games. This regression is not a normal variation in development and requires urgent attention. The sudden loss of skills can be distressing for families and may indicate underlying neurological changes that need prompt evaluation.

If a child loses language, social, or self-help skills at any age, parents should seek immediate assessment from a pediatrician or developmental specialist. Early intervention is critical, and urgent evaluation is strongly advised according to both CDC and NHS guidance.

Conclusion

Recognizing early signs of autism is crucial for ensuring children receive timely intervention and support. Trusting your instincts and observing developmental milestones can make a significant difference in a child’s progress and quality of life. If you notice any of the signs described, proactive screening and consultation with a pediatrician or specialist are recommended. Early action opens the door to resources, therapies, and community support that empower both children and families. For more information, visit the CDC’s Autism Information for Families or Autism Speaks for guidance and next steps.

Disclaimer

The information provided in this article is for general informational purposes only. While we strive to keep the information up-to-date and correct, we make no representations or warranties of any kind, express or implied, about the completeness, accuracy, reliability, suitability, or availability with respect to the article or the information, products, services, or related graphics contained in the article for any purpose. Any reliance you place on such information is therefore strictly at your own risk.

In no event will we be liable for any loss or damage including without limitation, indirect or consequential loss or damage, or any loss or damage whatsoever arising from loss of data or profits arising out of, or in connection with, the use of this article.

Through this article you are able to link to other websites which are not under our control. We have no control over the nature, content, and availability of those sites. The inclusion of any links does not necessarily imply a recommendation or endorse the views expressed within them.

Every effort is made to keep the article up and running smoothly. However, we take no responsibility for, and will not be liable for, the article being temporarily unavailable due to technical issues beyond our control.