Is my two year-old showing signs of autism?  Is it just a speech delay?  Am I just over-analyzing it?

Many parents are confused by conflicting information and advice they get about their child’s development.

Your in-laws might tell you that your spouse didn’t talk until they were 4 and you’re worrying too much.

Your child’s pediatrician might tell you that they aren’t concerned right now and they’ll see you in 6 months. (Read my post on why “wait and see” is terrible advice.)

Maybe your first child was delayed with their speech and you figure this kiddo might be too.

However, it’s critical parents know early signs of possible autism before age 2, so you can begin the process of getting a diagnosis and services if needed.

Before We Jump In…

First, I want to start out by stating that I do not diagnose autism.  

As a special education teacher, I can talk to parents and other caregivers about some of the early signs I am noticing during our home visits.  I also ask if their child’s pediatrician has voiced concerns about developmental delays or autism.  I ask if they are concerned about autism.

I’ve worked with hundreds of kids and their parents over the past 15 years.

It’s always a difficult conversation, but I wouldn’t be doing my job if I didn’t have this discussion with parents.  Parents deserve to know my thoughts about their child’s strengths and areas that we need to work on.  I firmly believe parents also need to know if I am seeing some early signs of possible autism.

Second, I want to point out that there is a range of what’s considered typical development for your child’s age.  Other factors such as prematurity, chronic illnesses and hospitalizations, and other diagnoses also impact your child’s development.

Third, it’s very important for parents to get accurate information from reliable sources.  As parents and caregivers, you need to weed out the good from the bad.

What Are Early Signs of Autism Before 2?

I absolutely love working with toddlers and two year-olds!  There is so much development going on during these first couple of years.

As I mentioned above, it is important to remember there is a range of typical development.  Kids do not develop and learn at the same rates.

However, parents and other caregivers need to know the early signs of autism and how they differ from what other kids are doing.

Knowing these early signs allows you to determine whether you need to explore an autism evaluation or if your child may be experiencing a speech delay or other developmental delay.

In no particular order, here are some of the early signs of possible autism that can be seen before 2 or around your child’s second birthday:

Social

• Limited / infrequent eye contact.
• Prefer to play or be on their own.
• Limited attention to faces.
• Limited smiles during play and other activities.
• Delayed or limited imitation of actions, sounds, and words.

Communication

• Not responding when name is called.
• Limited or delayed babbling.
• Limited or delayed use of gestures (pointing, reaching arms up, waving bye bye, etc.).
• Not consistently responding to simple one step directions (come here, give it to me, get shoes, etc.).
• Doesn’t seem to understand the names of objects, simple actions, and people.
• Doesn’t follow your point (Doesn’t respond when you try to draw their attention to something you see.).
• Used to have some words but isn’t using them anymore.

Repetitive Behaviors

• Insistence on sameness (You always have to drive the same way home, mom is the only one who can read a particular book, your child will only wear one shirt, etc.)
• Walking on toes a lot throughout the day.
• Lining up toys and other objects instead of playing with them.
• Carrying around objects instead of playing with them.
• Making piles of objects and toys instead of playing with them.
• Spinning, flapping hands, and other body movements repeated over and over throughout the day.

Behavioral

• May have frequent and intense tantrums.
• May have difficulties with transitions between activities (ending one activity and moving onto the next one).
• Difficulties with tolerating sensory input (new places, new people, loud noises, etc.).
• May have sleep difficulties (falling asleep, staying asleep without a lot of help from parents).
• May be very picky eaters / no longer eat foods they used to.

A Word About Autism and Early Signs

The only way to truly rule in or rule out autism is to get an evaluation.  

My list of early signs cannot diagnose your child.  Google can’t either.

We also all have differing experiences and understanding of autism.

If this is your first experience with possible autism, it can be very confusing.

Your child might be fairly consistent with looking at you.

Sometimes your child does respond to their name.

Occasionally your child does want to play with you or give you a hug.

I always tell the families that I work with that we need to keep in mind that an autism diagnosis is not “all or nothing.”

Your child does not have to have all of the early signs listed above to get an autism diagnosis.

Your child might have some of the characteristics above and not get a diagnosis.

If your child does get an evaluation, they will look at the quantity of certain behaviors and the quality of them.

They’ll also look at what your child’s skills are like compared to that of their peers of the same age.

How does your two year-old communicate compared to other two year-olds?

What does your 3 year old’s play and social skills look like compared to other preschoolers?

If You See Early Signs of Autism in Your Two Year-Old, Act Now!

My son was always super busy, emotional, and impulsive.  He also had a bit of a language delay.  He was a little immature.  I always chalked it up to him being a little boy.

As he got a little bit older, it didn’t get any better but not any worse either.

It took his second grade teacher telling me she thought he had ADHD to help me realize some of his behaviors were not typical of a second grader.

It was scary!  

I had to schedule an evaluation with his pediatrician.

I had to figure out medications, special education services, explain everything to my family and his teachers, and figure out how to best help him at home.

I cried a lot.  

Sometimes it was easier to ignore it or hope tomorrow would be better.  Maybe tomorrow I won’t get a phone call from school or daycare.

However, ignoring his behaviors and lagging skills wasn’t helping him.  I had to do something.

Once I got the ball rolling, I started to feel better.

Taking action took away some of my anxiety about the situation.

As a parent (or caregiver), it is up to us to take action and be our child’s advocate.

Some Steps To Get You Started:

• Set up an appointment with your child’s pediatrician to discuss your concerns.  Don’t wait for the next time you’re supposed to go in for a check-up.
• Write down your concerns and the behaviors you are seeing at home.  This will help you remember the important things to discuss with the pediatrician.
• Complete the autism screener at https://www.autismspeaks.org/screen-your-child.  This is not a diagnostic tool, but it will tell you if your child may have autism based on the score.  You can complete this before your appointment with the pediatrician or during the visit.
• Grab my 5 Steps to Take if You’re Concerned About Autism handout.
• Visit the CDC for milestones at each stage of development.  They also have a milestone tracker and certain skills to make sure your child is doing at each stage.
• Check out my 3 favorite books on autism for parents (here, here, and my absolute favorite book)

“Action Alleviates Anxiety”

I listen to a ton of podcasts.  One of my favorites is about exercise and nutrition and during one episode the trainer who leads the podcast said, “Action alleviates anxiety” and that has stuck with me ever since.

I get anxious and bogged down when I’m stressed and there’s so much to do.  I tend to avoid everything that needs to get done because it’s overwhelming.

However, if I can take a couple of steps towards what I need to do, my anxiety starts to go down.

Our kids develop so much during their first few years of life.

It is incredibly important for us parents and teachers and caregivers to notice early signs of possible autism.  

The earlier we can get an evaluation completed and services started, the better the outcome!