Autism is a developmental difference that shows up as patterns across communication, social interaction, play, routines, and sensory experience. One sign on its own does not mean autism. The patterns that matter are repeated, show up across settings, and are present over weeks or months.
This guide is a friendly checklist to help parents notice what is worth writing down before a pediatrician visit.
Speech and communication signs
- Speech is delayed (no single words by 18 months, no two-word phrases by 24 months).
- Repeats words or phrases without using them to communicate (called echolalia).
- Does not point to share interest ("look at the dog!").
- Does not bring objects to show you.
- Limited back-and-forth conversation as they get older - may answer in single words or scripts.
- Loss of words or skills the child used to have. This should be discussed with the pediatrician promptly.
Social interaction signs
- Does not respond to name consistently, even when hearing is fine.
- Brief, infrequent, or different-feeling eye contact.
- Less sharing of facial expressions (smiling, surprised look).
- Limited interest in peers, especially same-age children.
- Prefers playing alongside other kids rather than with them.
- Does not seek comfort from parents in usual ways when upset or hurt.
Play and repetitive behavior signs
- Plays with toys in unusual ways (lining up cars, spinning wheels, focusing on parts).
- Strong attachment to one toy, object, or topic for long stretches.
- Limited pretend play (feeding a doll, pretending the box is a boat).
- Repetitive motor movements: hand flapping, rocking, finger flicking, spinning, walking on toes.
- Big distress when routines change - a different route, a new cup, a missed bedtime step.
- Watches the same short video clip many times.
Sensory signs
- Covers ears at the vacuum, hand dryer, fireworks, or babies crying.
- Refuses clothing textures, tags, or sock seams.
- Very narrow food preferences based on color or texture.
- Strong reactions to bright lights, strong smells, or busy spaces.
- Seeks out spinning, jumping, deep pressure, or specific textures for comfort.
- Higher or lower pain awareness than peers.
Regression: an important warning
If a child loses words, social skills, or play skills they previously had - at any age - please talk to a pediatrician promptly. Regression should not be watched and waited on.
What to write down before a doctor visit
For 2 weeks, jot short notes:
- 3-5 specific examples (with what happened and where).
- A short video if possible (vacuum reaction, lining-up play, no response to name).
- Whether the same pattern shows up at daycare or with relatives.
- Sleep, food, and sensory notes.
A simple next step
Bring your notes, videos, and any screening result to the pediatrician. If your child is 16-30 months, the M-CHAT-R is the most common autism screener. If your child is older, ask the pediatrician about a developmental evaluation referral and your local Early Intervention services.