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When do children usually show symptoms of autism spectrum disorder (ASD)?

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The symptoms of autism always appear early in development.1 Many children show symptoms of autism by 12 months to 18 months of age,2,3 for example:4,5,6

  • Problems with eye contact
  • No response to his or her name
  • Problems following another person's gaze or pointed finger to an object (or "joint attention")
  • Poor skills in pretend play and imitation
  • Problems with nonverbal communication

Many parents are not aware of these "early" signs of autism and don't start thinking about autism until their children do not start speaking at a typical age.

Most children with autism are not diagnosed until after age 3, even though health care providers can often see developmental problems before that age.7,8,9

Research shows that early detection and early intervention greatly improve outcomes,10 so it's important to look for these symptoms when a child is as young as possible.11

Regression

Some children with autism regress, meaning they stop using language, play, or social skills that they've already learned. This regression usually happens between ages 1 and 2 years. It might happen earlier for some social behaviors, such as looking at faces and sharing a smile. Researchers don't know why some children regress into autism or which children are likely to regress.12,13,14,15,16

Other Early Signs

There also may be early biological signs of ASD. Recent studies have shown that:

  • People with autism have unique brain activity, structures, and connections.17,18
  • There are differences in brain growth in ASD as early as 6 months of age.19,20

  1. Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. (2013). American Psychiatric Association: Washington, DC. [top]
  2. Johnson, C. P., & Myers, S. M.; American Academy of Pediatrics Council on Children with Disabilities. (2007). Identification and evaluation of children with autism spectrum disorders. Pediatrics, 120(5), 1183–1215. [top]
  3. Lord, 1995; Stone, 1999; & Charman, 1997. As cited in: Filipek, P. A., Accardo, P. J., Ashwal, S., Baranek, G. T., Cook, E. H. Jr., Dawson, G., et al. (2000). Practice parameter: Screening and diagnosis of autism. Report of the Quality Standards Subcommittee of the American Academy of Neurology and the Child Neurology Society. Neurology, 55, 468–479. [top]
  4. Zwaigenbaum, L., Thurm, A., Stone, W., Baranek, G., Bryson, S., Iverson, J., et al. (2007). Studying the emergence of autism spectrum disorders in high-risk infants: Methodological and practical issues. Journal of Autism and Developmental Disorders, 37(3), 466–480. [top]
  5. Yoder, P., Stone, W. L., Walden, T., & Malesa, E. (2009). Predicting social impairment and ASD diagnosis in younger siblings of children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 39(10), 1381–1391. [top]
  6. Rogers, S. J. (2009). What are infant siblings teaching us about autism in infancy? Autism Research, 2(3), 125–137. [top]
  7. Barbaro, J., & Dissanayake, C. (2009). Autism spectrum disorders in infancy and toddlerhood: A review of the evidence on early signs, early identification tools, and early diagnosis. Journal of Developmental and Behavioral Pediatrics, 30(5), 447–459. [top]
  8. Shattuck, P. T., Durkin, M., Maenner, M., Newschaffer, C., Mandell, D. S., Wiggins, L., et al. (2009). Timing of identification among children with an autism spectrum disorder: Findings from a population-based surveillance study. Journal of the American Academy of Child and Adolescent Psychiatry, 48(5), 474–483. [top]
  9. Autism and Developmental Disabilities Monitoring Network Surveillance Year 2006 Principal Investigators, CDC. (2009). Prevalence of autism spectrum disorders – Autism and Developmental Disabilities Monitoring Network, United States, 2006. MMWR Morbidity and Mortality Weekly Report, 58(SS10), 1–20. Retrieved January 28, 2011, from http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5810a1.htm[top]
  10. Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J., et al. (2010). Randomized, controlled trial of an intervention for toddlers with autism: The Early Start Denver Model. Pediatrics, 125(1), e17–23. [top]
  11. Johnson, C. P. (2004). New tool helps primary care physicians diagnose autism early. AAP News, 24(2), 74. [top]
  12. Goldberg, W. A., Thorsen, K. L., Osann, K., & Spence, M. A. (2008). Use of home videotapes to confirm parental reports of regression in autism. Journal of Autism and Developmental Disorders, 38(6), 1136–1146. [top]
  13. Rodier, P. M., & Hyman, S. L. (1998). Early environmental factors in autism. Mental Retardation and Developmental Disabilities Research Reviews: Special Issue: Autism, 4, 121–128. As cited in: Lord, C., Shulman, C., & DiLavore, P. (2004). Regression and word loss in autistic spectrum disorders. Journal of Child Psychology and Psychiatry, 45(5), 936–955. [top]
  14. Werner, E., & Dawson, G. (2005). Validation of the phenomenon of autistic regression using home videotapes. Archives of General Psychiatry, 62(8), 889–895. [top]
  15. Luyster, R., Richler, J., Risi, S., Hsu, W. L., Dawson, G., Bernier, R., et al. (2005). Early regression in social communication in autism spectrum disorders: A CPEA study. Developmental Neuropsychology, 27(3), 311–336. [top]
  16. Ozonoff, S., Iosif, A. M., Baguio, F., Cook, I. C., Hill, M. M., Rogers, S. J., et al. (2010). A prospective study of the emergence of early behavioral signs of autism. Journal of the American Academy of Child and Adolescent Psychiatry, 49(3), 256–266. [top]
  17. Anderson, J. S., Lange, N., Froehlich, A., DuBray, M. B., Froimowitz, T. J., Alexander, A. L., et al. (2010). Decreased left posterior insular activity during auditory language in autism. American Journal of Neuroradiology, 31(1), 131–139. [top]
  18. Kaiser, M. D., Hudac, C. M., Shultz, S., Lee, S. M., Cheung, C., Berken, A. M., et al. (2010). Neural signatures of autism. Proceedings of the National Academies of Science USA, 107(49), 21223–21228. [top]
  19. Shumann, C. M., Bloss, C. S., Barnes, C. C., Wideman, G. M., Carper, R. A., Akshoomoff, N., et al. (2010). Longitudinal magnetic resonance imaging study of cortical development through early childhood autism. Journal of Neuroscience, 30(12), 4419–4427. [top]
  20. Wolff, J. J., Gu, H., Gerig, G., Elison, J. T., Styner, M., Gouttard, S., et al. (2012). Differences in white matter fiber tract development present from 6 to 24 months in infants with autism. American Journal of Psychiatry. doi: 10.1176/appi.ajp.2011.11091447 [top]

Last Updated Date: 01/16/2014
Last Reviewed Date: 12/18/2013
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