Abby Barnes, M.S., CCC-SLP
When you have a toddler at home, it’s normal to watch their development to see if they’re meeting expected childhood milestones. As part of that, you may wonder if there are specific signs of autism to look for.
When children are 2 years old, some signs of autism may already be present. Let’s discuss possible signs of autism at age 2, how a diagnosis is made, and how speech therapy can help support autistic kids.
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Screener for childrenEarly signs of autism in toddlers
According to the Centers for Disease Control and Prevention (CDC), about 1 in 31 children in the United States is autistic. Boys are 3.4 times more likely to be diagnosed with autism than girls. The overall prevalence of autism is lower among non-Hispanic White children than among children of other races.
There are signs of autism related to communication, behavior, and social skills that may be present in a 2-year-old. However, keep in mind that not all autistic toddlers will have all of these signs.
Signs of autism at 12 months
At 12 months old, most children can immediately look in the direction of an object when you point to it. They will then look back at you and mimic your expression, such as a smile. However, in these situations, an autistic toddler may appear to ignore the person. They may also have these signs:
Little to no babbling
Little to no gesturing, such as pointing or waving
Does not respond to hearing their name
Signs of autism at 18 months
At 18 months old, most children have begun speaking. They typically have at least 5 to 10 words they use regularly and spontaneously. They often imitate words as well.
An 18-month-old will typically point at things they find interesting. They look back and forth between an object and a parent to make sure the parent is interested, too.
Autistic toddlers will often point to an object because they want a parent to get it for them, not because they want the parent to enjoy the object with them. They may also have these signs:
Uses very few words, or no words at all
Overall difficulty communicating their needs and desires
Does not play make-believe or pretend games
Signs of autism at 24 to 36 months
There are a variety of other signs of autism that may appear in a 2-year-old:
As a result of speech delays, uses challenging behaviors (such as crying or tantrums) instead of words or gestures to communicate what they want
Difficulty understanding conversations and instructions; may respond to a question by repeating it rather than answering
Consistently repeats words or phrases they just heard or that they heard days earlier, almost as if they’re echoing speech
Speaks in a robotic tone of voice that lacks inflection or intonation
Lacks interest in the world around them; for example, doesn’t respond when you point out an object, like a plane flying overhead
Difficulty with sharing toys or taking turns
Avoids eye contact
Prefers not to be touched, held, or cuddled
Dislikes certain sounds, smells, or textures (for example, may choose foods based on texture)
Becomes distressed by a change in daily routine
Repeats unexpected behaviors, such as lining up their toys, rocking their head back and forth, spinning their body, or having trouble staying still
Does a speech delay mean autism?
While a delay in spoken language is a sign of autism, having a speech delay does not mean a child is autistic. A speech delay is typically present with autism. However, a speech delay can exist separately from autism.
There are other speech-related signs of autism that may be noticed at age 2. These include:
Not pronouncing simple, single words by age 16 months
Inability to use simple, two-word phrases
Loss of language skills that the child previously had
Can autism be diagnosed at age 2?
Diagnosing autism can be challenging. Your doctor will look at your child’s developmental history, as well as their communication and behavior, to make a diagnosis.
While autism can sometimes be diagnosed at age 18 months or younger, by age 2 most diagnoses performed by qualified professionals are reliable. However, some children don’t receive a diagnosis until they’re older, even into their teen or adult years.
How is autism diagnosed in toddlers?
There are several steps involved in an autism diagnosis. The CDC outlines each of these steps in great detail. Ensuring that your child is properly monitored, screened, evaluated, and diagnosed is essential to getting them the care they need to live a productive and fulfilling life.
Different experts can diagnose autism. These professionals may include psychologists, pediatricians, and neurologists. Psychologists are a big part of the diagnostic process.
According to the American Psychological Association (APA), a psychologist will likely use the following information to help with their diagnosis:
Talking with the child
Observing the child’s behavior
Tests of cognitive and language abilities
Medical tests to rule out other conditions
Interviews with parents, teachers, or other adults who can answer questions about the child’s social, emotional, and behavioral development
How is autism treated in toddlers?
Speech therapy is an important part of treatment for autistic people of all ages. Challenges with communication and speech, like all aspects of autism, vary from person to person. At age 2, some autistic kids may not be talking at all. Others may speak, but they still can't communicate their needs clearly.
Speech-language pathologists, also known as speech therapists, play a key role in supporting people with autism. They can help autistic people become better communicators and improve both their verbal and nonverbal communication skills. This can help autistic people form relationships with others and function better in day-to-day life.
Find the right speech therapist for your child
We'll match you with a licensed speech therapist who's experienced in your child's needs and available when you are.
Get startedA speech therapist will assess and evaluate your child's communication strengths and challenges, and develop a treatment plan tailored to their needs. Your speech therapist will find ways to engage with your child during sessions, whether that involves play, storytime, or movement activities. For example, let’s say the child is working on requesting an item using words or signs. The speech therapist may present something interesting, like bubbles, and have the child either imitate the word or make the sign for “more” or “please.”
Some children may be nonverbal. There are many types of assistive devices and technologies to help them communicate. These tools are called augmentative and alternative communication (AAC). Your speech therapist will let you know whether your child would benefit from AAC and teach you how to use it. Examples of AAC methods include:
Sign language
Picture exchange communication system (PECS)
Communication applications on tablets or iPads
Speech output devices (such as Dynavox)
What to do if you think your toddler might have autism
If you have any questions at all about your child’s development, talk to your pediatrician or reach out to a speech therapist. You can take our free online speech and language screener, or find the right speech therapist for your child by clicking here.
No matter what your child’s potential diagnosis may or may not be, there are professionals who can help. At Expressable, we’re here to listen to your concerns and talk about the next steps that are right for your child.
FAQs about autism in toddlers
1. What are the early signs of autism in a 2-year-old?
Early signs of autism in toddlers can include delays in talking, trouble communicating their needs, repeating the same actions, avoiding eye contact, and lack of interest in playing with others. If you notice these signs, try our free screener to check your child's communication development.
2. Does a speech delay mean my child has autism?
A speech delay can be a sign of autism, but it doesn't always mean your child is autistic. Speech delays can have a variety of causes. If you're worried about your child's speech, get matched with a speech therapist who can help you understand what's going on and what to do next.
3. Can autism be diagnosed in toddlers?
Yes, by age 2 most diagnoses performed by qualified professionals are reliable. To diagnose autism, doctors look at a child's development, how they communicate, and how they behave. Specialists such as psychologists, pediatricians, and neurologists can make the diagnosis. If you think your child might be autistic, our free screener can help you decide if you need to see a specialist.
4. How can speech therapy benefit a 2-year-old with autism?
Speech therapy can help autistic children learn to communicate better, express their needs, and interact with others. A speech therapist will create a care plan targeted for your child’s specific needs. To learn more about how speech therapy can help, take a look at this article.
5. How can I help my child communicate if they're nonverbal?
AAC methods, like sign language, picture cards, and communication apps, help children who have trouble speaking. If you think your child might benefit from AAC, a speech therapist can help you choose the best tools. Start with our free screener to see what your child might need.
An important note: We believe that when speaking about any community as a whole, the best approach is to prioritize that community’s voices, needs, and preferences. Within the larger autism community, the current language preference is identity-first (e.g., "autistic children"), which is why we use that language in our content. Expressable is committed to listening to and learning from the populations we serve. If and when their preferences change, we’ll adjust our approach accordingly.
