/assets/images/provider/photos/2867146.jpeg)
According to the CDC, about one in 31 8-year-old children in the United States have been identified with autism spectrum disorder (ASD). Signs may appear during the first year of life or become noticeable later.
At THINK Neurology for Kids, our team helps families recognize developmental concerns and understand when an autism evaluation may be appropriate.
Autism spectrum disorder basics
Autism is a spectrum condition because its characteristics, strengths, and support needs vary widely among individuals. Some people with ASD have advanced communication skills, while others are non-verbal; some require intensive daily support, while others live independently and excel in their chosen field of work.
The core characteristics of autism fall into three main areas: social communication, restricted and repetitive behaviors, and sensory processing. This often involves:
- Deviation from standard understanding of verbal and non-verbal cues
- Differences in perception of body language, tone of voice, and eye contact
- A preference for predictable routines and deep-dive special interests
- Repetitive self-soothing actions known as stimming (e.g., hand-flapping)
- Heightened or reduced sensitivity to lights, sounds, textures, tastes, or smells
Pediatric ASD diagnoses are five times more prevalent today than they were in 2000. Although research indicates that autism cases are rising, these numbers also reflect an increased ability to recognize ASD signs earlier in a child’s life; indeed, autism screenings are now a standard part of pediatric well-child checkups at 18 and 24 months of age.
The feeling that something is “off”
Core ASD characteristics may become more pronounced in later childhood, but initial signs often first appear by age 3. Parents sometimes notice differences in eye contact, speech, or behavior long before an autism diagnosis. If something about your child's development concerns you, don't dismiss your instincts or assume they'll simply outgrow it.
Spotting the early signs of autism
While not every developmental concern points to autism, certain signs at certain ages warrant evaluation. Initial ASD symptoms typically emerge between six months and three years of age; key early indicators fall into three categories:
1. Social and communication milestones
Not meeting certain developmental milestones related to early social interaction and communication can indicate ASD. Specifically, be aware of:
By six months
Potential autism indicators at six months of age include very little or no eye contact, minimal facial expressions, a lack of social smiling, or low attention.
By nine months
No back-and-forth sharing of sounds, vocalizations, smiles, or facial expressions may point to ASD at nine months.
By 12 months
By your baby’s first birthday, ASD signs include a lack of babbling, inconsistent response to their name, and an absence of communicative gestures like pointing, reaching, or waving.
By 16 months
No spoken, meaningful single words by this age could indicate autism.
By 24 months
By two years of age, ASD can manifest as a lack of meaningful, spontaneous two-word phrases (excluding immediate repetition or echoing), limited pretend play, or persistent social communication delays.
2. Red flag signs of regression
A sudden or gradual loss of speech, babbling, eye contact, or social interaction at any age can indicate developmental regression, which calls for prompt evaluation by our team.
3. Restrictive and repetitive behaviors
You may also notice certain “off” behaviors that emerge between 12 and 36 months of age. For example, repetitive actions — such as hand-flapping, rocking, or spinning in circles — are common with ASD. So are sensory sensitivities, or showing severe over- or under-reactions to sensory inputs like textures, lights, or specific sounds.
You may also notice that your toddler develops “routine rigidity,” becoming distressed by minor changes in routines or environment, or “object fixation,” obsessively tracking or lining up toys, or fixating on specific parts of objects (e.g., the spinning wheels of a toy car).
Benefits of a timely ASD diagnosis
ASD differences can lead to challenges at school, work, and in other areas of life. Fortunately, interventional support can improve developmental outcomes and adaptive skills, helping kids build coping mechanisms and become as independent as possible.
Early intervention matters because young brains have high neuroplasticity, meaning they adapt, form new neural connections, and respond best to early therapies.
Research shows that starting speech, occupational, or behavioral therapies by age three or four fosters healthier brain communication pathways, leading to greater gains in IQ, language, and adaptive daily living skills than starting ASD therapies later.
Pediatric autism experts in Texas
Have you noticed a concerning developmental delay in your child? Schedule a visit at your nearest THINK Neurology for Kids office in The Woodlands, Sugar Land, or Houston, Texas, or call 281-298-1144 to request a virtual visit.
Our team — including Shaun Varghese, MD, Cristina Marchesano, MD, Lorena Herbert, MD, Barbara Kiersz-Mueller, DO, Lauren Weaver, MD, Alicia Walls, MD, Sherwin Oommen, MD, Jennifer Duchaney, CPNP-PC, Tammy DeLaGarza, FNP-C, and Heather King, CPNP-PC — is here to help.