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The signs of autism most often show up somewhere around the second or third year of life. What symptoms may indicate that your toddler could be on the spectrum?

Have you noticed that your toddler — aged between 12 and 36 months — is a bit different, and are you concerned? Have others, such as friends, relatives, or daycare staff, made comments about your child's behavior or way of being? Research shows that signs of autism most often make themselves apparent during the toddler phase, and taking them seriously can lead to an earlier diagnosis. 

Diagnosing autism is quite complex, as the process depends on human judgment rather than, say, a urine or blood test, and you'll ultimately need a professional like a developmental pediatrician, child neurologist, or pediatric psychiatrist to determine whether your little one is on the spectrum.

As a parent, you're in the best place to notice the little things that lead you to the diagnostic process in the first place, however. What are some of the signs that could indicate that your child is autistic?

1. Your child doesn't make eye contact 

The fact that many folks on the spectrum find eye contact extremely uncomfortable — and even painful — is pretty well known. With time, an autistic person may learn to mimic eye contact by looking in the general direction of the eyes rather than directly at them, but toddlers won't have mastered these "masking" behaviors yet. If your toddler consistently doesn't make eye contact with you or anyone else, that's one sign that they may be autistic. 

2. Unusual speech development

The autism spectrum is exactly that — a spectrum. Some folks with autism will be non-verbal and require assistive speech devices to talk, but others will be fully verbal or even hyper-verbal. A lack of infant "babbling" or speech by age two can be a sign of autism, but speech delays can also be caused by many other things. Autistic children who do speak may use their words in a bit of an atypical way, however. An autistic toddler may not respond if their name is called, may confuse pronouns, may repeat certain words over and over again in a way that doesn't seem to be communication-oriented, and may also initially have verbal communication skills that are typical for their age, only to stop talking and communicating sometime before age three. 

3. Unusual nonverbal communication

Words only make up a small portion of what neurotypical people communicate. Typically-developing toddlers will be pointing at things, reaching for things, and hugging to show they care. Autistic toddlers often don't do these things. You may notice that your toddler is quite physically active, but that they use their body to self-stimulate in the form of things like rocking, spinning, and hand flapping rather than to communicate with you. Autistic toddlers may not seek much physical contact with other people, including parents, and may dislike hugs or touch. Social smiles play an important role in typical development, but if your child is autistic, they may not engage in them. 

4. Intense interests 

Yes, some autistic people are intensely fascinated by trains (which, let's face it, are pretty cool), but intense, all-encompassing, interests — often called "obsessions" — can really relate to anything a person finds interesting. If your toddler knows all the bird species native to your locality (a real-life example from a friend of mine), consistently only wants to wear Spider-Man themed t-shirts, knows everything about car brands, or can list all Peppa Pig episodes in order, they may simply have found themselves a hobby they'll enjoy for a long time. They may also be autistic. This one has to be taken in context, but it can be part of the picture. 

5. Doesn't like pretending or mimicking 

Neurotypical toddlers learn a lot from pretend play and mimicking the adults and others around them. Autistic children often don't engage in these behaviors. Instead, they may play with their toys the same way each time, maybe lining them up rather than role-playing. An autistic child will also often be perfectly happy playing on their own, while group play is much more difficult and sharing toys may not come naturally at all.

6. Prone to sensory overload

Does your toddler hate the way labels in t-shirts make them feel, or just certain fabrics in general? Do they tend to get overwhelmed — and throw what looks like a typical toddler tantrum — when exposed to loud places, places with strong smells, or large crowds? Sensory overload, too, can be an early sign of autism. On the other hand, your child may also be less sensitive to something than you'd expect them to be. They may get hurt and not seem to be bothered at all, for instance.

7. Hates change

It's said that all children thrive on routines, but this is especially true for autistic kids. They may want to eat the same foods all the time, for instance, become very upset if you change your curtains (again, a real-life example), or want to walk the same route to the same place each time. Changes in routine can cause real emotional distress, beyond what you'd expect from a typically-developing toddler. 

What now?

Parents who notice that their toddlers are developing a bit differently or are concerned about any aspect of their child's physical, emotional, or cognitive development should always talk to their pediatrician about their worries. If you concretely suspect autism, feel free to bring the possibility up with your child's doctor. Early diagnosis can lead to early intervention that may benefit your child for the rest of their lives. Toddlers, autistic or not, are pretty odd in general, however, so don't jump to conclusions and let the diagnostic process figure out where you stand. 

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