Early traits of autism

Does not smile at others (from 12 months)

You try to engage with your child and smile at them, but your child does not respond. Your child may be less focused on the people around them and less likely to smile back when others smile at them. They may also be less likely to initiate shared enjoyment by smiling at others.

Does not react when spoken to (from 12 months)

When your child is called by name, they may seem as if they are deaf. Your child may respond less often or not at all and may barely look up.

Does not babble (from 12 months)

Your child makes no or few sounds that resemble words, and babbles little or not at all during play.

Does not make gestures (pointing and waving) (from 12 months)

Your child does not make gestures, and/or points yet. Examples of gestures are: nodding yes, shaking no, waving, a gesture for 'up' or 'away'.

Has no interest in other people (from 12 months)

Your child is mainly focused on themselves and shows little interest in the people around them. For example, they may show little curiosity about an adult’s involvement in their play or rarely watch what other children are doing.

Does not make use of words in a functional manner (from 18 months)

Your child does not use words (or sounds that resemble words) to indicate that they want something or to draw attention to something.

Does not use two-word sentences (excluding echolalia) (from 24 months)

Your child does not use spontaneous two-word sentences to communicate. Such as: 'drive car' or 'have cake'. Repeating what another person says without the intention to communicate (echolalia) is not meant here. Naturally, this symptom can for instance also point to – besides a risk of autism – language development issues without autism.

Any loss of language or social skills (any age)

Your child loses skills they previously had, for example in language or social skills. Examples include:

• your child stops talking.
• your child no longer waves.
• your child makes little or no eye contact.

Even though your child used to do this before.

If your child loses skills or is no longer able to do things as well as before, this is concerning, regardless of their age. Unless it is clearly related to particular circumstances and is temporary.

1. Social interaction

• has difficulty making eye contact;
• finds it difficult to establish and maintain friendships with peers;
• shows little awareness of other people’s feelings.

2. Communication

• has difficulty engaging in back-and-forth conversations, including about topics other than their own interests;
• has difficulty using and understanding humour;
• has no understanding of proverbs and sayings;
• uses few gestures to support communication;
• shows differences in language use, such as: taking things very literally (e.g. when told “get your coat,” the child picks up the coat without putting it on); using unusually formal or bookish language; echolalia (repeating what others say) or using fixed phrases; and referring to themselves in the third person (“he/she”).

3. Stereotypies

• has limited areas of interest (e.g. only interested in dinosaurs or computers);
• cannot play imaginatively;
• does not lose himself/herself in pretend play;
• sticks to rituals (always does things in the same order);
• adheres ridgidly to rules;
• has difficulty coping with changes.

4. Stimulus processing

Shows unusual sensory processing: they may be particularly sensitive or under-sensitive to certain sensory stimuli. For example, they may smell everything, seek out or linger on tactile sensations, be highly interested in flashing lights, or repeatedly cover their ears in response to loud sounds.

Overall, does not appear to be developmentally appropriate for their age.