Signs of Autism in Children

Autism spectrum disorder (ASD) is a relatively common neurodevelopmental disorder often diagnosed in childhood. In England, the prevalence of the condition is around 1.32% according to recent statistics. The prevalence in adults is less – but this is likely down to an underdiagnosis of adults as more is now understood about the condition compared to in previous generations.

There is also a disparity between males and females. It ranges from between 3:1 and 5:1, depending on where you look. In this case, the disparity is likely down to females being underdiagnosed because they’re better at ‘masking’ difficulties and are more likely to camouflage the condition to fit in with societal norms.

In this article, we’ll aim to uncover some of the typical signs of autism in children. The earlier the condition is diagnosed, the earlier support and interventions can be given – if they’re needed or desired. An important thing to remember, though, is that all those diagnosed with autism are unique. Although there are many shared traits, there are also huge variances in how the condition affects individuals. And this must be considered when talking about autistic people as a whole.

What is Autism?

First things first, what is autism? According to the National Autistic Society, autism is a “lifelong developmental disability which affects how people communicate and interact with the world.”

It is a natural variation in how a person experiences the world, processes information and interacts with others. It is simply a neurodevelopmental difference. It is not a disease or something that needs to be ‘fixed,’ though some autistic people do need accommodations, support or reasonable adjustments in school, life and work.

Autism exists on a spectrum. While all autistic people share some traits, their experiences, strengths and challenges do vary widely.

Autism is typically characterised by:

• Differences in communication.
• Differences in sensory processing.
• Differences in social interaction.
• Strong interests.
• Unique ways of thinking or looking at the world.

Many autistic people prefer identity-first language (e.g. “autistic person” rather than “person with autism”) because they see the condition as an integral part of who they are.

Rather than focusing on deficits, we must recognise autism as a different way of being. One that comes with both challenges and strengths. Some autistic people may need more support in certain areas. Others may be highly independent. Understanding and acceptance are crucial. Then, we can ensure autistic children and adults can thrive in a world that wasn’t designed for their neurotype.

What Causes Autism?

Autism is a natural part of human diversity. It is not caused by vaccines, parenting styles, screen time, or environmental factors. Rather, it is an inherent neurodevelopmental difference that has always existed. Research suggests it’s largely genetic. This means there is likely to be more than one autistic person in a family. There has been no single ‘autism gene’ identified. Instead, it’s believed that there are a combination of genetic variations at play that contribute to the way an autistic brain develops and processes the world.

It is important to move away from outdated ideas that frame autism as something that happens to a person. Autistic people are simply wired differently – and this difference exists from birth.

How Does Autism Affect Children?

Many autistic children communicate differently. Some use speech while others prefer AAC (augmentative and alternative communication), typing or non-verbal methods. Their social interactions may not follow non-autistic expectations. They often engage in deep interests that bring them joy. These are also a source of learning and self-expression.

Sensory differences are also common. An autistic child may experience the world as too loud, too bright or too overwhelming. Others may be sensory seekers and seek out sensory experiences for comfort and regulation. Stimming (repetitive movements or sounds) are natural ways autistic children manage their environment and emotions.

Autism is often misunderstood as a linear spectrum. This describes individuals as being ‘more’ or ‘less’ autistic. This idea leads to labels like ‘high-functioning’ and low-functioning or Level 1, 2 and 3 autism. However, these terms oversimplify things. They can be misleading. This is because they fail to capture the complexity of an autistic person’s experiences and needs.

Autism is better understood as a circle. Different autistic people have different strengths and challenges across multiple areas like communication, sensory processing, executive functioning, emotional regulation and motor skills. Some might need support in one area but are highly independent in another. This can also change depending on the situation or environment.

Labels like ‘high-functioning’ often dismiss struggles because they assume an autistic person is doing fine just because they can mask (hide their autistic traits). Meanwhile, ‘low-functioning’ can be harmful because it assumes a lack of ability, even when an autistic person might have a rich inner world and strong skills that aren’t immediately visible.

Rather than thinking of autism as a hierarchy, it’s more accurate to see it as an individualised experience.

Signs of Autism in Babies

Autistic traits can be present from birth, but they are not always recognised immediately. Some may show noticeable differences early on, while others may develop in ways that seem typical before traits become more apparent.

Here are some signs that may indicate a baby is autistic:

Communication and Social Interaction

• A baby may not make eye contact or may find it uncomfortable.
• They may not respond to their name being called.
• They may prefer observing rather than engaging in social interaction.
• They may not use typical social gestures like waving or pointing.
• They may show unique facial expressions. These may not align with social expectations.
• They may be happy playing alone. They may not seek out interactions in expected ways.

Sensory Processing Differences

Babies may show sensory processing differences by:

• Being highly sensitive to sounds, lights or textures. They may also seem unbothered by tings that others find overwhelming.
• They might not react to loud noises or sudden changes in the environment as typical babies do.
• They might enjoy repetitive sensory experiences. This might be staring at moving objects or feeling certain textures repeatedly.
• They may seek sensory input in different ways. They might rock, flap their hands or make repetitive sounds.

Movement and Play

An autistic baby might show differences in how they move and play. They might:

• Show an early preference to specific types of movement. This might be spinning, rocking or bouncing.
• Focus deeply on specific objects instead of shifting focus as you might expect.
• Arrange their toys or objects in a particular way. They may not engage in pretend play or use their toys in their typical designed use. For example, they may line up dolls instead of playing ‘mums and dads.’
• Have an early attachment to patterns or routines. If these differ, they might become unusually distressed by the changes.

It is important to recognise that a baby displaying any of these signs could be neurotypical. Rather, it is a pattern that is best looked at holistically. Just because a baby lines up their toys doesn’t mean they are autistic. This is a natural schema and way of learning about the world. The difference is that there will usually be several signs pointing to autism rather than just one perceived difference.

Signs of Autism in Toddlers

When babies reach toddlerhood, any autistic differences may become more apparent. Especially in boys. It’s important to see these as ‘differences’ rather than ‘deficits.’ These are simply variations in development. Some signs of autism may become more noticeable now because of social and communication expectations. However, every autistic child is unique and these traits can vary widely.

Communication and Social Interaction

An autistic toddler may show some of these traits:

• They may not use words or gestures in typical ways. They might communicate through body language or echolalia (scripting or gestalt language processing).
• They might prefer to play alongside others instead of with them or having back-and-forth interactions.
• They might still not respond to their name. This isn’t out of defiance or being hard of hearing. Rather, it’s because their attention is focused elsewhere. This is also common in ADHD, a frequent comorbidity of ASD.
• They might show interest in people but they may interact with them differently. They might observe instead of engaging in typical exchanges. They may behave in ways that it seems they don’t acknowledge the presence of others.
• Unlike neurotypical toddlers, they may not copy facial expressions or gestures instinctively.
• They might prefer to initiate interactions on their own terms. They might not respond to social cues.

Sensory Processing and Regulation

Toddlers who are autistic might be highly sensitive to sounds, lights, textures or certain environments. They might be fearful of hand dryers in public toilets, for example. They might also seek out intense sensory experiences.

Like babies, they make self-regulate through stimming. This might be seen as flapping hands, rocking, spinning or making vocal sounds.

They may also have strong preferences for certain foods and textures. Many autistic people prefer to eat the same foods and these are often plain, very palatable foods like chips, chicken nuggets and pizza, for example. Although some degree of fussiness is typical in toddlers when it comes to food, autistic children tend to be ‘fussier.’

Eating can become so restricted in autistic children that it becomes a more serious issue. Some are diagnosed with ARFID (avoidant restrictive food intake disorder). This is a separate diagnosis but is often a comorbidity with autism. You can have ARFID and be autistic, however. ARFID is not well-understood and is a relatively new diagnosis. It is considered to be an eating disorder but is the only eating disorder that is not linked to body image and a desire to look different.

Alongside sensitivities to food and sounds, autistic toddlers may avoid certain clothing. They may struggle with labels in clothing or certain fabrics. It is common for autistic children to prefer wearing jogging bottoms, for example, over jeans.

When coping with sensory needs, autistic toddlers may need time to decompress. And they may become overwhelmed in busy or loud places.

Repetitive Behaviours and Routines

Autistic toddlers tend to find comfort in routines. They may become distressed by unexpected changes. Their preference for repetition is also apparent in how they enjoy lining toys up, watching objects spin or in how they themselves engage in repetitive actions.

Some autistic people focus deeply on specific interests. They may develop a special interest in a certain topic or item. This may change over time but it can stay the same. For example, an autistic toddler may display a strong interest in tractors and be able to name different makes and models of tractors. A typical child who likes tractors may do this too but usually the degree of knowledge and fascination is much greater in the autistic toddler.

Movement and Coordination

Autism, though a neurodevelopmental condition, can also affect movement and coordination. An autistic toddler may show signs of a unique gait or walking pattern. They may walk on their tip-toes, for example. They may struggle with certain motor tasks like using utensils or climbing stairs. Equally, they may show advanced physical abilities.

They may also show advanced skills for their age—they might recognise patterns, have an exceptional memory or show talents for puzzles.

Recognising these signs or potential signs of autism is about understanding the general picture of the child and understanding their way of being. Autistic toddlers thrive in environments that support and accept them and allow them to develop in their own way.

Signs of Autism in Older Children

As children grow, autistic differences may be more noticeable. This is especially true when academic and social expectations increase. Some autistic children may still go under the radar until later. This is particularly true for girls and those who mask.

Signs in older children include:

• Preferring structured interactions over open-ended socialising.
• Struggling with small talk but great when it comes to deep conversations about their special interests.
• Difficulties understanding social rules, unspoken expectations or sarcasm.
• Finding eye contact unnatural or uncomfortable. Some may force it to fit in.
• Preferring one-on-one friendships or relationships with older people or younger people instead of same-age peers.
• Struggling with teamwork. This is especially true when the roles and rules aren’t clearly defined.
• Having strong emotional responses. They may also express emotions differently than expected.

Sensory Processing and Regulation

Older children might still become overwhelmed in loud, bright or chaotic environments like classrooms, lunch halls or shopping centres. They may stim to self-regulate though many are adept at suppressing this in public.

Food, texture and clothing sensitivities are still there. They may naturally choose looser clothing and cut out tags.

They may also find relief in predictable routines and may struggle with transitions or unexpected changes.

Cognition and Learning

It’s somewhat of a myth that all autistic people are ‘gifted’ or ‘savant,’ though some are. Autistic older children may excel in some areas but struggle in others like writing, for example. They might be deeply knowledgeable about a specific interest but struggle with broader ideas.

Thought patterns with autism tend to be logic and pattern-orientated. Abstract and hypothetical situations are more difficult to grasp.

Cognition and learning may also be affected by poor executive functioning. This includes things like time management, organisation and task prioritisation.

Differences in Autistic Boys and Girls

Many autistic girls are overlooked because they often mask their traits. This means they consciously or unconsciously imitate non-autistic social behaviours to fit in. This can delay recognition and support.

Autistic boys tend to show more obvious signs (repetitive behaviours, intense interests and difficulties with social norms). Girls often have special interests but these are on more socially acceptable topics like celebrities, books or animals. Girls may mimic peers or use learned social scripts. This makes their struggles less obvious. They may also internalise their difficulties. This can lead to anxiety, depression or burnout.

What to Do If You Are Concerned

If you think your child might be autistic, trust your instincts. Every child is different but noticing patterns in their behaviour can help you decide what to do next.

Pay attention to how your child plays, communicates and reacts to different situations. Look for patterns in their behaviours and how they respond to change.

It’s also important to learn about autism. Instead of seeing it like a problem to fix, think of it as a different way of experiencing the world. Learning from autistic voices can help parents understand what their child might need. But remember, that one autistic person is just one autistic person.

If you want an assessment, talk to a GP or health visitor. Some areas require referrals to be made by schools. For those who mask, getting school on board can present challenges.

An autism assessment can help you and others understand your child’s needs. Diagnosis should not be seen as a label. Rather, it is a way of understanding and acknowledging while being able to access appropriate support. Some people choose to self-identify as autistic. Largely due to the waiting lists for adults.

Support for Children with Autism

Children who are diagnosed autistic (or suspected to be) can access a range of support. Though sometimes it is a fight to get this in place!

Help at school includes IEPs or EHCPs for those struggling the most, and reasonable adjustments. Autism is classed as a disability and is a protected characteristic per the Equality Act 2010. This means autistic children have legal rights to fair treatment, support and protection from discrimination.

The Challenges of Getting an Autism Diagnosis

One of the biggest challenges of all is getting an autism diagnosis. Many waiting lists are long. Recently, Sheffield Hospitals announced that those recently accepted on the autism pathway are looking at an 8-year wait. According to NHS England, there were 193,203 patients with an open referral awaiting assessment for autism. Of these, 83% had been waiting over 13 weeks. Some families go private but assessments are expensive.

The Right to Choose Pathway

The Right to Choose pathway is an initiative that allows families to take control of their assessment and treatment. It means you can choose where and how you access services. This was introduced to help people access services in other areas if their own wait times are too long. Some private providers are included on the Right to Choose pathway, and these are paid for by the NHS.

Final Thoughts: Recognising Autism in Children

Recognising the signs of autism in children can be challenging. Each autistic child is unique and understanding how broad the spectrum is makes things even more difficult. Generally, it’s about gaining a broad picture of a range of signs. Having one sign of autism doesn’t mean a person is autistic. If there are concerns that a child is not developing typically, getting on the assessment waiting list as soon as possible is important.

Early diagnosis and tailored interventions can improve a child’s wellbeing. It’s important to approach autism with an open mind. Focus on understanding the individual child and accepting them how they are. With appropriate support, autistic children can have fulfilling lives with many celebrating their differences as strengths.