First Signs of Autism in Children: What to Watch, When to Act, and What to Do First

Parents of children with autism often describe the same experience: they knew something was not quite right. They just didn’t know what. And sometimes it took a long time before they reached someone who could help them understand why. This article was created for that exact reason. So you know what to look for. So you know what to do when you have doubts. And so you don’t have to go through it blindly.

What is autism and why timing matters

Autism, professionally referred to as Autism Spectrum Disorder (ASD), manifests in three main areas: social interaction, communication, and repetitive patterns of behavior. Every child with this diagnosis is different. Some require intensive daily support. Others grow up, graduate, and live relatively independent lives. Autism is a spectrum, and that spectrum is very broad. The number of diagnosed cases in the population has been increasing. While in 2012 autism spectrum disorder was identified in 62 out of 10,000 children, by 2022 this number had risen to 100 out of 10,000, which is approximately one percent of the child population.

Why does timing matter? A young child’s brain develops and learns at a speed that cannot be replicated later. The earlier a child receives the right kind of support, the better the outcomes. This is not just theory. It is supported by decades of research and the experience of thousands of families.

Signs of autism from age 1

The first signs of autism can appear as early as the first year of life, sometimes even before parents fully realize that something may be different. Not every sign needs to be present, and a single isolated behavior does not mean autism. What matters is the overall pattern.

Social interaction and responses By around 6 months, a baby should return a smile and respond to faces. If this does not happen, it is worth paying attention. By 9 months, a child should respond to their name. If they consistently do not respond across different situations and levels of voice, it is not always a hearing issue. It can be one of the early indicators. Children with autism often do not engage in interactive games like peekaboo. They may not respond to shared play, do not wait for reactions, and show less interest in faces compared to other children.

Speech and gestures By the first year, a child should babble, point to objects, and reach out to be picked up. If these behaviors are missing, it is a signal that should not be ignored.

Movement and body Some children with autism walk on their toes, have unusual posture, or react differently to touch than expected. On their own, these signs do not mean much, but as part of a broader pattern they become important.

Watch for regression Some children develop typically at first, reach milestones on time, and then suddenly or gradually lose skills they had already gained. They may stop using words they once said. They stop responding to their name. They withdraw. If this happens, it is a strong warning sign and should be addressed without delay.

Signs of autism around age 3

Around the age of three, the picture is usually clearer. The child is in contact with peers, and differences become more noticeable.

Speech and communication Delayed speech development or complete absence of speech. Repeating words or entire sentences without connection to what is happening in the moment. Difficulty starting or maintaining a conversation. A child may speak, but not really to you, more as if speaking next to you. Difficulties understanding figurative language are also common later on.

Social behavior The child plays next to other children, not with them. They may show little interest in peers or not know how to join a group. They often struggle to express what they want or how they feel.

Sensory responses Strong sensitivity to sounds, light, touch, or smells. Or the opposite, reduced sensitivity and a need for intense sensory input. Refusing food based on texture. Meltdowns triggered by sounds that other children do not even notice.

Routine and repetitive behavior Lining up objects in a row. Fascination with one specific thing. For example, instead of playing with a toy car in a typical way, the child may hold it close to their face and spin the wheels. Any change in routine can trigger a strong reaction. A different route home, a different cup, a different order of breakfast. For the child, this is not stubbornness. It is a real source of stress.

Asperger’s syndrome: when signs appear later

In Asperger’s syndrome, the child does not show significant speech delay or intellectual impairment. Because of this, the signs can go unnoticed for a long time, sometimes until school age or even adulthood. These children speak, they are intelligent, and they are curious about the world. But something feels different. The environment often describes it as being unusual, odd, or simply a different personality.

What to watch for from age 5 and in school

The child wants to have friends but does not know how to build relationships. They take things literally and struggle to understand sarcasm or irony. They can be very honest, even in situations where it is socially inappropriate. They may develop deep, almost encyclopedic knowledge about a specific topic such as trains, dinosaurs, or planets, and can talk about it for hours. In school, they may excel in some subjects while struggling significantly in others. Teachers often describe them as withdrawn, unusual, or difficult to work with. They may also become targets of bullying, precisely because they do not intuitively understand social rules that other children grasp naturally. Diagnosis in adulthood is not uncommon. Many adults learn about their Asperger’s syndrome only after years of trying to understand why their life feels different. For many, the diagnosis brings relief and a sense of clarity.

If you have concerns: don’t ignore them

It is natural to look for reasons why it might not be autism. To tell yourself it is just a phase. That boys develop slower. That a grandparent says the father was the same. That reaction is completely understandable. Accepting the possibility is not easy. But when you delay addressing early signs, you are also delaying the time when your child can receive the most effective support. A child’s brain develops rapidly, especially in the first five years, in ways that cannot be repeated later. Every month of early intervention has a direct impact on how your child will function in the future. Diagnosis is not a sentence. It is an answer. It ends uncertainty and opens the door to targeted support. Many parents say that after the diagnosis, they finally understood why their child behaves the way they do. And that understanding changes everything.

First Steps: Where to Go and in What Order

Step 1: Clinical Psychologist This is your first step. A clinical psychologist with experience in autism spectrum disorder (ASD) will carry out a comprehensive assessment of your child, talk with you, and evaluate whether signs of autism are present. Based on this, they will guide you on what to do next and which specialists to contact. How to find one: through your health insurance provider, specialized centers in your region, or by recommendation from your pediatrician.

Step 2: Neurologist A pediatric neurologist helps rule out other neurological causes of the symptoms and assesses the child’s overall neurological development. Some behaviors that resemble autism may have different explanations. At the same time, some children with autism may also have additional neurological conditions that need to be identified.

Step 3: ENT Examination One of the early warning signs of autism is that a child does not respond to their name. However, before considering autism, it is important to rule out hearing issues. A child with hearing impairment may also not respond to sounds, not because they choose not to, but because they cannot hear them. An ENT (ear, nose, and throat) examination focused on hearing is quick and gives you confidence that you are ruling out the right causes in the right order.

Step 4: Specialized Support Centers Specialized educational and support centers provide professional guidance, monitor the child’s development, and in many cases offer therapeutic services. These services are often publicly funded. After the initial consultation with a clinical psychologist, it is recommended to connect with such a center near you for ongoing monitoring and support.

Therapies in Autism: Overview and What to Expect

After a diagnosis, one question naturally follows: what now? There are many different therapies, and navigating them is not easy. Here is an overview of the most important ones, briefly explaining what each does and who it can help.

ABA Therapy , or Applied Behavior Analysis, is the most researched therapy for autism worldwide. It is intensive, structured, and always individualized, designed specifically for the child. It focuses on reinforcing desired behaviors and gradually building new skills in communication, social interaction, and daily functioning. It is recommended to start as early as possible after diagnosis. It is time-intensive, and parental involvement is an essential part of the process.

TSMT is a movement-based therapy that works with the child’s sensorimotor development. It is based on the idea that proper movement patterns form the foundation for the development of speech, attention, and social skills. In autism, it is particularly helpful for sensory challenges, balance issues, and coordination. Many parents observe improvements in attention and a reduction in sensory sensitivities after TSMT.

Speech Therapy in autism is not only about pronunciation. It focuses on communication in a broader sense, including language comprehension, alternative communication methods for nonverbal children, and how the child uses language in social situations. For most children with autism, speech therapy is essential.

Auditory Therapy In autism, the way the nervous system processes sound is often different. Auditory therapies, such as the Berard method, focus on how the brain receives and interprets sounds. They may help with sensitivity to noise, difficulties concentrating in noisy environments, or delayed speech development.

Hippotherapy Working with a horse provides rich sensory input. The rhythmic movement of the horse stimulates the nervous system while the child builds trust, develops attention, and improves motor skills. For many children with autism, hippotherapy creates a space where they open up in ways that are otherwise difficult to achieve.

Orofacial Therapy focuses on the mouth and facial area. In autism, it is important for children who have difficulties with eating, swallowing, or speech production. It works with muscle tone and sensory sensitivity in this area.

EEG Neurofeedback is a method in which the child gradually learns to regulate their own brain activity through feedback. It is non-invasive and painless. Research shows positive effects on attention, communication, and sleep quality in children with autism. It requires consistency and patience, as results appear gradually over time.

How to navigate therapies Do not start everything at once. Begin with what a clinical psychologist recommends and gradually add therapies based on how your child responds. The most important indicator is not the number of therapies, but where your child is making progress. Where they feel comfortable. Where they are willing to go. These are the signals worth paying attention to.

Don’t forget about yourself

Every parent processes this situation differently, and every pace is valid. Some accept the diagnosis quickly and take action right away. Others need more time. Both are normal. One thing applies to everyone: you cannot keep giving what you no longer have. A burned-out parent cannot be fully present for their child. Taking care of yourself is not selfish. It is part of caring for the entire family. If things become overwhelming, it is important to ask for help. From friends, family, or a professional. A psychologist or therapist is not only for crisis situations. They are there for anyone carrying more than they can handle alone.

Conclusion If you take one thing from this article, let it be this: take action. Not out of fear, but because time matters. A diagnosis is not the end. It is the beginning of understanding, the beginning of the right support, and the beginning of a journey. And it is a journey you do not have to walk alone.

Author

Nina Bakalová Mother of two and co-founder of the TAMITOS project. For several years, I have been walking alongside my daughter on the autism spectrum, sharing what we truly live through honestly, openly, and with hope.