Noticing something different about your child’s development can bring a mix of emotions — worry, confusion, and an urgent need to understand what’s happening. You may have started searching online at midnight, talked to your pediatrician, or heard something from a family member that made you wonder. Whatever brought you here, trust that instinct. When it comes to autism, earlier support consistently leads to better outcomes, and the first step is simply knowing what to look for.
This guide walks through the early signs of autism by age, explains what an evaluation involves, and describes how Autism Centers of Utah supports families from that very first phone call.
Why Early Identification Matters
The brain develops rapidly in the first three years of life. During this period, children are forming the neural pathways that underpin communication, social connection, and learning. When autism is identified early and a child receives appropriate support, those pathways can be strengthened through therapy during the window when they are most responsive to change.
Research consistently shows that children who begin evidence-based intervention in toddlerhood make greater gains in language, social skills, and adaptive behavior than those who start later. Early identification is not about labeling a child — it is about giving them access to the support they need during the years when it matters most. Families looking for a starting point can find an overview of early autism services for toddlers and what that process involves.
Early Signs at 12 Months
Most children begin communicating socially well before they say their first word. By 12 months, typical development includes making eye contact, responding to their name, babbling back and forth with caregivers, pointing to objects of interest, and sharing a smile or laugh. Signs that may warrant a closer look include:
- Not responding consistently when their name is called
- Limited or infrequent eye contact, especially during interactions
- No babbling or very little back-and-forth vocalization
- Not using gestures such as waving, reaching, or pointing
- Seeming more interested in objects than people
It is important to note that no single sign is definitive. Children develop at different rates, and some signs may have other explanations. What matters is a pattern of differences observed over time.
Early Signs at 18 Months
By 18 months, most children are saying at least a handful of words and beginning to use them intentionally to communicate. They typically point to show you something interesting, follow your gaze when you look at something, and engage in simple pretend play. Signs that may suggest a need for evaluation at this age include:
- No single words being used to communicate
- Not pointing to share interest in things (pointing to request is different from pointing to share)
- Difficulty following simple directions, even with gestures
- Little to no imitation of sounds, words, or actions
- Strong reactions to sensory experiences — certain sounds, textures, or lights causing distress
- Repetitive movements such as hand-flapping, rocking, or spinning objects
The American Academy of Pediatrics recommends autism-specific screening at 18 and 24 months as part of well-child visits. If your pediatrician has not administered one, you can ask for the M-CHAT-R screening tool.
Early Signs at 24 Months and Beyond
At two years, children are typically using two-word phrases, engaging in parallel or simple interactive play, and showing clear interest in other children. Any loss of previously acquired language or social skills at any age is a significant sign that warrants prompt evaluation. Additional signs in the 24-month-and-older range include:
- Fewer than 50 words, or no two-word combinations by age two
- Echolalia — repeating words or phrases heard on TV or from others — without clear communicative intent
- Strong insistence on sameness in routines, with significant distress when routines change
- Narrow, intense interests in specific objects or topics
- Limited imaginative or pretend play
- Difficulty understanding or responding to other people’s emotions
A regression — for example, a child who was saying words and then stops — should always be discussed with a medical professional right away. For a fuller picture of what to watch for across all developmental domains, see our guide on developmental milestones and autism.
What an Evaluation Involves
An autism evaluation is not a single test. It is a structured process of gathering information about a child’s development across multiple domains. A thorough evaluation typically includes:
Parent and caregiver interview: Professionals ask detailed questions about development history, current behaviors, family observations, and any concerns. Your insight as a parent is one of the most valuable sources of information in this process.
Developmental and behavioral assessment: Clinicians observe how the child communicates, plays, and interacts. Standardized tools are used to compare the child’s skills to developmental norms.
ADOS assessment: The Autism Diagnostic Observation Schedule (ADOS) is a gold-standard structured observation tool used by trained clinicians. Autism Centers of Utah can conduct ADOS assessments in appropriate cases, providing families with a clearer clinical picture as part of the intake process.
The evaluation process results in a clearer understanding of a child’s strengths and areas of need — and serves as the foundation for building an individualized therapy plan.
What to Do If You’re Concerned
If you are noticing signs described in this guide, the most important thing you can do is act rather than wait. “Wait and see” is rarely the right approach when developmental concerns are present. Here are the steps many families take:
- Talk to your pediatrician. Share your specific observations. Ask for a developmental screening or a referral to a specialist.
- Request an evaluation. You do not need a prior diagnosis to reach out to a center like Autism Centers of Utah. Families can contact us directly to begin the conversation.
- Begin the intake process. At Autism Centers of Utah, families start with a welcome call, followed by insurance verification and a visit to our Sandy facility. From there, a clinical assessment is conducted before therapy begins. You can learn what to expect at your child’s first visit.
Getting an evaluation does not commit you to any particular path. It gives you information — and information is what allows you to make the best decisions for your child.
How Autism Centers of Utah Supports Families at This Stage
Autism Centers of Utah is a center-based provider located in Sandy, Utah, serving children ages 2 through 12. Our services include ABA therapy as the primary intervention, with speech therapy, occupational therapy, and feeding therapy available on-site for ABA clients. Having all services under one roof means therapists collaborate directly, and families do not need to coordinate care across multiple locations.
Our BCBAs — Board Certified Behavior Analysts — hold master’s-level credentials, design each child’s treatment plan, conduct assessments, and provide ongoing supervision. Registered Behavior Technicians (RBTs) deliver direct therapy under that supervision, maintaining the consistency that is essential in early intervention.
We are in-network with Blue Cross Blue Shield and Utah Medicaid, and our team helps families navigate insurance questions from the very beginning. We understand that figuring out coverage while also worrying about your child’s development is stressful — we try to make that part as straightforward as possible.
Frequently Asked Questions
At what age can autism be diagnosed?
Autism can often be reliably diagnosed as early as 18 to 24 months by experienced clinicians. A formal diagnosis is made through a clinical evaluation, not a single test.
What should I do if my child’s pediatrician dismisses my concerns?
Trust your instincts. You can seek a second opinion or contact a specialist directly. Parents know their children better than anyone, and your observations matter.
Does my child need a diagnosis to start ABA therapy?
Requirements vary by insurance. In many cases, a formal autism diagnosis is needed for insurance authorization. The team at Autism Centers of Utah can help clarify what your specific plan requires during the intake process.
What is the difference between a developmental delay and autism?
A developmental delay refers to a child reaching milestones later than expected in one or more areas. Autism is a specific neurodevelopmental condition characterized by differences in social communication and the presence of restricted or repetitive behaviors. A child can have both, and a thorough evaluation can provide clarity.
How soon can therapy start after an evaluation?
At Autism Centers of Utah, the process from initial contact through assessment and program start is designed to move efficiently. Once insurance is verified and assessment is complete, families begin their child’s program as soon as possible. For a step-by-step walkthrough, see our guide on how to schedule an appointment at Autism Centers of Utah.
If you are worried about your child’s development — whether they are a toddler in Draper, a two-year-old in South Jordan, or a young child anywhere in the Salt Lake Valley — please do not wait. Reach out to Autism Centers of Utah at (385) 417-3869 to start with a welcome call. Our team is here to answer your questions, walk you through the process, and make sure your child gets the support they deserve.