Autism Early Signs Checklist

Ages 12 Months to 5 Years

Observable developmental behaviors that may indicate the need for an autism evaluation. Organized by age group. Use this checklist to track observations and start a conversation with your child's doctor. This checklist is not a diagnostic tool.

Important Disclaimer — Please Read This checklist is for educational and observational purposes only. It is NOT a diagnostic tool and cannot determine whether a child has autism. Only qualified clinical professionals (developmental pediatricians, child psychologists, neuropsychologists) can diagnose autism through a comprehensive evaluation. Checking multiple items on this list is not a diagnosis, and checking few or no items does not rule out autism. If you have any concerns about your child's development at any age, talk to your pediatrician and request a referral for evaluation. Early evaluation is always appropriate when there are concerns — there is no downside to seeking more information.

Watch Behaviors that often prompt clinical attention

Milestone Positive development to look for

How to use this checklist: Work through each age section for your child's current and previous age groups. Check items you have noticed. Bring this completed checklist to your next pediatric visit or share it with an evaluating clinician. You can also print this page (File > Print) for an offline copy.

12 mo

12 Months (1 Year)

Key window: social communication and early pointing milestones

No babbling by 12 months. Baby is not producing consonant-vowel combinations (ba, da, ma, ga) or other vocal play. Watch

Not pointing to show interest or to request. Does not point to objects to direct your attention — e.g., pointing at a bird or airplane to share the experience. Watch

No response to their own name when called in a quiet environment, with no other hearing concerns. Watch

Not following a pointed finger. When you point to something and say "look," baby does not follow your finger to look at the object. Watch

Not waving bye-bye or imitating gestures. No imitative gestures like clapping, waving, or mimicking simple actions shown by a caregiver. Watch

Limited eye contact — does not make eye contact during social interaction, feeding, or play. Watch

Showing social smile and sharing joy — smiles in response to faces, laughs, and shows enjoyment of social play like peekaboo. Milestone

No gestures at all (waving, reaching with arms up to be held, showing objects). Watch

18 mo

18 Months

Key window: words, imitation, joint attention, and early play

Fewer than 6 words (or no words at all) used meaningfully and consistently. Not counting words heard once or sporadically. Watch

Loss of previously acquired words or skills. Any regression in language, social connection, or developmental skill that was previously present. Watch

No pretend or functional play. Does not use objects functionally (brush on hair, cup to mouth, phone to ear) or engage in simple pretend scenarios. Watch

Does not bring objects to show you (to share, not to request). Showing requires understanding that the other person has a mind to share an experience with. Watch

Repetitive behaviors with objects — lining things up, spinning wheels, turning objects over and over, watching ceiling fans or spinning objects for extended periods. Watch

Intense reactions to sensory input — screaming at ordinary sounds, extreme distress from textures (food, clothing), unusual sensitivity to light, or seeking intense sensory experiences. Watch

Imitating simple actions and sounds seen and heard from caregivers — copying patting, stirring, simple words. Milestone

Showing joint attention — looking back and forth between an interesting object and your face, as if checking that you see what they see too. Milestone

24 mo

24 Months (2 Years)

Key window: two-word phrases, social connection, and imaginative play

Not using two-word phrases spontaneously (not counting imitated or prompted phrases). E.g., "more juice," "daddy go," "big dog." Watch

Vocabulary of fewer than 50 words used meaningfully. Many 2-year-olds have 200+ words; 50 words is the lower end of typical. Watch

Echolalia as the primary communication form — repeating words, phrases, or scripts from TV or others rather than generating own language. Some echolalia is normal; predominant echolalia warrants evaluation. Watch

Prefers to play alone rather than with other children or adults; does not seek social interaction for enjoyment. Watch

Rigid insistence on routines or sameness — extreme distress when routines are changed, routes altered, or familiar sequences disrupted. Watch

Unusual movement patterns — persistent toe walking, hand flapping, spinning, rocking, or other repetitive body movements for extended periods. Watch

Does not point to things in books when asked ("Where is the dog?"). Following questions to pictures requires language comprehension and joint attention. Watch

Any loss of language or social skills previously acquired — at any point. This is always a reason to seek immediate evaluation. Watch

Simple pretend play with dolls, animals, or objects (feeding a doll, making a toy car drive, having two figures talk). Milestone

3 yr

3 Years

Key window: conversational language, peer play, and understanding social rules

Speech not understood by familiar adults most of the time. Strangers should understand about 75% of speech at age 3. Watch

Not using 3–4 word sentences for most communication needs. Watch

Does not understand simple questions — "Where is your shoes?" "What do you want?" — or follows only one-step directions. Watch

No interest in other children or actively avoids peer interaction. At 3, most children are at least observing other children and beginning parallel play. Watch

Talks about one topic only (restricted interest) to the exclusion of all other conversational topics, regardless of listener interest. Watch

Severe difficulty with transitions between activities — intense, prolonged distress when moving from preferred to non-preferred activities beyond typical 3-year-old protests. Watch

Unusual sensory interests — persistent smelling of objects, licking non-food items, staring at lights, fascination with textures or visual patterns to the exclusion of other activities. Watch

Engages in multi-step imaginative play — takes on roles, assigns roles to others, creates play scenarios with beginning/middle/end. Milestone

Shows concern when another person is hurt or upset — early empathy and understanding of others' emotional states. Milestone

Remember: Autistic children vary enormously. Some develop language typically but have significant social differences. Others have language delays without other autism traits. Some of these items occur in typical development occasionally — it is the pattern, persistence, and functional impact that matters clinically. This checklist captures common observations; a qualified evaluator will assess far more comprehensively.

Take Our Free Online Screening Tool

Our free autism screening tool helps identify developmental patterns that may warrant professional evaluation. It takes about 5 minutes and generates a report you can share with your doctor. It is not a diagnosis — it is a starting point.

Take the Free Screening Tool

What to Do If You Have Concerns

Talk to your pediatrician at your next well-child visit — bring this checklist with items noted. Ask for a referral to a developmental pediatrician or child psychologist for a comprehensive autism evaluation.
Don't wait for the next scheduled visit if you're concerned now. Call the office and ask for an urgent developmental concern appointment. Concerns about regression are especially urgent.
Request an Early Intervention evaluation (if your child is under 3) — call New York State's EI hotline: 1-800-522-5006. Referrals are free and don't require a doctor's referral.
Request a CPSE evaluation from your school district (if your child is 3–5) — contact the special education office of your local school district to request a preschool evaluation at no cost.
Read our full guide on How to Get an Autism Evaluation and Early Signs of Autism in Young Children.
Visit our Autism Resources Hub for evaluation support, early intervention information, school advocacy guides, and community resources.

GRSCorp Autism Early Signs Checklist | blogs.grscorp.us | Published September 2026 | Not a diagnostic tool. For educational purposes only.