Introduction
Many parents wonder whether autism can be recognised during the first year of life. While autism cannot usually be diagnosed reliably in early infancy, research suggests that some autistic children show developmental differences during their first 12–24 months. These differences are often subtle and are most noticeable in social communication, attention to people and responsiveness to the environment.
It is important to remember that all babies develop at different rates. A single behaviour does not indicate that a child is autistic. Rather, autism is identified through a pattern of differences across multiple areas of development. Some autistic babies show clear early signs, while for others, the signs may not emerge until toddlerhood or much later in life.
This article explores what research tells us about the earliest signs of autism in babies and the developmental milestones that parents may wish to monitor.
Can Autism Be Identified in Babies?
Research suggests that some differences associated with autism can be observed during the first year of life, although these differences are often subtle. Many of the earliest signs relate to social communication and a developmental skill called joint attention.
Joint attention refers to the ability to share attention with another person. It is the foundation of social communication, language development and learning from others. Researchers consistently identify differences in joint attention as one of the earliest markers associated with later autism diagnoses.
Difficulties with Joint Attention:
One of the clearest early signs of autism involves differences in how babies share attention with other people.
Typically developing babies begin developing joint attention skills between 8 and 12 months of age. During this period, babies start looking between objects and people, following another person’s gaze and sharing experiences through eye contact and gestures.
Parents may notice that an autistic baby:
- Does not consistently look where another person is pointing.
- Shows limited interest in sharing experiences.
- Does not frequently look back and forth between an interesting object and a parent.
- Appears less motivated to share enjoyment with others.
It is important to remember that some babies show these behaviours occasionally, and occasional differences are not usually a cause for concern.
Reduced Response to Their Name:
Most babies begin responding consistently to their name during the second half of their first year.
Research has found that some children later diagnosed with autism are less likely to orient towards their name being called. Parents may notice that their baby appears to ignore them despite having normal hearing.
However, response to name should never be considered in isolation. Babies may fail to respond because they are tired, distracted or focused on another activity.
Differences in Eye Contact:
A common misconception is that autistic babies never make eye contact.
In reality, many autistic babies do make eye contact. However, the way eye contact is used may differ.
Parents may notice:
- Less frequent eye contact during interaction.
- Less looking towards caregivers during play.
- Reduced use of eye contact alongside smiling or vocalising.
Differences in Social Smiling:
Most babies enjoy social interaction and participate in simple back-and-forth exchanges with caregivers.
For example:
- Smiling when someone smiles at them.
- Enjoying games such as peek-a-boo.
- Anticipating familiar routines and playful interactions.
Some autistic babies may show less interest in these reciprocal interactions or may engage differently. Parents occasionally describe a feeling that their baby seems more focused on objects than people.
Again, this should be viewed as part of a broader developmental picture rather than a single sign.
Limited Use of Gestures:
Gestures are a crucial part of early communication.
By around 12 months, many babies begin:
- Pointing towards interesting things.
- Reaching to be picked up.
- Waving goodbye.
- Showing objects to others.
Research suggests that delays in gesture development can be an early indicator of autism. In particular, some autistic children are less likely to point simply to share interest with another person.
Instead, they may communicate needs by:
- Taking an adult’s hand.
- Pulling someone towards an object.
- Physically guiding another person.
Differences in Babbling and Communication
Communication differences can sometimes emerge during infancy.
Parents may notice:
- Reduced babbling.
- Less imitation of sounds.
- Fewer back-and-forth vocal exchanges.
- Reduced use of facial expressions during communication.
Some autistic children develop language later than expected, while others develop words within expected time frames but show differences in how communication is used socially.
It is important to note that many non-autistic children also experience speech delays, so language development alone cannot determine whether a child is autistic.
Repetitive Movements and Play:
Some of the earliest behavioural signs of autism involve repetitive movements, sometimes referred to as stimming.
Parents occasionally report behaviours such as:
- Hand flapping.
- Finger movements near the eyes.
- Repetitive rocking.
- Unusual interest in spinning objects.
- Watching moving objects for prolonged periods.
Research suggests that repetitive behaviours can emerge early in some autistic children, although these behaviours vary considerably between individuals.
It is important to remember that many babies enjoy repetition as part of normal development.
Sensory Differences:
Some autistic babies may demonstrate unusually strong reactions to:
- Loud noises.
- Being bathed or changed.
- Bright lights.
- Particular smells.
What If My Baby Shows Some of These Signs?
Many babies display one or more of these behaviours at some point. It is not possible to know whether a baby has autism or not; an assessment can usually be completed from the age of 2.
Autism is identified through a pattern of differences that persists over time and affects social communication, interaction and behaviour.
If you are concerned about your child’s development, it can be helpful to discuss your observations with your health visitor or your GP.
Conclusion
Autism can sometimes be associated with subtle developmental differences during infancy, particularly in areas such as joint attention, gesture use, social interaction and communication.
Differences in these early social communication skills are amongst the strongest research-supported indicators of later autism.
However, every baby develops differently, and many typically developing children show some of these signs at one point or another.
Autism can be diagnosed from around the age of 2, if you still have concerns at this age you may wish to consider an autism assessment. In the meantime, talk to your health visitor if you have significant concerns about your baby’s development.
References
Charman, T. (2003) ‘Why is joint attention a pivotal skill in autism?’, Philosophical Transactions of the Royal Society B: Biological Sciences, 358(1430), pp. 315–324.
Jones, W. and Klin, A. (2013) ‘Attention to eyes is present but in decline in 2–6-month-old infants later diagnosed with autism’, Nature, 504(7480), pp. 427–431.
Ozonoff, S., Iosif, A.-M., Baguio, F., Cook, I.C., Hill, M.M., Hutman, T., Rogers, S.J., Rozga, A., Sangha, S., Sigman, M. and Young, G.S. (2010) ‘A prospective study of the emergence of early behavioural signs of autism’, Journal of the American Academy of Child & Adolescent Psychiatry, 49(3), pp. 256–266.
Zwaigenbaum, L., Bryson, S., Rogers, T., Roberts, W., Brian, J. and Szatmari, P. (2005) ‘Behavioral manifestations of autism in the first year of life’, International Journal of Developmental Neuroscience, 23(2–3), pp. 143–152.
