Autism in Toddlers
Autism in toddlers can present as differences in communication, play, social interaction, or sensory responses. While diagnosis in early childhood can be complex, seeking support early can lead to tailored interventions and improved outcomes. Oxford CBT offers private autism assessments to people from London, Oxford and nearby areas.
It’s natural to have questions when your toddler’s development doesn’t quite follow the pattern you expected. Perhaps they’re not speaking as much as other children their age, or they seem unusually sensitive to certain sounds or textures. Maybe they prefer to play alone or repeat the same actions again and again (you might like to take a look at our article Stimming in Autism to get a better understanding of this behaviour). These differences can be confusing, and it’s common to wonder what they might mean.
Autism is one possible explanation, and recognising the signs early can be a helpful first step toward understanding your child’s unique way of experiencing the world. While every toddler is different, knowing what to look for and where to seek support can make a real difference to your child’s well-being, both now and in the years ahead.
In this article, we’ll explore how autism may present in toddlers, what the diagnosis process involves, and how parents and caregivers can support their child with confidence and compassion.
How Autism Can Present in Toddlers
Autism can look very different from one toddler to the next. Some children show noticeable differences in behaviour or development early on, while others may seem to be developing typically and then begin to show signs more gradually.
It’s not always easy to tell what’s part of a child’s personality and what might signal something more, but the following areas highlight how autism may present in young children.
Social and Emotional Differences
Toddlers on the autism spectrum may respond to social situations in ways that feel unfamiliar. They might seem less interested in people around them, find eye contact uncomfortable, or prefer playing alone. Some may not respond to their name or may show less awareness of others’ emotions. This doesn’t mean they don’t care or enjoy connection, it often means they’re processing social information differently.
Communication and Language Delays
Speech and language can develop more slowly in autistic toddlers. Some children may speak later than expected or use fewer gestures, like pointing or waving. Others may develop language on time but use it in ways that seem unusual, such as repeating phrases from TV shows (echolalia) or speaking in a sing-song voice.
It’s also common for autistic toddlers to have difficulty with back-and-forth conversation or to appear to show less interest in sharing things for social reasons (like pointing out something just to show you).
Sensory Sensitivities and Repetitive Behaviours
Many toddlers with autism experience the world through heightened or reduced sensitivity to sights, sounds, textures, or movement. They may cover their ears in response to everyday noises or become distressed by certain clothing textures. Others might seek out sensory experiences, like spinning, flapping hands, or watching things that move repetitively. Repetitive behaviours, such as lining up toys or sticking rigidly to routines, can also be a sign.
Play and Interaction Styles
Play can offer valuable insight into how your toddler sees the world. Some autistic toddlers may not engage in pretend play or might play in ways that seem more focused on objects than on people, for example, spinning wheels instead of pushing a toy car.
It’s important to remember that all children have different personalities, and there’s a wide range of what’s considered typical. If you have more than one child, you may find yourself comparing their behaviours, which can be both reassuring and confusing. For example, if you have an older child who is autistic, you may wonder if your younger toddler is showing similar traits or something completely different. Autism is a spectrum, so even siblings with the same diagnosis can present in very different ways.
On the other hand, if you have an older neurotypical child and notice your toddler is developing differently, it’s understandable to question whether it’s simply a difference in personality or something that needs further exploration.
In many cases, your instincts as a parent or caregiver are worth listening to. If something doesn’t feel quite right, it’s okay to seek advice, even if you’re not sure what you’re seeing fits a specific pattern.
Can Toddlers Be Diagnosed with Autism?
While diagnosing autism in toddlers can be complex, it is possible and often beneficial to identify signs early. For many parents, concerns arise during the toddler years, particularly as language and social milestones become more apparent. Although every child develops at their own pace, consistent differences in communication, play, or social engagement may prompt a closer look.
When Professionals May Consider a Diagnosis
Healthcare professionals may begin considering an autism diagnosis when a toddler consistently shows signs such as delayed speech, limited eye contact, difficulty with social interaction, or unusual behaviours like repetitive movements or intense reactions to sensory input. These signs are typically observed over time, rather than based on a single appointment.
If concerns are raised either by parents, nursery staff, or health visitors, a referral for a more formal developmental assessment may be made. In the UK, this might happen through the NHS or via a private clinic like Oxford CBT, depending on the route you choose.
Typical Age of Assessment
A formal diagnosis of autism can be made from around 18 to 24 months, although some children are assessed later. Many professionals prefer to wait until at least age 2, when developmental patterns are clearer, especially in terms of communication, social interaction, and play.
However, this doesn’t mean you have to wait until your child is older to seek support. If you’re noticing signs now, raising them with your GP or health visitor can help get the right support in place by school age, as the waiting list for NHS assessments are often several years long.
Developmental Variability and What to Watch For
As discussed earlier, autism presents differently from child to child. Some toddlers may not speak at all, while others might use a large vocabulary but struggle with back-and-forth conversation. One child might avoid eye contact and prefer to play alone, while another enjoys interaction but becomes overwhelmed easily.
It’s helpful to look at your child’s development in context. Are they meeting milestones in communication and play? Are you seeing differences that feel significant compared to their peers or siblings?
The key is consistency and context. If certain patterns keep appearing, especially in multiple settings, like home and nursery, they may point to underlying neurodevelopmental differences worth exploring further with a professional.
Understanding the Autism Diagnosis Process
If you decide to pursue an autism assessment for your toddler, understanding how the process works can help you feel more prepared. Assessments are designed to build a full picture of your child’s development, not just through what they do on the day, but through your observations as a parent or caregiver, and those of other professionals who know your child well.
Who Carries Out the Assessment
In the UK, autism assessments for toddlers are typically carried out by a multi-disciplinary team. This may include a paediatrician, speech and language therapist, psychologist, or specialist in neurodevelopmental conditions. Sometimes, especially in private settings, assessments may be carried out by a single highly trained clinician with experience in early childhood autism.
Whether through the NHS or a private provider like Oxford CBT, the team will take time to explore your child’s developmental history, current behaviours, and any concerns you’ve raised.
Tools Used to Assess Autism in Young Children
Professionals use a combination of structured tools and observations to guide their decision-making. These might include:
- The ADOS-2 (Autism Diagnostic Observation Schedule): a play-based assessment used to observe social communication, play, and repetitive behaviours
- The DISCO (Diagnostic Interview for Social and Communication Disorders): an in-depth parent interview covering a child’s developmental history
- Developmental checklists based on DSM-5 or ICD-11 criteria for autism
- Speech and language assessments to understand communication strengths and difficulties
Parental input is central. You’ll often be asked to describe behaviours at home and in nursery, share any reports from professionals, and reflect on your child’s development over time.
What to Expect During the Appointment
The appointment usually includes both observation and conversation. A clinician may play or interact with your child in structured ways while noting their responses, interests, and communication patterns. At the same time, you’ll be asked questions about how your child behaves in everyday life – their routines, reactions to change, social preferences, and more.
Sometimes, multiple sessions are needed to complete the assessment, especially if your child is very young, tired, shy, or overwhelmed on the day.
After the assessment, the team may provide verbal feedback first, followed by a written report with their findings and recommendations. If a diagnosis is made, it will also include advice on next steps and available support.
Limitations of Diagnosing Autism in Toddlers
Diagnosing autism in very young children can be challenging. Many behaviours that are considered ‘red flags’ for autism, such as delayed speech or limited eye contact, can also be part of typical development or related to other developmental conditions.
It’s important to understand that autism is a lifelong diagnosis. This means professionals take great care before making a decision, especially when a child is under the age of 3. Some practitioners may prefer to monitor a child over time before confirming a diagnosis, while others may offer a provisional diagnosis with a plan for ongoing review.
This caution isn’t about withholding support, it’s about ensuring any diagnosis is accurate and meaningful. If your child doesn’t meet the full criteria at the time of assessment, you can still access help based on their needs and continue to seek further evaluation later if needed.
Why Seek a Diagnosis in the Toddler Years?
For many parents, the idea of pursuing a diagnosis in the toddler years can feel daunting. It’s a big step, and it’s natural to wonder whether it’s too early or whether things might “even out” with time. While it’s true that development can vary widely in the early years, there are compelling reasons why exploring a diagnosis early can be helpful, even if the outcome is simply better understanding and support.
Early Support Can Make a Difference
When autism is recognised early, support can begin earlier too – and that can make a meaningful difference to your child’s development. For example, interventions that focus on communication, emotional regulation, and social interaction are often more effective when introduced early, during the toddler years, due to the brain’s heightened neuroplasticity [1]. An early diagnosis doesn’t change who your child is, but it can help you better understand how they experience the world and how to support them as they grow.
Access to Tailored Interventions and Services
In both NHS and private settings, a formal diagnosis may open doors to support services that might otherwise be difficult to access. This can include:
- Specialist speech and language therapy
- Parent-child interaction programmes
- Support with sensory processing
- Nursery or school-based adjustments
- Local authority early years inclusion support
Having a diagnosis also helps professionals tailor their approach to your child’s needs, ensuring they’re not expected to “fit in” with typical developmental models, but are supported in ways that align with how they naturally learn and communicate.
Supporting the Wider Family and Nursery Environment
A diagnosis can also help those around your child like siblings, extended family and nursery staff, better understand their behaviour and needs. It allows you to advocate for your child with more clarity, and gives others a framework for offering support.
For nursery settings, a diagnosis may trigger access to extra funding or one-to-one support, as well as training for staff on how to create a more autism-friendly environment. At home, it can give parents and carers the reassurance that their observations are valid and provide a foundation for making informed decisions about routines, communication strategies, and family life.
How to Show Your Toddler Meets Diagnostic Criteria
One of the most helpful things you can do during the assessment process is to provide a clear picture of your child’s behaviour over time and in different settings. Professionals don’t rely on a single moment or test to make a diagnosis – they need to build a rounded view of how your toddler communicates, interacts, and experiences the world. Your input is central to this.
Gathering Observations and Examples
Start by noting specific behaviours that stand out to you. These could include:
- Limited response to name
- Lack of pointing to share interest
- Unusual ways of playing with toys
- Strong reactions to sensory experiences
- Repetitive movements or routines
- Difficulty with changes in routine or transitions
Whenever possible, include examples, for instance, “He doesn’t point to show us things he likes” or “She prefers to watch other children rather than play with them.”
Even if a behaviour doesn’t happen every day, it’s still worth noting. Patterns over time are often more informative than isolated incidents.
Completing Questionnaires or Screening Tools
As part of the process, you may be asked to complete developmental questionnaires or autism screening tools. These might include:
- M-CHAT-R/F (Modified Checklist for Autism in Toddlers – Revised with Follow-Up)
- Ages and Stages Questionnaires (ASQ)
- Social Communication Questionnaire (SCQ)
Answering these as honestly and thoroughly as you can helps professionals understand which areas need further exploration. If you’re unsure how to answer certain questions, for example, if your child’s behaviour varies from day to day, you can make a note of that too. These tools aren’t meant to give a final answer but to support deeper conversations during assessment.
Input from Nursery or Childcare Settings
If your toddler attends nursery, preschool, or is regularly cared for by someone outside the family, their input can be very valuable. Often, professionals will ask for observations from staff who see your child in a group setting. They may also request a report or ask for specific feedback around:
- How your child plays and interacts with others
- Communication styles and challenges
- Sensory sensitivities or repetitive behaviours
- Any strategies already in place to support them
Differences between home and nursery behaviour can also be helpful to highlight as many autistic toddlers “mask” or behave differently in one setting than another, and professionals take this into account when building a full picture.
How to Support Your Toddler if You Suspect Autism
If you’re starting to think your toddler may be autistic, you don’t need to wait for a formal diagnosis to begin offering support. Many simple, everyday strategies can help your child feel more secure, understood, and connected. At the same time, it’s important to look after your own well-being and know when to seek professional advice
Practical Ways to Help with Communication and Behaviour
You don’t need specialist training to start making a difference at home. A few key approaches can go a long way:
- Follow their lead in play, even if it’s repetitive or unusual. Join in gently rather than trying to redirect.
- Use clear, simple language and allow extra time for responses. Pairing words with gestures can be helpful.
- Create routines to build predictability – visual schedules or photos can help toddlers understand what’s coming next.
- Minimise sensory overload and be mindful of noise, lighting, or clothing that might feel overwhelming.
- Acknowledge their communication style. Whether it’s through actions, gestures, or behaviour, all communication is valid.
Above all, observe what soothes or excites your child and adapt your environment to support them.
Finding Support as a Parent or Carer
Caring for a child whose development is different can be emotionally demanding, especially when you’re juggling uncertainty and trying to do what’s best. It’s normal to feel unsure, frustrated, or isolated at times.
Connecting with others who’ve been through similar experiences, whether through support groups, online communities, or local parent networks, can be a valuable source of reassurance and advice.
It may also help to speak with a therapist or parenting professional who understands neurodiversity. At Oxford CBT, our clinicians regularly support parents in navigating these early stages, helping you feel more confident and equipped to support your child.
When and How to Seek Professional Help
If your concerns persist, or if your instincts tell you something needs a closer look, reaching out to a professional is a positive step. You might choose to speak to:
- Your GP or health visitor (especially if you’re looking to pursue NHS assessment)
- A speech and language therapist
- A neurodevelopmental specialist or psychologist
- A private assessment service like Oxford CBT
Oxford CBT offers private autism assessments for children in Oxford, London, and surrounding areas. If you’re based locally and would like to explore whether a formal assessment is appropriate, our team can guide you through the process and help you understand your options.
Even if your child is not diagnosed, the process can bring clarity and lead to helpful recommendations for supporting their development.
What Is the Outlook for an Autistic Toddler?
Hearing the word “autism” in relation to your child can raise a lot of questions about their future. But the reality is that there is no single outcome for autistic children because there is no single way to be autistic. Autism is a spectrum, and each child will follow their own path, shaped by their strengths, needs, environment, and the support they receive.
Understanding the Spectrum
Autism is not a linear scale from “mild” to “severe”, it’s a broad and varied profile that affects people in different ways across different areas of life. Some autistic children grow up to need minimal support and will thrive with support in mainstream settings. Others may need more ongoing help with communication, daily routines, or managing sensory experiences.
Importantly, early signs don’t predict long-term ability. A toddler who isn’t yet speaking may go on to develop fluent language. One who avoids group play might later enjoy strong one-to-one friendships. Outcomes are shaped by more than traits – support, understanding, and acceptance all play a crucial role.
Areas of Strength and Challenge
While some aspects of development may be delayed or different, autistic children often show deep strengths and passions. These might include:
- A strong memory for facts or routines
- Exceptional attention to detail
- Creative or abstract thinking
- A deep affinity for specific interests
At the same time, your child may face challenges in certain areas, such as managing emotions, understanding social cues, or adapting to change. These challenges aren’t fixed and can be supported in ways that make day-to-day life more manageable.
The Role of Individualised Support
Tailored, early support is often linked with more positive outcomes. For example, a 2014 study published in the Journal of the American Academy of Child and Adolescent Psychiatry found that children diagnosed before age 4 were more likely to receive early intervention services, which were in turn associated with improved long-term outcomes in social and adaptive functioning [2].
Other studies have shown that parents who identify and respond to early differences, even before a formal diagnosis, often play a key role in helping their children develop vital communication and social skills [3]. The fact that you’re reading this article today demonstrates your commitment to supporting your child, which will stand them in good stead for their future.
Importantly, an early diagnosis doesn’t mean a child will always need high levels of support. Many autistic children go on to become independent, fulfilled adults. Likewise, some children who seem to be doing well early on may need additional help at later stages, such as during school transitions or adolescence, so it’s important to remember that like with any life, there will be highs and lows and periods of adapting.
What matters most is recognising and responding to each child’s individual profile, rather than making assumptions based on a label. With the right support, autistic toddlers can grow into confident, capable young people with a strong sense of self and a wide range of opportunities.
Conclusion
Noticing early differences in your toddler’s development can bring up a mixture of emotions – curiosity, concern, even confusion. But tuning into your instincts and seeking answers is a positive and proactive step. Whether or not your child goes on to receive a diagnosis, exploring these signs can help you better understand their needs and create a more supportive environment for them to grow and thrive.
Autism is not a fixed outcome, it’s a different way of experiencing the world. And with the right support, autistic children can flourish in ways that reflect their unique strengths and personalities.
If you’re based in Oxford, London, or the surrounding areas and would like to speak with a specialist about your child’s development, Oxford CBT offers private autism assessments for children. Our experienced clinicians can guide you through the process with care, clarity, and compassion, helping you take the next step with confidence.
To learn more or to book an initial consultation, please contact us at Oxford CBT.
References
- Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J., Donaldson, A., & Varley, J. (2010). Randomized, controlled trial of an intervention for toddlers with autism: The Early Start Denver Model. Pediatrics, 125(1), e17–e23. https://doi.org/10.1542/peds.2009-0958
- Daniels AM, Halladay AK, Shih A, Elder LM, Dawson G. Approaches to autism spectrum disorder diagnosis: Use of evidence-based and individualized assessments in community settings. J Am Acad Child Adolesc Psychiatry. 2014 Apr;53(4):390–398. https://web.math.princeton.edu/~sswang/developmental-diaschisis-references/Daniels%20et%20al%202014%20J%20Am%20Acad%20Child%20Adolescent%20Psychiatry.pdf
- Zwaigenbaum L et al. Early identification and interventions for autism spectrum disorder: Executive summary. Pediatrics. 2015 Oct;136(Supplement 1):S1–S9.https://europepmc.org/article/PMC/PMC9923899
Author – Tom Murfitt
With over a decade’s experience in providing Cognitive Behavioural Therapy, Tom has worked in both the NHS and private sector to help adults and children to overcome a range of difficulties and improve their mental wellbeing. In addition to being an experienced CBT therapist, Tom is also an accredited Mindfulness teacher, providing courses locally, in businesses and schools. You can read more about us here.
DISCLAIMER: The information provided in this article is intended for general informational purposes only and should not be construed as medical advice, diagnosis, or treatment. The products and methods mentioned are not a substitute for professional medical advice from a trained healthcare specialist. Always seek the guidance of your doctor or other qualified health professional with any questions you may have regarding your health or a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. Use of the information and products discussed is at your own risk.
