Abby Barnes, M.S., CCC-SLP
When you have a toddler at home, it’s normal to watch their development to see if they’re meeting expected childhood milestones. As part of that, you may wonder if there are specific signs of autism to look for.
When children are 2 years old, some signs of autism may already be present. Let’s discuss possible signs of autism at age 2, how a diagnosis is made, and how speech therapy can help support autistic kids.
Early signs of autism in toddlers
There are some specific signs of autism related to communication, behavior, and social skills that may be present in a 2-year-old:
Delays in spoken language; may talk very little for their age or not at all
Difficulty communicating their needs and desires
As a result of speech and language delays, frequently uses challenging behaviors (such as crying or tantrums) instead of words or gestures to communicate what they want
Difficulty understanding conversations and instructions; may respond to a question by repeating it rather than answering
Consistently repeats words or phrases they just heard or that they heard days or weeks earlier, almost as if they’re echoing speech
Speaks in a robotic tone of voice that lacks inflection or intonation
Lacks interest in the world around them; for example, doesn’t respond when a caregiver points out an object, like a plane flying overhead
Difficulty with sharing toys or taking turns
Avoids eye contact
Prefers not to be touched, held, or cuddled
Dislikes certain sounds, smells, or textures (for example, may like very few foods or choose foods based on texture)
Becomes distressed by a change in daily routine
Repeats unexpected behaviors, such as lining up their toys, rocking their head back and forth, spinning their body, or having trouble staying still
Does a speech delay mean autism?
While a delay in spoken language is a sign of autism, having a speech delay does not mean a child is autistic. A speech delay is typically present with autism. However, a speech delay can exist separately from autism.
There are other language-related signs of autism that may be noticed at age 2. These include:
Not pronouncing simple, single words by age 16 months
Inability to use simple, two-word phrases
Loss of language skills that the child previously had
Can autism be diagnosed at age 2?
Diagnosing autism can be challenging. Your doctor will generally look at your child’s developmental history, as well as their communication and behavior, to make a diagnosis.
While autism can sometimes be diagnosed at age 18 months or younger, by age 2 most diagnoses performed by qualified professionals are reliable. However, some children don’t receive a diagnosis until they’re older, even into their teen or adult years.
There are several steps involved in an autism diagnosis. The Centers for Disease Control and Prevention (CDC) outlines each of these steps in great detail. Ensuring that your child is properly monitored, screened, evaluated, and diagnosed is essential to getting them the care and services they need to live a productive and fulfilling life.
Various experts can diagnose autism. These professionals may include psychologists, pediatricians, and neurologists. Psychologists are a big part of the diagnostic process.
According to the American Psychological Association (APA), a psychologist will likely use the following information to help with their diagnosis:
Talking with the child
Observing the child’s behavior
Tests of cognitive and language abilities
Medical tests to rule out other conditions
Interviews with parents, teachers, or other adults who can answer questions about the child’s social, emotional, and behavioral development
How speech therapy can help toddlers with autism
Challenges with communication and speech, like all aspects of autism, vary from person to person. At age 2, some autistic kids may not be talking at all. Others may speak but are still unable to communicate their needs clearly.
Speech-language pathologists, also known as speech therapists, play a key role in supporting people with autism. They can help autistic people become better communicators and improve both their verbal and nonverbal communication skills. This can enable autistic individuals to form more relationships with others and function better in day-to-day life.
A speech therapist will assess and evaluate your child's communication strengths and challenges, and develop a treatment plan tailored to their specific goals. Your speech therapist will find ways to engage with your child during sessions, whether that involves play, storytime, or movement activities. For example, let’s say the child is working on requesting an item using words or signs. The speech therapist may present something interesting, like bubbles, and have the child either imitate the word or make the sign for “more” or “please.”
Some children may be nonverbal, and there are many types of assistive devices and technologies to help them communicate. These tools are referred to as augmentative and alternative communication (AAC). Your speech therapist will provide guidance on whether your child would benefit from AAC and teach you how to use it. Examples of AAC methods include:
Sign language
Picture exchange communication system (PECS)
Communication applications on tablets or iPads
Speech output devices (such as Dynavox)
What’s the next step?
If you have any questions at all about your child’s development, talk to your pediatrician or reach out to a speech therapist. You can contact Expressable for a free phone consultation to speak with a licensed speech therapist, or take our free online speech and language screener.
No matter what your child’s potential diagnosis may or may not be, there are professionals who can help and provide guidance. At Expressable, we’re here to listen to your concerns and talk about the next steps that are right for your child.
An important note: We believe that when speaking about any community as a whole, the best approach is to prioritize that community’s voices, needs, and preferences. Within the larger autism community, the current language preference is identity-first (e.g., "autistic children"), which is why we use that language in our content. Expressable is committed to listening to and learning from the populations we serve. If and when their preferences change, we’ll adjust our approach accordingly.
