From A Mile To A Smile

Symptoms And Signs Of Autism

Symptoms Of Autism

Autism symptoms emerge in toddlers around 18 months but can also be identified in primary school due to complex social environments. Symptoms include challenges in social rules, communication, emotions, rigid behavior, and learning difficulties like inattentiveness and poor observation skills.


You should feel concerned if more than one of these symptoms has occurred: 

  • Not able to point or follow others’ pointing (poor joint attention skills) 
  • Difficulties in understanding others’ emotions and expressing own feelings 
  • Avoidance of eye contact 
  • Poor perspective-taking abilities 
  • Repeating words or sentences and speaking in incomplete sentences 
  • Poor adaptive skills 


boy, child, fishing rod-909554.jpg

Prevalence of Autism

In Hong Kong, the prevalence rate is around 1 in 100 children. In just 10 years, the prevalence rate of autism has risen from 1 to 150 to 1 in 68 children.  

Below is a chart taken from CDC website showing the prevalence findings. 

Risk Factors

Individuals with ASD can be diagnosed at the age of 18 months old or younger. One should be assessed immediately to avoid missing the golden window for interventions, which is normally between the age of 2 to 6. The following groups are at higher risk of having ASD: 

  • Among identical twins, if one child has ASD, then the probability for the other child being affected is 36-95% 
  • Among non-identical twins,  if one child has ASD, then the probability of the other child being affected is  0-31%. 
  • If the first sibling has ASD, the chances for the second child are around 2%-18%. 
  • Children who were born with low birth weight (<2500g) and prematurely (<33 weeks) are at higher risks for having ASD. [Read article] 

There Are Couple Reasons For The Rising Numbers

  1. Broader definition of ASD
  2. Better understanding of ASD
  3. Clinicians have become better at identifying features that were previously missed
  4. Rising populations

4 Main Early Signs In Toddlers With Autism

Many parents are worried about whether their children are autistic. Of course, we encourage parents to seek an assessment as soon as they have doubts.  


However, parents can use the list below as a reference to see if your child needs an autism assessment. Please keep in mind that early assessment will enable you to grasp the prime time and let your children receive treatment as soon as possible. 

Although Each Child Has A Different Type Of Autism, The Main Affected Areas Include:

Defective Language And Communication Skills

Social Skills And Social Interaction Barriers

Poor Cognitive And Adaptive Skills

Limited, Repetitive And Rigid Behavior And Interest

Defective language and communication skills

Parents should monitor their children’s speech development, as most can use single words at 16 months and progress to 2-word phrases by 24 months. Effective communication involves spontaneous expression, seeking help, making requests, and showing interest.

Social skills and social interaction barriers

By 12 months, children start using body language (pointing, shaking/nodding heads), engage in interactions (smiling, pointing), and attempt communication. Eye contact, verbal language, imitation, and gathering information are essential aspects of their communication development.  

Poor cognitive and adaptive development

Cognitive ability is more difficult to observe, but parents can observe whether their children are having more difficulties adapting to changes. For example, whether your child would get upset and throw tantrums when you change the transportation to school. Difficulty adjusting to new classes or small changes in daily life may indicate a need for professional help.

Limited, Repetitive And Stubborn Behavior And Interest

Parents should observe if their children have restricted interests, like a sole focus on cars, common in autism. Resistance to new toys and repetitive behaviors, such as spinning wheels or opening doors, without imaginative play or variation, may indicate autism. 

toddler, girl, laugh-2675884.jpg

Diminished Of Eye Contact In Autism

Diagnosing autism involves assessing eye contact avoidance in children. A US study using eye-tracking technology revealed that typically developing children focus on others’ eyes, interpreting facial expressions and responding to changes. Children with autism also pay attention to eyes but struggle to understand facial expressions, indicating difficulty in comprehending their meaning. 

From a Mile to a Smile

If In Doubt, Seek Assessment As Soon As Possible.