# Signs of autism in young children, and when to ask for help > Signs of autism in young children include talking late, not responding to their name, not pointing or showing you things, playing alone or in the same way over and over, great distress at changes, and strong reactions to sounds, textures or food. No single sign means a child is autistic. If you notice a pattern at home and at nursery or school, talk to your GP, health visitor or SENCO. - Canonical page: https://rocksmakepebbles.co.uk/guides/signs-of-autism-in-children - Publisher: Rocks Make Pebbles (https://rocksmakepebbles.co.uk) - Topic: Signs, assessment and diagnosis - Applies to: UK - Last updated: 28 September 2026. Checked against sources: 28 September 2026 - Professional review: Not yet reviewed (waiting for review by a paediatrician or clinical psychologist and speech and language therapist) - Drafted with the help of AI tools and checked against the sources listed below. Editorial policy: https://rocksmakepebbles.co.uk/editorial-policy ## Key points - Professionals look for a pattern across home and nursery or school, not one sign on its own. - Eye contact, cuddles, pretend play and meeting language milestones do not rule autism out. - Autism can look different in girls and in children who talk well. - If your child loses words or skills they used to have, see your GP promptly. - Online checklists can't tell you if your child is autistic. Take your notes and examples to a professional instead. ## What are the signs of autism in young children? Signs of autism are differences in how a child communicates, plays and gets on with others, copes with change, and reacts to sounds, textures and other sensations ([NHS](https://www.nhs.uk/conditions/autism/signs/children/)). Some are skills that develop later than expected, such as talking or pointing. Others are behaviours that are unusual for the child's age, such as repeating phrases or great distress at small changes. NICE says these features "are not intended to be used alone, but to help professionals recognise a pattern" ([NICE CG128 full guideline](https://www.nice.org.uk/guidance/cg128/resources/autism-spectrum-disorder-in-under-19s-recognition-referral-and-diagnosis-pdf-35109456621253)). So one sign on its own does not mean a child is autistic. Professionals consider how strong the signs are, how long they have lasted, whether they show up in different places such as home and nursery, how much they affect your child and family, and whether something else could explain them ([NICE CG128](https://www.nice.org.uk/guidance/cg128/chapter/Recommendations)). NICE also says professionals should always take parents' concerns about development or behaviour seriously, even if others don't share them. Use this guide to help you notice and describe what you see, not to diagnose. ## What can autism look like at different ages? Signs can change as children grow. This table groups examples from the [NHS](https://www.nhs.uk/conditions/autism/signs/children/) and [NICE](https://www.nice.org.uk/guidance/cg128/resources/autism-spectrum-disorder-in-under-19s-recognition-referral-and-diagnosis-pdf-35109456621253) lists. Signs overlap between age groups, and your child may show some at a different age, or not at all. | Age | Talking and understanding | Playing and being with others | Routines, movement and senses | |---|---|---|---| | Toddlers (about 1 to 3) | Late babbling or first words, such as fewer than 10 words by age 2; not responding to their name, even though their hearing is fine | Not pointing or showing you things to share interest; not following your point; smiling back less; playing alone | Playing the same way over and over, such as opening and closing doors; very strong, or very little, reaction to sounds, textures or food | | Preschool (about 3 to 5) | Repeating words or phrases ([echolalia](https://rocksmakepebbles.co.uk/glossary#echolalia)); saying "you" or their own name instead of "I" after age 3; a flat or unusual tone of voice | Little pretend play; copying others less; finding it hard to join in with other children | Hand flapping, rocking or spinning; very intense interests; great distress at changes or new places | | Primary school (5 to 11) | Talking a lot about their own interests; taking things literally and missing sarcasm; very formal speech | Few close friends; expecting others to stick rigidly to the rules of a game; acting out scenes from TV rather than making up play | Needing routines and things to be "just right"; change leading to anxiety or distress; intense, narrow interests | At any age, some autistic children avoid being touched or get very close to people, seek out movement or pressure, eat only certain textures, or find it hard to say when they are hungry or in pain ([NHS](https://www.nhs.uk/conditions/autism/signs/children/)). ## Can autism look different in girls, or in children who talk well? Yes. NICE warns that autism "may be under-recognised in girls", and may be missed in children who are verbally able or who have a learning disability ([NICE CG128](https://www.nice.org.uk/guidance/cg128/chapter/Recommendations)). Boys are diagnosed more often, but a review of 54 studies found the real ratio is "closer to 3:1" than the 4:1 often quoted, which suggests girls are being missed ([Loomes and colleagues, 2017](https://pubmed.ncbi.nlm.nih.gov/28545751/)). The [NHS](https://www.nhs.uk/conditions/autism/signs/children/) says autistic girls may be more likely to: - copy other children - stay quiet in situations they find hard - seem to cope well socially - show fewer repetitive behaviours than boys This is sometimes called [masking](https://rocksmakepebbles.co.uk/glossary#masking): hiding or making up for autistic traits to fit in. The NHS says boys can mask too. In a review of research on girls and young women, parents described barriers such as girls covering up their difficulties, other people's views and clinician bias ([Lockwood Estrin and colleagues, 2021](https://pubmed.ncbi.nlm.nih.gov/34868805/)). A child who talks early and well can still be autistic. The NHS lists an advanced but formal vocabulary and taking things literally among the signs in older children, and NICE describes children whose way of talking is "overly formal or inappropriately familiar" ([NICE CG128 full guideline](https://www.nice.org.uk/guidance/cg128/resources/autism-spectrum-disorder-in-under-19s-recognition-referral-and-diagnosis-pdf-35109456621253)). Some children seem settled at nursery or school and then struggle at home. The [NHS](https://www.nhs.uk/conditions/autism/supporting-a-child/) says behaviour can differ between school and home, and that children may need time to settle when they get back. Write down what happens after nursery or school as well as during the day. ## What doesn't rule autism out? Some things people say mean a child "can't be autistic" do not rule it out. [NICE guideline CG128](https://www.nice.org.uk/guidance/cg128/chapter/Recommendations) says autism should not be ruled out because of: - good eye contact, smiling and showing affection to family - pretend play, or meeting language milestones - difficulties seeming to ease once extra support is in place, such as a well-structured nursery - an earlier assessment that found no autism, if new information comes to light > **Myth:** "She looks at me and gives cuddles, so she can't be autistic." NICE says good eye contact, smiling and affection do not rule autism out. What matters is the overall pattern in how your child communicates, plays, copes with change and reacts to the world around them. The reverse is true too. NICE says individual signs can have other explanations ([NICE CG128](https://www.nice.org.uk/guidance/cg128/chapter/Recommendations)). Hand flapping when excited, or talking late, does not on its own mean a child is autistic. ## Is it autism or a speech delay? It can be hard to tell at first, and the two overlap. Talking late is one of the signs of autism, but it has other causes too, and NICE lists language disorders among the other conditions professionals should consider ([NICE CG128](https://www.nice.org.uk/guidance/cg128/chapter/Recommendations)). You don't have to work it out on your own. These steps help: 1. **Look beyond words.** Autism affects more than talking. Notice how your child shares interest with you, by pointing, showing you things or looking between you and something, and how they play, respond to their name and cope with change and noise. NICE looks at all of these alongside language ([NICE CG128 full guideline](https://www.nice.org.uk/guidance/cg128/resources/autism-spectrum-disorder-in-under-19s-recognition-referral-and-diagnosis-pdf-35109456621253)). 2. **Get your child's hearing checked.** NICE describes not responding to their name "despite normal hearing" as a feature, so it's worth ruling out hearing loss. A review found that when a child has both hearing loss and autism, diagnosing one often delays diagnosing the other, and that hearing tests which depend on a child's reactions can be less reliable in autistic children ([Beers and colleagues, 2014](https://europepmc.org/article/MED/24300947)). A GP can refer your child to an audiologist ([NHS](https://www.nhs.uk/conditions/hearing-tests-children/)). 3. **Ask for speech and language therapy.** You can ask for this without knowing whether your child is autistic. Start with your local NHS children's [speech and language therapy](https://rocksmakepebbles.co.uk/glossary#speech-and-language-therapist) team, or ask your GP for a referral ([Communication Matters](https://www.communicationmatters.org.uk/what-is-aac/assessment/)). Routes vary: one NHS trust, for example, offers parents of preschool children a phone advice appointment, while school-age children are referred through the SENCO ([Cambridgeshire and Peterborough NHS Foundation Trust](https://www.cpft.nhs.uk/speech-and-language-therapy-referrals/)). Waits are long: in April 2026, 66,695 children and young people in England were on speech and language therapy waiting lists ([UK Parliament written answer](https://questions-statements.parliament.uk/written-questions/detail/2026-06-22/11799)). 4. **Say if you're worried about autism.** You can raise a speech and language therapy referral and an autism referral at the same time. If you're told to wait and see, ask what to look out for and when it will be reviewed. If you still disagree, the [National Autistic Society](https://www.autism.org.uk/advice-and-guidance/diagnosis/before-diagnosis/how-to-request-an-autism-assessment) says you can ask a different doctor for a second opinion. If your family speaks another language at home, tell professionals how your child uses and understands that language too. NICE asks them to consider this ([NICE CG128](https://www.nice.org.uk/guidance/cg128/chapter/Recommendations)). ## What if my child has stopped using words or skills? Losing words or skills your child used to have, sometimes called [regression](https://rocksmakepebbles.co.uk/glossary#regression), should always be checked promptly, even if your child is already waiting for an autism assessment. It can be part of autism, but it can also have other causes, and NICE sends some children to a paediatrician or paediatric neurologist first ([NICE CG128](https://www.nice.org.uk/guidance/cg128/chapter/Recommendations)). | Your child's age | Skills lost | Where NICE says to refer | |---|---|---| | Under 3 | Language or social skills | The autism team | | Over 3 | Language | A paediatrician or paediatric neurologist first | | Any age | Movement skills, such as walking or using their hands | A paediatrician or paediatric neurologist first | In a 2013 review of 85 studies, about 1 in 3 autistic children were reported to have lost some skills, on average at about 21 months old. Rates were lower in studies of whole populations (22%) than in parent surveys (41%) ([Barger and colleagues, 2013](https://pubmed.ncbi.nlm.nih.gov/22855372/)). > **Get help now:** If your child has lost words, social skills or movement skills, see your GP promptly and describe what has changed and when. Don't wait for the autism assessment. Call 999 if your child has a seizure for the first time, or one that lasts longer than 5 minutes ([NHS](https://www.nhs.uk/conditions/epilepsy/)). ## Can an online checklist or the M-CHAT tell me if my child is autistic? No. Online quizzes and questionnaires, including the M-CHAT that many parents find online, can't tell you whether your child is autistic. NICE says tools like these are not essential and should not be used to make or rule out a diagnosis. A score that flags concerns may support a referral but can happen for reasons other than autism, and a score that doesn't flag concerns does not rule autism out ([NICE CG128](https://www.nice.org.uk/guidance/cg128/chapter/Recommendations)). The UK does not screen all children for autism. The [UK National Screening Committee](https://view-health-screening-recommendations.service.gov.uk/autism/) does not recommend it, because "there is not currently a test that is good enough for screening the general population" and it is not known whether screening would improve long-term outcomes. Children in England do have routine development checks, including a written progress check at age 2 and a health visitor check between 2 and 3 ([GOV.UK](https://www.gov.uk/children-with-special-educational-needs/special-educational-needs-support)). These are not autism tests, but they are a good time to raise concerns. A checklist can still help you organise your thoughts. Use it as a prompt for your own notes, then take the notes and examples, not the score, to a professional. ## Who should I talk to first, and how do I prepare? Talk to whoever is easiest for you to reach: your GP, your [health visitor](https://rocksmakepebbles.co.uk/glossary#health-visitor) if your child is under 5, or the [SENCO](https://rocksmakepebbles.co.uk/glossary#senco) (special educational needs co-ordinator) at nursery or school. The [NHS](https://www.nhs.uk/conditions/autism/signs/children/) says to speak to a GP if you think your child might be autistic. A GP can often refer your child to the local autism team, but in some areas the school or health visitor needs to make the referral ([NHS](https://www.nhs.uk/conditions/autism/assessments/)). GPs and health visitors don't diagnose autism themselves: a team of professionals does that at the [assessment](https://rocksmakepebbles.co.uk/guides/autism-assessment-for-children). Before the appointment: 1. Write down what you've noticed, with examples and rough dates, at home, at nursery or school and when you're out. The [National Autistic Society](https://www.autism.org.uk/advice-and-guidance/diagnosis/before-diagnosis/how-to-request-an-autism-assessment) suggests taking notes or a list of signs, and has a list of questions you could ask. 2. Note when your child reached milestones such as first words, pointing and walking, and anything they have stopped doing. 3. Take short videos of things a professional may not see in the room, such as how your child plays or reacts in a busy shop. Keep them private and share them only with professionals. 4. Ask nursery or school what they notice, and bring anything they write down. 5. Mention family history, such as an autistic brother or sister, which NICE lists among factors linked with a higher chance of autism ([NICE CG128](https://www.nice.org.uk/guidance/cg128/chapter/Recommendations)). 6. Write your questions down, and take someone with you if you can. If the GP won't refer your child and you're still worried, you can ask a different doctor for a second opinion ([National Autistic Society](https://www.autism.org.uk/advice-and-guidance/diagnosis/before-diagnosis/how-to-request-an-autism-assessment)). > **Good to know:** You don't need a diagnosis to get help. In England, nurseries and schools should support your child based on their needs, not a diagnosis ([IPSEA](https://www.ipsea.org.uk/blog/the-myth-of-needing-a-diagnosis-before-you-can-get-support)). See [what you can do while you wait](https://rocksmakepebbles.co.uk/guides/waiting-for-an-autism-assessment). > **Scotland, Wales and Northern Ireland:** The signs are the same across the UK, but routes to assessment differ. Scotland follows SIGN guidelines rather than NICE ([National Autistic Society](https://www.autism.org.uk/advice-and-guidance/diagnosis/before-diagnosis/how-to-request-an-autism-assessment)). In Northern Ireland, parents can also raise concerns directly with services ([Autism NI](https://autismni.org/what-is-autism/about-autism/autism-diagnosis)). Ask your GP or health visitor how referral works where you live. ## Where can I get more help? - The NHS page on [signs of autism in children](https://www.nhs.uk/conditions/autism/signs/children/) is useful to share with family. - The [National Autistic Society](https://rocksmakepebbles.co.uk/where-to-get-help#nas) explains how to ask for an assessment. - [Contact](https://rocksmakepebbles.co.uk/where-to-get-help#contact), the charity for families with disabled children, has a free helpline on 0808 808 3555 ([Contact](https://contact.org.uk/help-for-families/information-advice-services/)). - [Speech and Language UK](https://rocksmakepebbles.co.uk/where-to-get-help#speech-and-language-uk) has information if you're worried about your child's talking. - Your local [SENDIASS](https://rocksmakepebbles.co.uk/where-to-get-help#sendiass) gives free advice about support at nursery or school. - In Scotland, Wales and Northern Ireland, try [Scottish Autism](https://rocksmakepebbles.co.uk/where-to-get-help#scottish-autism), [SNAP Cymru](https://rocksmakepebbles.co.uk/where-to-get-help#snap-cymru) or [Autism NI](https://rocksmakepebbles.co.uk/where-to-get-help#autism-ni). - Next, read [what autism is](https://rocksmakepebbles.co.uk/guides/what-is-autism) and [what happens at an autism assessment](https://rocksmakepebbles.co.uk/guides/autism-assessment-for-children). ## Questions parents ask ### Is my toddler autistic or just a toddler? Many toddlers do some things that can also be signs of autism, such as talking late, flapping their hands when excited or getting upset when routines change. Professionals look for a pattern: several signs, lasting over time, seen at home and at nursery, that affect everyday life. If you're unsure, write down what you notice with dates and examples and talk to your health visitor or GP. NICE says professionals should always take parents' concerns seriously. ### My child makes eye contact and gives cuddles. Can they still be autistic? Yes. NICE guidance says autism should not be ruled out because a child has good eye contact, smiles and shows affection to family, plays pretend or met their language milestones. Autism looks different in different children. What matters is the overall pattern in how your child communicates, plays, copes with change and reacts to sounds, textures and other sensations. ### Is it autism or speech delay? It can be hard to tell at first. Talking late is one sign of autism, but it has other causes too, and NICE asks professionals to consider language disorders. Autism affects more than words, such as pointing, sharing interest, play and coping with change. Ask your GP or health visitor for a hearing check and a speech and language therapy referral, and say if you're worried about autism. You don't need to choose one route first. ### My child used to say words and has stopped. What should I do? See your GP promptly, and don't wait for an autism assessment. Losing words, social skills or movement skills always needs checking. NICE says children under 3 who lose language or social skills should be referred to the autism team, and children over 3 who lose language, or children of any age who lose movement skills, should see a paediatrician or paediatric neurologist first. Write down what your child used to do and when it changed. ### What are the signs of autism in girls? Autistic girls can show the same signs as boys, but the NHS says girls may be more likely to copy other children, stay quiet when things are hard, seem to cope socially and show fewer repetitive behaviours. NICE warns that autism may be under-recognised in girls. Notice whether your daughter seems settled at nursery or school but is exhausted or upset at home, and mention this when you speak to a professional. ### Is there an online test that can tell me if my child is autistic? No. Online quizzes and questionnaires, including the M-CHAT, cannot diagnose autism or rule it out. NICE says a score that flags concerns may support a referral but can happen for reasons other than autism, and a score that doesn't flag concerns does not rule autism out. The UK does not screen all children for autism, because no test is good enough. Take your notes and examples to your GP or health visitor instead. ### Can a health visitor diagnose autism? No. Health visitors and GPs do not diagnose autism, but they can listen to your concerns. A GP can often refer your child to the local autism team, and in some areas the health visitor makes the referral. The diagnosis itself comes from a team, which NICE says should include a paediatrician or child psychiatrist, a speech and language therapist and a psychologist. If your child is under 5, your health visitor is a good person to talk to first. ### Nursery says my child is fine, but at home it's very different. Who is right? You may both be right. Many autistic children behave differently in different places, and some seem settled at nursery or school but need time to recover when they get home. NICE says professionals should always take parents' concerns seriously, even if others don't share them. Keep notes and short videos of what happens at home, and share them with your GP, health visitor or SENCO. ## Sources 1. [Signs of autism in children](https://www.nhs.uk/conditions/autism/signs/children/), NHS, 6 May 2026 2. [Autism spectrum disorder in under 19s: recognition, referral and diagnosis (CG128), recommendations](https://www.nice.org.uk/guidance/cg128/chapter/Recommendations), NICE, April 2025 3. [Autism spectrum disorder in under 19s: recognition, referral and diagnosis (CG128), full guideline PDF](https://www.nice.org.uk/guidance/cg128/resources/autism-spectrum-disorder-in-under-19s-recognition-referral-and-diagnosis-pdf-35109456621253), NICE, 20 December 2017 4. [What is the male-to-female ratio in autism spectrum disorder? A systematic review and meta-analysis (Loomes, Hull and Mandy)](https://pubmed.ncbi.nlm.nih.gov/28545751/), Journal of the American Academy of Child and Adolescent Psychiatry, June 2017 5. [Barriers to autism spectrum disorder diagnosis for young women and girls: a systematic review (Lockwood Estrin and colleagues)](https://pubmed.ncbi.nlm.nih.gov/34868805/), Review Journal of Autism and Developmental Disorders, 2021 6. [Supporting an autistic child](https://www.nhs.uk/conditions/autism/supporting-a-child/), NHS 7. [Systematic review of autism and hearing loss (Beers and colleagues)](https://europepmc.org/article/MED/24300947), International Journal of Pediatric Otorhinolaryngology, 2014 8. [Hearing tests for children](https://www.nhs.uk/conditions/hearing-tests-children/), NHS 9. [AAC assessment](https://www.communicationmatters.org.uk/what-is-aac/assessment/), Communication Matters 10. [Speech and language therapy referrals](https://www.cpft.nhs.uk/speech-and-language-therapy-referrals/), Cambridgeshire and Peterborough NHS Foundation Trust 11. [Written question 11799: speech and language therapy waiting lists](https://questions-statements.parliament.uk/written-questions/detail/2026-06-22/11799), UK Parliament, 1 July 2026 12. [How to request an autism assessment](https://www.autism.org.uk/advice-and-guidance/diagnosis/before-diagnosis/how-to-request-an-autism-assessment), National Autistic Society 13. [Meta-analysis of the prevalence and onset of regression in autism (Barger, Campbell and McDonough)](https://pubmed.ncbi.nlm.nih.gov/22855372/), Journal of Autism and Developmental Disorders, 2013 14. [Epilepsy](https://www.nhs.uk/conditions/epilepsy/), NHS 15. [Autism: screening recommendation](https://view-health-screening-recommendations.service.gov.uk/autism/), UK National Screening Committee, 2022 16. [Children with special educational needs and disabilities: SEN support](https://www.gov.uk/children-with-special-educational-needs/special-educational-needs-support), GOV.UK 17. [Autism assessments](https://www.nhs.uk/conditions/autism/assessments/), NHS, 6 May 2026 18. [The myth of needing a diagnosis before you can get support](https://www.ipsea.org.uk/blog/the-myth-of-needing-a-diagnosis-before-you-can-get-support), IPSEA, 25 April 2025 19. [Autism diagnosis](https://autismni.org/what-is-autism/about-autism/autism-diagnosis), Autism NI 20. [Information and advice services](https://contact.org.uk/help-for-families/information-advice-services/), Contact --- General information for families in the UK, not medical, legal or financial advice. If you are worried about your child's health, contact your GP or call NHS 111 (in Northern Ireland, your GP out of hours service). In an emergency, call 999.