Signs of autism in toddlers: a parent’s checklist by age

The two small things we noticed

In most ways, our daughter was an ordinary toddler. Around age two, we noticed two small things: she often didn’t turn when we called her name, and she rarely held eye contact or engaged with the people around her.

Her hearing was clearly fine — she’d light up the moment one of her favourite songs came on. So when we finally went to that first appointment, we were half-expecting a minor hearing issue, or to be told this was just her pace. Autism wasn’t on our minds.

That’s the honest shape of it for many families: not a dramatic moment, just one or two quiet things that don’t quite fit. This checklist is for noticing them.

How to use this checklist

• Look for the pattern, not the tick. Every toddler does some of these things sometimes. What matters is several signs, showing up often, and persisting.
• Subtle is normal. Some autistic children show clear signs early; many don’t. A child can be affectionate, smiley, and still be autistic.
• Ages are approximate. Children develop at different paces. The age markers below are “around when most children do this,” not deadlines.
• The output isn’t a conclusion — it’s a conversation. If you find yourself nodding along, the next step is your GP or polyclinic, who can look properly.

The checklist, by age

Around 12 months

Most children this age respond socially and follow your attention. Worth noting if your toddler often:

• Doesn’t turn when you call their name — even though they react to other sounds (the lift bell, a favourite song).
• Doesn’t look where you point. By 12 months, most children immediately look in the direction of an object a parent points at; an autistic child may appear to ignore the pointing.
• Uses few gestures — little waving, reaching up to be carried, or showing.
• Uses eye contact less often than you’d expect.

Around 15–18 months

This is when joint attention — sharing attention with you for the pleasure of sharing — normally blooms. Worth noting if your toddler:

• Leads you by the hand instead of pointing. By 15 months most children point at out-of-reach things they want; an autistic child may take your hand and bring you to the object instead.
• Points to get, but not to show. By 18 months most children point at things purely because they’re interesting, looking back and forth between the object and you. Pointing only to obtain things — never to share them — is the sign clinicians watch.
• Has few or no single words, or has stopped using words they once had (see the note below).
• Shows little pretend play starting to emerge — feeding a teddy, “talking” on a toy phone.

Around 2–3 years

• Little interest in other children, or finds it hard to join their play.
• Not much pretend play, but strong attachment to repetitive actions — opening and closing doors, lining things up, watching the same segment on repeat.
• Speech that’s late, limited, or different — few words, repeated phrases, or a flat or unusual tone.
• Repetitive movements — rocking, spinning, hand-flapping (stimming).
• Big reactions to small changes — a different route home, a moved chair, a change in routine.
• Strong sensory responses — reacting intensely (or not at all) to sounds, lights, smells, textures; only eating certain foods or refusing foods that touch.

The signs that hide

Some children — girls especially — show autism more quietly. The NHS notes autistic girls may be more likely to copy how other children behave and play, stay quiet in situations they find difficult, appear to cope socially, and show fewer repetitive behaviours than autistic boys. From the outside that can look like shyness, or like nothing at all.

The same goes for the famously “easy” baby — content alone, undemanding, absorbed in their own world. Sometimes that’s just temperament. Sometimes it’s a child who isn’t seeking social connection the way most infants do. Quiet isn’t a red flag by itself; it’s just not automatic reassurance either.

What a single sign doesn’t mean

This page is for noticing, not for panicking, so let’s be equally clear about the other direction:

• Late talking alone is not autism. Plenty of late talkers catch up, and speech delay has many causes — hearing, environment, simple variation. What distinguishes autism is the social thread: gestures, shared attention, response to name — not just word count.
• Lining up toy cars once in a while is play. Repetition becomes notable when it’s the dominant mode, strongly preferred, and hard to interrupt.
• A tantrum about change is toddlerhood. Distress at change becomes notable when it’s consistent, intense, and tied to a wider need for sameness.

And the beat we repeat on every page like this, because it’s true: signs can be subtle, and missing them for a while is normal. We lived with our daughter every day and saw only two small things in two years. Noticing late says nothing about your parenting. Acting on what you notice is the part that counts — and you’re doing that right now.

What to do next in Singapore

If several items above feel familiar, here’s the road, and one fact that removes most of the “should we wait?” agonising:

• Start with your GP or polyclinic. Describe what you’ve noticed in concrete terms (“she doesn’t turn to her name; she pulls me by the hand instead of pointing”). Ask about a developmental referral to KKH’s Department of Child Development or NUH’s Child Development Unit — or see a private developmental paediatrician.
• You don’t need a diagnosis to start getting help. In Singapore, early-intervention support through EIPIC doesn’t require a formal autism diagnosis — a paediatrician’s assessment that your child is at risk of a developmental condition is enough to apply. So seeing the doctor early isn’t jumping the gun; it’s what opens doors, whichever way the assessment goes.
• The full route — referrals, waits, costs — is mapped in our step-by-step guide: how to get an autism diagnosis in Singapore. And if you’re at the very start of this and unsure what order to do things in, Start Here lays it out.