- No big smiles or joyful expressions by 6 months: By age 6 months, children begin to exhibit social reciprocity. They understand that smiling or laughing will typically cause a smile or laugh or connection with caregivers. Children with suspected ASD may be less aware of the social cues given by caregivers, or less able to display the social cues when they want social engagement.
- No sharing of smiles, sounds, or facial expressions by 9 months: Shared social connections, particularly mimicked expressions (smiling when a caregiver smiles, cooing or babbling when the caregiver makes a noise) are typically emerging by 9 months.
- No babbling by 12 months: Language development is often a social process, with more sounds and babbles reinforced by caregiver response and enthusiasm. Language delays are often a diagnostic indicator of ASD, and a lack of babbles and sounds by 12 months is a cause of concern. Hearing ability should be measured at this point as well.
- No back and forth gestures by 12 months (waving, pointing, etc.): Nonverbal language also is a social developmental process. Similar to verbal language, a delay in gestures should be considered by a developmental professional.
- No words by 16 months: Typically one syllable simple words like “No” “More” “Mom” or “Dad” are typically evident in children by this age. A language delay by this age should warrant early intervention consultation.
- No meaningful two word phrases by 24 months: At this point, single word syllables are strung together to make meaningful phrases. “More juice.” “Go out.” Early intervention should be consulted if there are no phrases by age 2.
- Any loss of speech or social skills: Because social skills and language development has a social component, if there is not a social reinforcement, or an ability to receive this reinforcement, a delay or loss of social skills should be evaluated to determine the cause.
