In short: Early signs of autism usually appear in social communication — fewer shared smiles, not responding to their name, not pointing to show you things — alongside repetitive play or strong sensory reactions. If you are worried, ask your paediatrician about screening.
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Every child develops at their own pace. These signs of autism in toddlers are not a diagnosis — they are reasons to talk to a professional.
By 12 months
- Rarely responds to their name
- Few gestures (waving, reaching to be picked up)
- Limited babbling or shared smiles
By 18 months
- Does not point to show you something interesting
- Does not look where you point
- Few or no single words
- Loss of words or skills they had before (always see a doctor)
By 24 months
- No two-word phrases
- Little pretend play
- Lines up toys or repeats the same actions
- Strong reactions to sounds, textures or lights
By 36 months
- Difficulty playing with other children
- Intense focus on particular objects or topics
- Distress at small changes in routine
The M-CHAT screener
The Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F) is a parent questionnaire for children aged about 16–30 months. Take it on the official M-CHAT website and discuss the result with your paediatrician.
Who to see in South Africa
Start with your GP or paediatrician. They may refer you to a developmental paediatrician, child psychiatrist, psychologist, speech therapist or occupational therapist. Early support makes a difference. Find help in our directory.
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Sources & further reading
Last checked: 31 October 2026. If you spot something out of date, tell us.