What are common autism red flags in toddlers?

• A. Delayed walking and poor language only
• B. Lack of pretend play, limited eye contact, and poor joint attention by 18-24 months
• C. Advanced verbal skills and early reading
• D. Excessive physical activity and hyperfocus on objects

Answer: (B)

Social communication deficits are the primary clue in toddlers. By 18 to 24 months, typical children start using eye contact and sharing attention with others, and they engage in pretend play. When a child shows limited eye contact, does not participate in joint attention (for example, not looking where a caregiver points or not sharing interest in objects), and shows little to no pretend play, these patterns together signal potential autism risk. Joint attention and pretend play reflect how a child interacts socially and uses nonverbal cues to engage with others; delays in these areas are among the earliest and most consistent red flags that prompt referral for evaluation.

In contrast, delayed walking and poor language alone can occur with a variety of development issues and are not as specific to autism. Advanced verbal skills and early reading are not typical red flags for autism, and while some children may have unusual interests or activity levels, those features don’t align as clearly with the social-communication red flags described above.