Early social interaction and communication skills are important developmental milestones for children. Children typically begin to show an interest in people and faces around 2-3 months of age, and by 6 months they will start to babble and make sounds. By the age of 1 year, children should be able to say a few simple words like “mama” and “dada” and understand simple commands like “come here” or “give me the ball”.
Children with autism spectrum disorder (ASD) may have delayed or atypical social interaction and communication skills. According to the CDC’s developmental milestone checklist, some signs that a child may be at risk for ASD include not responding to their name, not pointing at objects to show interest, and not playing “pretend” games.
Motor Skills and Sensory Processing
Motor skills refer to a child’s ability to move and control their body. Gross motor skills include crawling, walking, and running, while fine motor skills include grasping objects and using utensils. Sensory processing skills involve how a child’s brain interprets and responds to sensory inputs like touch, sound, and light.
Children with ASD may have delayed or atypical motor skills and sensory processing. For example, some children may have difficulty with coordination or balance, while others may be hypersensitive to certain textures or sounds. However, it is important to note that every child with ASD is unique and may have different strengths and challenges.
Play and Imitation Skills
Play and imitation skills are important for children’s social and cognitive development. By the age of 2 years, children should be able to engage in simple pretend play and imitate actions and words. By the age of 3 years, children should be able to engage in more complex pretend play and understand the concept of taking turns.
Children with ASD may have delayed or atypical play and imitation skills. For example, some children may prefer repetitive or solitary play, while others may have difficulty with imaginative play. However, it is important to note that every child with ASD is unique and may have different strengths and challenges.
Autism Milestone Chart
6 Months
Typical Development:
- Responds to own name
- Begins to show curiosity about things and tries to get things that are out of reach
- Uses sounds to express happiness and displeasure
- Starts to smile at people
- Makes sounds of joy and tries to copy sounds
Possible Signs of Autism:
- No big smiles or other warm, joyful expressions
- Limited or no eye contact
- Lack of response to name
9 Months
Typical Development:
- Watches the path of something as it falls
- Looks when you point
- Responds to own name
- Uses fingers to point at things
- Imitates sounds and gestures of others
Possible Signs of Autism:
- No back-and-forth sharing of sounds, smiles, or other facial expressions
- No response to name or other sounds
12 Months
Typical Development:
- Uses simple gestures, like shaking head “no” or waving “bye-bye”
- Says “mama” and “dada” and exclamations like “uh-oh!”
- Responds to simple spoken requests
- Tries to repeat words you say
- Enjoys playing games like “peek-a-boo” and “pat-a-cake”
Possible Signs of Autism:
- No babbling or “baby talk”
- No back-and-forth gestures such as pointing, showing, reaching, or waving
- No response to the name
18 Months
Typical Development:
- Points to show others something interesting
- Says several single words
- Knows what ordinary things are for; for example, telephone, brush, spoon
- Shows interest in a doll or stuffed animal by pretending to feed
- Points to one body part when asked
Possible Signs of Autism:
- No single words
- Does not point to showing things to others
- No interest in interactive games
24 Months
Typical Development:
- Says sentences with two to four words
- Follows simple instructions
- Repeats words overheard in conversation
- Points to things in a book
- Begins to sort shapes and colors
Possible Signs of Autism:
- No two-word meaningful phrases (without imitating or repeating)
- Does not follow simple instructions
- Does not point to objects or pictures
36 Months (3 Years)
Typical Development:
- Follow instructions with 2 or 3 steps
- Can name the most familiar things
- Understands words like “in,” “on,” and “under”
- Says first name, age, and sex
- Names a friend
- Carries on a conversation using 2 to 3 sentences
Possible Signs of Autism:
- Limited or no spoken language
- Does not engage in pretend play
- Does not understand simple instructions
- Shows limited interest in peers
48 Months (4 Years)
Typical Development:
- Enjoys doing new things
- Plays “Mom” and “Dad”
- Would rather play with other children than by themselves
- Talks about what they like and what they are interested in
- Knows some basic rules of grammar
Possible Signs of Autism:
- Rarely engages in pretend or imaginative play
- Shows little interest in peers
- Difficulty understanding and following social rules
- Limited use of language in social interactions
60 Months (5 Years)
Typical Development:
- Wants to please friends
- Likes to sing, dance, and act
- Can tell what’s real and what’s make-believe
- Speaks clearly
- Tells a simple story using full sentences
Possible Signs of Autism:
- Difficulty making friends
- Trouble understanding and expressing feelings
- Repetitive or rigid language
- Struggles with conversational skills
Milestones for School-Aged Children
As children with autism spectrum disorder (ASD) grow and develop, they may encounter unique challenges in their academic, social, and emotional development. Tracking developmental milestones can help parents and caregivers identify any potential delays and seek appropriate support and intervention.
Academic and Cognitive Skills
Children with ASD may struggle with academic and cognitive skills, such as reading, writing, and math. However, with the right support and accommodations, they can make progress in these areas. Some milestones to look for in school-aged children with ASD include:
- Demonstrating an understanding of basic math concepts, such as addition and subtraction
- Reading and comprehending simple texts
- Writing simple sentences and paragraphs with correct grammar and spelling
- Understanding abstract concepts, such as time and money
Behavioural and Emotional Regulation
Children with ASD may experience challenges with behavioural and emotional regulation, such as difficulty managing their emotions and behaviour in social situations. Some milestones to look for in school-aged children with ASD include:
- Developing coping strategies to manage stress and anxiety
- Demonstrating appropriate behaviour in social situations, such as taking turns and following rules
- Understanding and responding appropriately to social cues, such as facial expressions and body language
- Developing self-awareness and self-advocacy skills
Social Relationships and Peer Interaction
Children with ASD may struggle with social relationships and peer interaction, but with the right support, they can develop meaningful relationships with their peers. Some milestones to look for in school-aged children with ASD include:
- Demonstrating an interest in making friends and participating in social activities
- Engaging in reciprocal conversations with peers
- Developing empathy and understanding of others’ perspectives
- Demonstrating appropriate social behaviour, such as sharing and taking turns
Overall, tracking developmental milestones can help parents and caregivers identify areas where a child with ASD may need additional support and intervention. With the right support, children with ASD can make progress in their academic, social, and emotional development.
Adolescence and Transition to Adulthood
As children with autism spectrum disorder (ASD) enter adolescence, they face a number of challenges that can affect their daily lives. The transition from adolescence to adulthood is complex and can be particularly challenging for individuals with ASD. It is defined by many objective and subjective milestones and requires careful planning and support to ensure a successful transition.
Independence and Self-Care
One of the key milestones of adolescence and transition to adulthood is the development of independence and self-care skills. This includes personal hygiene, dressing, grooming, and managing daily routines. Individuals with ASD need to develop these skills as they prepare to enter adulthood. Parents and caregivers can support this process by providing opportunities for their children to practice these skills in a safe and supportive environment.
Vocational Skills and Employment
Another important aspect of the transition to adulthood is developing vocational skills and finding employment. Many individuals with ASD have unique strengths and talents that can be harnessed in the workplace. However, finding and maintaining employment can be challenging for individuals with ASD. Vocational training programs and job coaches can help support individuals with ASD as they develop the skills needed to succeed in the workplace.
Community Participation and Social Connections
Finally, community participation and social connections are essential for a successful transition to adulthood. Adolescents and young adults with ASD may struggle with social skills and making connections with peers. Parents and caregivers need to support their children in developing social skills and finding opportunities to participate in community activities. This can include joining clubs or organizations, volunteering, or participating in recreational activities.
Monitoring and Support Strategies
Early intervention is crucial for children with autism to reach their full potential. It involves identifying and addressing developmental delays as early as possible. The American Academy of Pediatrics recommends developmental screening at 9, 18, and 30 months, as well as ongoing surveillance by healthcare providers. Parents and caregivers can also use developmental milestone checklists to monitor their child’s progress.
Educational and Therapeutic Approaches
There are a variety of educational and therapeutic approaches that can help children with autism learn and develop. Applied Behavior Analysis (ABA) is a widely used therapy that focuses on teaching new skills and behaviours through positive reinforcement. Other therapies, such as speech therapy, occupational therapy, and physical therapy, can also be beneficial for children with autism.
Educational programs that are tailored to the child’s individual needs can help them reach their full potential. Special education programs, such as those offered through the Individuals with Disabilities Education Act (IDEA), can provide children with autism with the support they need to succeed in school.
Family Support and Resources
Families of children with autism often need support and resources to help them navigate the challenges of raising a child with special needs. Support groups, such as those offered through the Autism Society and Autism Speaks, can provide families with a sense of community and connection.
There are a variety of resources available to families of children with autism. These include assistive technology, such as communication devices and sensory aids, as well as financial assistance programs, such as Medicaid and the Supplemental Nutrition Assistance Program (SNAP).
