Autism, or autism spectrum disorder (ASD), refers to a broad range of conditions characterized by challenges with social skills, repetitive behaviors, speech and nonverbal communication. According to the Centers for Disease Control, autism affects an estimated 1 in 59 children.

One of the most important things you can do as a parent or caregiver is to learn the early signs of autism and become familiar with the typical developmental milestones that your child should be reaching.

The timing and severity of autism’s early signs vary widely. Some infants show hints in their first months. In others, symptoms become obvious as late as age 2 or 3.

Not all children with autism show all the signs. Many children who don’t have autism show a few. That’s why professional evaluation is crucial.

The following “red flags” may indicate your child is at risk for an autism spectrum disorder. If your child exhibits any of the following, please don’t delay in asking your pediatrician or family doctor for an evaluation:

By 6 months

Few or no big smiles or other warm, joyful and engaging expressions.
Limited or no eye contact.

By 9 months

Little or no back-and-forth sharing of sounds, smiles or other facial expressions

By 12 months

Little or no babbling
Little or no back-and-forth gestures such as pointing, showing, reaching or waving
Little or no response to name.

By 16 months

Very few or no words.

By 24 months
Very few or no meaningful, two-word phrases (not including imitating or repeating)

At any age

Loss of previously acquired speech, babbling or social skills
Avoidance of eye contact
Persistent preference for solitude
Difficulty understanding other people’s feelings
Delayed language development
Persistent repetition of words or phrases (echolalia)
Resistance to minor changes in routine or surroundings
Restricted interests
Repetitive behaviors (flapping, rocking, spinning, etc.)
Unusual and intense reactions to sounds, smells, tastes, textures, lights and/or colors

Oftentimes, there is a wait for a formal evaluation or services. Fortunately, there are a number of actions you can take while you wait. Below is a list of suggested activities:

Be persistent.
You may try calling the office or clinic again to see if an appointment opens up sooner. If there is a research study in your area that offers diagnosis and evaluation services, consider participating.

Learn more about developmental delays and services and treatments available to help your child. This will help you develop a list of questions for the specialist and prepare you to take action if your child is diagnosed with autism or another developmental disability.

Know what to expect. Your child may have to complete one or more cognitive or “thinking skills” tests, and you will be asked questions about your child’s behavior and development. In addition, you’ll probably fill out one or more “checklists.” In all, the evaluation will take at least several hours and more than one appointment to complete.

Gather information. It is recommended to put together a folder with your child’s medical records and any previous developmental or behavioral evaluations your child has received. Bring your notes on your own observation of your child’s behavior in different places and with different people.

Arrange to bring someone with you. Many parents find the process emotional. Rather than go it alone, consider who you can ask to come with you to help you take notes on what was said and help you make sure your questions get answered.

Prepare to get your child’s intervention started. Even if your child is not diagnosed with autism, the evaluation may reveal developmental delays that would benefit from intervention. The professionals conducting your child’s evaluation can provide you with phone numbers and guidance.