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Is my toddler showing early signs of autism?

Some differences in how your toddler plays, points, and connects with you by 12, 18, and 24 months are worth asking your pediatrician about, but they are not a diagnosis, and only a qualified evaluator can make one. The CDC publishes free milestone checklists for exactly this reason, and your pediatrician is supposed to run a formal autism screening tool at the 18 and 24 month checkups whether or not you have raised a concern. This page walks through what those checklists and screens actually check for, and what to do this week if something feels off.

What does the CDC say to watch for by 12, 18, and 24 months?

The CDC's free "Learn the Signs. Act Early." checklists describe what most children, meaning 75 percent or more at that age, are doing at each checkup. By 12 months, that includes playing simple games like pat a cake, waving bye bye, calling a parent by a special name, and pausing when you say no. By 18 months, it includes pointing to show you something interesting rather than just to get something, following a one step direction without a gesture, and trying to say three or more words besides mama or dada. By 24 months, it includes saying two words together like more milk, pointing to at least two body parts when asked, pointing to a named picture in a book, and noticing when someone else is hurt or upset. These are not pass or fail tests. A child behind on one item and on track everywhere else is a very different picture from a child behind across several areas at once, and that pattern is what a screening tool and your pediatrician are for.

What is the M-CHAT-R, and why does my pediatrician screen at 18 and 24 months?

The M-CHAT-R is the Modified Checklist for Autism in Toddlers, Revised, a short parent-completed questionnaire and one of the most widely used autism screening tools in pediatric offices. You fill it out in the waiting room or online before your visit, answering yes or no questions about everyday behavior like whether your child points, imitates you, or responds when you call their name. The American Academy of Pediatrics recommends that every child get a specific autism screen at the 18 month and 24 month well child visits, in addition to general developmental screening at 9, 18, and 30 months, regardless of whether a parent has raised a concern. If your pediatrician has not offered this screen at those visits, you can ask for it by name. A screen takes minutes, costs you nothing beyond the visit itself, and its only job is to flag whether a fuller look is worth scheduling, not to say what is or is not going on with your child.

Does a positive screen mean my child has autism?

No. A screen is a sorting step, not a diagnosis. The M-CHAT-R and tools like it are built to catch every child who might need a closer look, which means some children who screen positive turn out, after a full evaluation, not to have autism, and a small number who screen negative are later found to have it anyway. A diagnosis can only be made by a qualified evaluator, typically a developmental pediatrician, child psychologist, or a multidisciplinary team, using direct observation, developmental history, and standardized diagnostic tools over more than one visit. If your child screens positive, the honest next sentence from your pediatrician should be that an evaluation is worth scheduling, not that your child has autism. Try not to let a single score, in either direction, settle the question in your head before an evaluator has actually looked. Screening and diagnosis are two different jobs, done by two different processes, and mixing them up is the single most common source of both false alarm and false reassurance.

What should I do this week?

Two things can happen at the same time, and neither one waits on the other. First, call your pediatrician's office and ask directly for a formal autism screen such as the M-CHAT-R if one has not already been done at your child's most recent well visit. Second, and separately, call your state's early intervention program yourself and ask to have your child evaluated. Under Part C of the Individuals with Disabilities Education Act, every state runs a program that evaluates children under three for developmental delays, including in communication and social skills, and the evaluation itself is free to you, and you do not need a doctor's referral or a diagnosis to request it. You can find your state's program through the federal IDEA site or by searching your state name plus early intervention program. Making both calls in the same week means you are not waiting on one system before starting the other, and either process can lead to services regardless of what the other one finds.

How do I keep track of what I'm noticing?

Whatever you have already noticed is useful information, and writing it down before your appointment makes it far more useful than trying to remember it under time pressure in an exam room. Keep a short running note on your phone: the date, what happened, and what you saw or did not see, such as whether your child looked toward you when you said their name three times this week, or whether they pointed at the dog before you pointed first. A 30 to 60 second video on your phone of an everyday moment, like snack time or a family member walking in the door, often shows a pediatrician or evaluator more in half a minute than a paragraph of description can. You are not building a case or trying to prove anything either way. You are giving the people whose job this is the clearest, most specific picture you can, so their screen or evaluation works from real moments instead of a worried parent's memory of a hard week.

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Next: How to get an autism evaluation for your child

Written and reviewed by Special Learning's clinical team. Special Learning has served families and professionals in 140+ countries since 2010.

Last updated 2026-09-02. This page is general information, not medical advice. Talk with your child's clinician about your specific situation.