Seeing the Signs: Understanding the Early Red Flags of Autism

Ashley Valdes
Nov 9
7 min read

By Ashley Valdes --- an Autism Mom, Anthropologist, and Lifelong Advocate for Awareness and Connection, with select quotations from other Autism Moms who were willing to share.

I still remember the moment I accepted that something was different. My father would forward me screenshots with highlights and circles around flags for developmental delays. As a first-time mom—and a first-time mom with twins at that—if I hadn't believed the science and ignored the warnings from experienced parents and educators (my dad and step-mom at the time), our story might be different today.

At first, I brushed it off — I told myself that they weren't difficult babies, they were perfect, they were just really quiet, they weren't interested in the world around them. But that world, I came to understand, was a different world from the one I knew, and it was the beginning of our journey with autism.

I’m sharing this not because our story is universal — autism is as varied as the children who live it — but because recognizing early signs can change lives. Early awareness opens doors to support, understanding, and growth. So let’s explore what research tells us about the early “red flags” of autism spectrum disorder (ASD), how they might appear, and what caregivers and professionals can do.

Image: Jonathan and Joel, diagnosed with level 3 autism spectrum disorder at 22 months, now at age 8, are learning life skills together.

The Importance of Early Awareness

Autism Spectrum Disorder (ASD) affects how a person perceives and interacts with the world. Early signs can appear as early as 6 to 12 months, though diagnosis often happens years later. Studies from the National Institute of Child Health and Human Development (NICHD) show that children identified and supported earlier — even before age two — often experience improved communication, adaptive skills, and quality of life.

Recognizing red flags isn’t about labelling — it’s about unlocking potential. Early intervention works best when started as soon as possible, and it begins with awareness.

At the time, we were lucky to get a quick diagnosis for the twins at 22 months old --- I did not realize the "luck" until years later. However, I do want to say that although early intervention is a significant key factor in development, sometimes the autism level is still severe and requires lifelong care. We will get into severe autism at another time, as it is a complex discussion in itself.

What Do We Mean by “Early Signs” and “Red Flags”?

Early signs are subtle differences in development or interaction that might emerge in the first years of life.
Red flags are patterns of behavior that suggest a need for further screening or professional evaluation.

They are not proof of autism on their own — they are invitations to look closer.

1. Social and Communication Differences

The earliest differences often appear in how a baby connects with others:

Limited or declining eye contact: Research from the National Institute of Mental Health (NIMH) found that infants later diagnosed with autism show a decline in eye contact between 2 and 6 months of age.
No response to name by 12 months: One of the most consistent early signs cited by NICHD.
Lack of gestures or pointing: By about 12 months, most children point or wave “bye-bye.” Children with autism may not.
Reduced back-and-forth interaction: Limited cooing, babbling, or turn-taking.
Not showing or sharing interest: For example, not pointing out a bird in the sky or bringing a toy to show a parent.

🧩 Anecdote: “I realized my daughter never pointed at things she wanted. She would take my hand and put it on the object instead — it was her way of communicating, but it looked different.”

2. Language and Play

Delayed speech: No words by 16 months or two-word phrases by 24 months may indicate developmental delay.
Echolalia: Repeating words, phrases, or sounds rather than generating spontaneous language.
Limited pretend play: For instance, not pretending to feed a doll or “drive” a toy car.
Inconsistent listening or seeming “in their own world.”

🧩 Anecdote: “We thought our son just loved routines — lining up toy cars was his thing. It wasn’t until much later that we learned it was a comfort behavior, a way to make the world predictable.”

3. Behavior and Sensory Patterns

Repetitive movements: Hand-flapping, spinning, or rocking.
Strong preference for sameness: Becoming distressed at small changes in routine.
Intense interests or fixations: Fascination with certain textures, lights, or objects.
Sensory differences: Over- or under-sensitivity to sound, touch, or temperature.

Research from the National Autism Center and Mayo Clinic Press supports that these sensory and repetitive behaviors are among the core early indicators of autism.

4. Developmental Regression

For some children, signs of autism emerge after a period of typical development:

Loss of previously acquired skills (e.g., words or gestures).
Reduced social engagement (less smiling or interaction).

Regression can occur between 15 and 30 months and is a key reason for prompt developmental screening.

5. Age-Related Checkpoints (Guidelines, Not Absolutes)

Age	Typical Milestones	Red Flags to Watch For
6 months	Smiles, makes eye contact, coos	Limited to no eye contact or social smiling
12 months	Responds to name, points, waves	No gestures, no babbling
16–18 months	Single words, imitation, engagement	No words, limited eye contact
24 months	Two-word phrases, pretend play	No phrases, lack of interest in others

Again, these are guides, not absolutes. Every child develops differently — but if delays or patterns persist, it’s worth investigating.

For Parents and Caregivers: What You Can Do

Trust your instincts. You know your child best.
Keep notes. Write down what you observe — how often, when, and in what context.
Ask your pediatrician about screening tools. The M-CHAT-R/F (Modified Checklist for Autism in Toddlers, Revised with Follow-Up) is a widely used screening tool for children between 16 and 30 months.
Request referrals if needed. Developmental pediatricians, child psychologists, and early intervention specialists (we used the Early Steps program) can conduct comprehensive assessments.
Begin early intervention right away. In the U.S., children under age 3 can access services through Early Intervention (Part C of IDEA) — even before a formal diagnosis.
Seek community. Online and local autism parent groups can offer both emotional and practical support.

🧩 A note of hope: “When we started early speech therapy, I didn’t know what to expect. But over time, my son began to connect — not always with words, but with shared moments, laughter, and glances that spoke volumes.”

For Professionals: How to Support Families

Listen with compassion. Parents often arrive scared and overwhelmed — empathy is the bridge to trust. Believe what they are telling you at face value.
Normalize screening. Routine developmental surveillance reduces stigma.
Be culturally aware. Understand that communication norms differ across cultures; one family’s “quiet baby” may not signal the same concerns in another context. (I will discuss how cultural differences can affect care and diagnosis in a later anthropological post)
Provide clear, research-informed resources. Offer written information and follow-up steps.
Collaborate with parents. They are experts on their children — professionals are partners, not gatekeepers.

Why Early Recognition Matters

The first few years of life represent a period of immense neural plasticity. Research published in PubMed (2020) shows that early identification (before age two) can improve social engagement and communication outcomes.

Autism is lifelong, but support can transform experience. Early recognition allows children to develop their strengths and gives families tools to navigate challenges with confidence and compassion.

Closing Thoughts

Recognizing early signs of autism is not about fear — it’s about hope. It’s about seeing the beauty in difference, the patterns in the quiet, and the meaning in every small moment of connection.

My children's ongoing journey continues to teach me that while autism may feel like carrying tragic moments, it isn’t a tragedy — silence isn’t absence, and sameness isn’t stubbornness. It’s a different language of being, one that deserves to be understood and included in research to better the lives of these individuals and their families.

If you suspect a child might be on the spectrum, take heart: you are not alone. Awareness is love in action. And love, as we’ve learned in our home, is the best intervention there is. 💙

Resources

Here’s a focused directory of autism support & service providers in Miami-Dade, Broward & Palm Beach counties, organized by category (early intervention, daytime therapy/learning centers, adult services, schools & respite) for families navigating these regions.

Early Intervention Programs (birth-to-3 / young toddlers)

Early Steps (Florida state-wide) — services to eligible infants/toddlers (birth-36 months) with developmental delays or at-risk conditions. FDOH Early Steps+1
Easterseals South Florida — Child Development Centers in Miami & Miami Gardens, serving children 0-5 with special needs, therapy on-site. Easterseals
Little Leaves Behavioral Services (Miami Lakes) — center-based ABA program for children ages 1-6 on the autism spectrum. Little Leaves Behavioral Services
InBloom Autism Services (Broward County) — early intervention ABA therapy for children 18 months-5 years. InBloom Autism Services

Daytime Therapy / Learning Centers & Daytime Programs

South Florida ABA Center — early intervention therapy centre specialising in ASD and family-involved services. South Florida ABA
Breakthrough Therapy Services (Davie, Broward) — therapy centre (speech, OT) that serves children with autism in Broward County. breakthroughtherapyservices.com
Abacus Therapies (Broward County) — in-home and school-based ABA therapy for children with autism. Abacus Therapies

Adult Services / Adult Programs (18+, 22+ etc)

Ann Storck Center — Adult Day Training (ADT) in Broward County for individuals age 22+ with developmental disabilities (includes autism). Ann Storck Center
Autism Project of Palm Beach County — includes housing and support services for adults with ASD in Palm Beach County (e.g., group home “Babe’s House”). Autism Housing Network
South Florida Autism Center — offers adult programming (vocational, independent living) for 22+ in the South Florida region. South Florida Autism Center

Schools & Educational Centers Specializing in Autism

Palm Beach School for Autism — tuition-free public charter school (ages 3-21) in Lake Worth, Palm Beach County, serving students on the autism spectrum. pbsfa.org +1
Connections Education Center (Palm Beach County) — Non-profit school for students with autism (ages 3-14) and adult programs age 23+ (Palm Beach County). Connections School
South Florida Autism Charter School — School in South Florida (charter) specialising in autism; workshops also offered. sfacs.org

Respite & Family Support Services

Broward Children’s Center — offers respite care for families of children with special needs (including autism) in Broward County. bcckids.org
The Arc Broward — advocacy & support for children/adults with autism and related disabilities in Broward; connects with service grants. Arc Broward
Also, the regional branch of Center for Autism & Related Disabilities (CARD) (based at Nova/UM/NSU) provides family support, resource navigation in Broward & Miami-Dade. CSC Broward+1