1 in 50
According to the 2019 Canadian Health Survey on Children and Youth, about 1 in 50 children and youth aged 1 to 17 in Canada had an autism diagnosis
Primary source Public Health Agency of Canada (2024) Verified 2024-03-26
Autism in Toddlers : Early Signs and When to Seek Help
Autism can often be identified by age 2. Knowing the signs helps parents act sooner and access support faster.
When can autism be identified in a toddler?
Autism can often be reliably identified by age 2. Early signs in toddlers include not responding to their name, limited eye contact, not pointing to show interest, and repetitive behaviours. The M-CHAT-R is one screening tool doctors in Canada can use at 18 to 24 months.
Autism assessment and diagnosis, Government of Ontario · Autism fact sheet, World Health Organization · Verified 2026-11-03
In short
- Autism can often be diagnosed by age 2 by trained professionals
- The M-CHAT-R/F is a parent-report screening tool for toddlers aged 16 to 30 months
- In Ontario, OAP registration does not guarantee early services; reported wait: 5+ years for families registered in August 2021 (community-reported, Ontario Autism Coalition, July 2026).
General information only, not a diagnosis, treatment plan, crisis service, or individual estimate. Confirm your next step with the linked source or a qualified professional.
Early Signs of Autism in Toddlers
Autism signs in toddlers vary significantly from child to child, there is no single profile. Some children show clear signs very early; others develop typically for a while and then lose skills they previously had (called regression). The CDC lists these signs; children with autism may show all, some or none of them:
- Does not respond to their name by 9 months.
- Avoids or does not keep eye contact.
- Does not point to show you something interesting by 18 months.
- Repeats words or phrases over and over, or has other repetitive behaviours.
- Has unusual reactions to how things sound, smell, taste, look or feel.
- Has delayed language skills.
Remember: all autistic children are different. Some may have excellent verbal language but significant sensory and social communication differences. If you have concerns, act on them, developmental assessments can only help, and a negative result provides valuable reassurance.
Signs by Age: Quick Reference
Signs to watch for
- Does not respond to name by 9 months
- Avoids or does not keep eye contact
- Does not point to show something interesting by 18 months
- Repetitive words, phrases or movements
Signs vary widely. Not every autistic child shows all signs, and some children develop typically for a while before showing regression.
Next Step: Assessment and OAP Registration
In Ontario, you can start with your child’s doctor or contact one of the five diagnostic hubs directly, without a referral. With a written diagnosis, register with the OAP. Reported wait: 5+ years for families registered in August 2021 (community-reported, Ontario Autism Coalition, July 2026).
Source: MCCSS FOI via OAC · May 2026. As of as of May 2026; page verified 2026-11-03.
The M-CHAT-R Screening
The Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R/F) is a validated screening tool for toddlers aged 16 to 30 months, completed by parents or caregivers. It asks 20 yes/no questions about your child's behavior, things like whether your child makes eye contact, responds to their name, and points to show you things they are interested in.
A score above the threshold prompts a follow-up interview and, if concerns remain, a referral for full diagnostic assessment. The M-CHAT-R is a screening tool, not a diagnostic test: a positive screen does not mean your child has autism, and a negative screen does not rule it out. Parent concern, even in the context of a negative M-CHAT-R, should still be taken seriously and monitored.
Key Questions the M-CHAT-R Asks
The full M-CHAT-R consists of 20 questions. The following are examples of the kinds of things it asks about:
- Does your child respond to their name when you call it?
- Does your child look at things you point to?
- Does your child point with one finger to ask for something or to show you something interesting?
- Does your child play pretend (e.g., pretend to drink from an empty cup or talk on a toy phone)?
- Does your child make eye contact with you?
- Does your child bring objects to show you, just to share interest, not to ask for help?
- Does your child look at your face to check your reaction when in an unfamiliar situation?
- Does your child imitate or copy things you do (e.g., wave, clap, make a funny noise)?
These examples are paraphrased from the M-CHAT-R/F. A concerning pattern of answers does not mean your child has autism, it means further assessment is warranted. Speak with your pediatrician if you have concerns based on any of these items.
If you are worried about your child's development, you can ask your doctor about screening, including the M-CHAT-R. The questionnaire takes about five minutes.
What to Do If You're Concerned
If you have concerns about your toddler's development, do not wait for a scheduled check-up. Call your family doctor or pediatrician and request an appointment specifically to discuss developmental concerns. Write down the specific behaviors that concern you, dates, frequency, specific examples, before the appointment. This documentation helps the clinician assess the situation accurately.
Ask your doctor specifically for a developmental referral. In Ontario, you can also contact one of the five diagnostic hubs directly, without a doctor’s referral. If your doctor is not responsive to your concerns, you can seek a second opinion.
While waiting for assessment, ask your doctor or your local children's treatment centre which services you can reach without a formal diagnosis.
The Ontario Wait and Why Early Action Matters
91,974 registered children were in the Ontario Autism Program, and 71,263 registered children had no active core funding agreement as of May 2026 (MCCSS FOI via OAC · May 2026). Reported wait: 5+ years for families registered in August 2021 (community-reported, Ontario Autism Coalition, July 2026). Waiting may delay services for toddlers. Interim supports, such as speech therapy, OT and community programs, may help while you wait.
Getting an Assessment in Ontario and Canada
Assessment routes and source references
| Route | What to expect | Source |
|---|---|---|
| Public assessment | Doctors, pediatricians and other qualified professionals can diagnose autism, or you can contact one of Ontario's five diagnostic hubs directly, without a referral. With a written diagnosis, you can register with the OAP. | Government of Ontario |
| Private assessment | Private assessment is available in Ontario and across Canada. Costs and wait times vary by provider. OAP registration needs a written diagnosis from a qualified professional. | Private assessment providers |
| Outside Ontario | Other provinces have varying access and timelines. British Columbia, Alberta, and Quebec each have their own autism program structures. Families outside Ontario should contact their provincial autism organization for province-specific guidance. | Provincial autism organizations |
Frequently Asked Questions
What are the early signs of autism in toddlers?
Early signs of autism in toddlers may include: not responding to their name by 9 months; limited or absent eye contact; not pointing to show something interesting by 18 months; delayed language skills; repetitive movements (hand-flapping, rocking, spinning); intense interest in parts of objects (like spinning wheels on a toy car); unusual reactions to sensory input; and limited imitation of others. Signs vary widely and not every autistic child shows all signs.
At what age can autism be diagnosed?
Autism can often be reliably diagnosed by age 2 by experienced clinicians, though diagnosis is often made later. Many children are not diagnosed until preschool or school age. Some people are not diagnosed until adolescence or adulthood. Earlier diagnosis is generally associated with better access to early intervention, but a diagnosis at any age is valid and valuable.
What is the M-CHAT screening test?
The Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R/F) is a validated parent-report screening tool for toddlers aged 16 to 30 months. In Canada, the Rourke Baby Record recommends autism-specific screening at 18 to 24 months when a child has a risk factor, such as a parent concern or a sibling with autism, and names the M-CHAT as one tool. It consists of 20 questions answered by parents about their child's development and behavior. A positive screen indicates a higher likelihood of autism and prompts referral for a full diagnostic assessment. The M-CHAT-R is a screening tool, not a diagnostic test, a positive result does not mean a child has autism.
What should I do if I'm concerned my toddler has autism?
If you are concerned about your toddler's development, speak to your family doctor or pediatrician at your next visit, or call to make an appointment specifically to discuss your concerns. Bring a list of specific observations. Ask for a developmental screening (such as the M-CHAT-R) and, if indicated, a referral to a developmental pediatrician or autism assessment clinic. You do not need to wait for a scheduled check-up, any concern about your child's development warrants a conversation with your doctor.
How do I get my toddler assessed for autism in Ontario?
In Ontario, the pathway to autism assessment for toddlers typically begins with an appointment with your child’s doctor. Doctors, pediatricians, developmental pediatricians, psychiatrists, psychologists, psychological associates and nurse practitioners can diagnose autism. You can also contact one of Ontario’s five diagnostic hubs directly, without a doctor’s referral. With a written diagnosis, you can register with the OAP.
Where the waitlist stands
Families navigating autism services in Ontario face a documented multi-year wait. Here is the Ontario data — and a two-minute way to push back, when you are ready.
- Autism assessment and diagnosis. Government of Ontario (2026)
- Autism Fact Sheet (updated September 17, 2025). World Health Organization (September 17, 2025)
Sources on this page
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Facts 3
Sources 3
Evidence supports autism screening and intervention commencing in the first 2 years of life — earlier identification directly enables earlier intervention during the highest neural plasticity window
Primary source Zwaigenbaum L, Bauman ML, Stone WL, et al. (2015) Verified 2015-10-01
WHO recommends accessible, community-based early interventions for children with autism. Timely evidence-based psychosocial interventions improve communication and social engagement
Primary source World Health Organization (2025) Verified 2025-09-17
Open complete source list(3)
Last system verification: 2026-11-03. Next scheduled update: 2027-02-01.
About this page
Check the author’s context, review method, and how to report an error.
Written by Spencer Carroll
Founder & Autism Advocate
Lived experience: Parent of autistic child in the OAP system