Signs of Autism by Age Group
Autism signs present differently at different stages of development. Understanding what to look for at each age can help parents and caregivers seek assessment at the right time. No child will show every sign listed below, and some children show only subtle differences that become clearer as expectations increase with age.
12–18 Months
Between 12 and 18 months, early signs may include a limited or inconsistent response to their own name when called — not due to hearing problems, but because of reduced social attention. Reduced eye contact is common, particularly the spontaneous, socially motivated eye contact that typically developing infants use to engage caregivers. Pointing to share interest (called protodeclarative pointing — pointing to show you something, not just to request it) is often absent or delayed. These early signs are subtle and can be missed at regular check-ups unless parents specifically raise concerns.
18–24 Months
The 18-month and 24-month well-child visits are when the M-CHAT-R/F screening is administered in Canada. At this stage, concerning signs include no two-word spontaneous phrases by 24 months, loss of previously acquired language or social skills (regression — present in approximately 25% of autistic children), and limited pretend play. A child who enthusiastically played peek-a-boo at 12 months but has become less responsive by 20 months may be showing a regression pattern worth investigating.
3–5 Years
By preschool age, social differences often become more apparent in group settings. Children may have difficulty with peer interaction — preferring solitary play, struggling with turn-taking, or not understanding the unwritten rules of social play. Rigid routines and strong distress at changes (such as a different route home or a substitute teacher) are common. Intense, focused interests — sometimes called "special interests" — may emerge, with children displaying encyclopedic knowledge about a narrow topic. These traits are part of who autistic children are, not problems to be eliminated.
Getting an Autism Diagnosis in Ontario
In Ontario, a formal autism diagnosis requires assessment by a registered psychologist, psychiatrist, or developmental pediatrician. The diagnosis is based on clinical observation, developmental history, and standardized assessment tools. Both the public and private pathways lead to the same diagnostic outcome — a diagnosis through either route is equally valid for OAP registration, school board IPRC identification, and other purposes.
Public Pathway
The public pathway begins with a referral from your family doctor or pediatrician to a hospital-based autism assessment program or developmental pediatrician. This referral places your child on a waitlist. In major Ontario centres such as Toronto, Ottawa, and Hamilton, waitlists for publicly funded pediatric autism assessments typically range from one to three years or longer depending on the region and program. The assessment itself is covered by OHIP. Once diagnosis is confirmed, families register with the Ontario Autism Program through AccessOAP.ca. Registration date determines OAP waitlist position, so registering promptly after diagnosis is important.
Private Pathway
Private assessment bypasses public waitlists by booking directly with a registered psychologist in private practice. Costs typically range from $3,000 to $5,000 for a comprehensive assessment, though some clinics charge more. Private assessments can generally be completed within weeks to a few months. The resulting report is accepted by the OAP, school boards, and other programs. Some employer benefits plans or disability insurance policies may cover part of the cost — check your coverage before booking.
See also: Autism diagnosis costs in Ontario — complete diagnosis guide — IEP guide for autistic students.