Problems with communication and social interaction

ASD can involve a range of issues with communication, many of which appear before age 5.

Here’s a general timeline of what this might look like:

• From birth: trouble maintaining eye contact
• By 9 months: not responding to their name
• By 9 months: not displaying facial expressions reflective of their emotions (like surprise or anger)
• By 12 months: not engaging in basic interactive games, like peek-a-boo or pat-a-cake
• By 12 months: not using (or only using a few) hand gestures, like hand-waving
• By 15 months: not sharing their interests with others (by showing someone a favorite toy, for example)
• By 18 months: not pointing or looking where others point
• By 24 months: not noticing when others appear sad or hurt
• By 30 months: not engaging in “pretend play,” like caring for a baby doll or playing with figurines
• By 60 months of age: not playing turn-taking games, like duck-duck goose

Additionally, autistic children might have trouble expressing their feelings or understanding those of others starting at 36 months.

As they age, they might have difficulty talking or very limited speaking skills. Other autistic children might develop language skills at an uneven pace. If there’s a particular topic that’s very interesting to them, for example, they might develop a very strong vocabulary for talking about that one topic. But they might have difficulty communicating about other things.

As autistic children begin talking, they might also talk in an unusual tone that can range from high-pitched and “sing-songy” to robotic or flat.

They might also show signs of hyperlexia, which involves reading beyond what’s expected of their age. Children on the autism spectrum might learn to read earlier than their neurotypical peers, sometimes as early as age 2. But they tend to not comprehend what they’re reading.

While hyperlexia does not always accompany autism, research suggests nearly 84 percent of children with hyperlexia are on the spectrum.

As they interact with others, autistic children might have difficulty sharing their emotions and interests with others or find it hard to maintain back-and-forth conversation. Nonverbal communication, like maintaining eye contact or body language, might also remain difficult.

These challenges with communication can persist throughout adulthood.