In Quebec, Autism Spectrum Diagnosis is not possible prior to the 18 months developmental period. However, early signs of this neurological disorder are still present prior. Therefore, we are providing various signs of Autism characteristics and symptoms that are present during 0-24 month developmental period to support parents who question their children’s developmental trajectory. As mentioned by the American Psychiatric Association (2013), the symptoms are dependent on the severity of Autism and are not always manifested during the early stages of development.

* Please note that not all traits and symptoms need to be present, but enough to meet Autism Spectrum Diagnosis as specified by the American Psychiatric Association (2013).

Early signs and symptoms:

  • Absent, reduced or atypical eye contact (relative to cultural norms)
  • Overly compliant (ex: “easy” children, parents typical call them the “perfect” child)
  • Overly difficult (ex: children who have a difficult time being soothed by a parent or caregiver, or tantrums a lot)
  • Delays in gross motor development (ex: turning over, sitting up, crawling, standing, and walking)
  • Delays in fine motor development (ex: holding a pen or pencil properly, tracing, cutting & writing)
  • Has severe separation anxiety or extreme shyness in new environments
  • Lack, reduced or atypical exploration of environment
  • A total lack of facial expressions and non-verbal communication
    • Difficulties understanding parental or caregiver facial expressions
  • Impairment in joint-attention (lack of pointing, showing, or bringing objects to share interest with others, or failure to follow someone’s pointing or eye gaze)
  • Lack or delay in babbling
  • Lack, delay or loss of verbal language
  • May appear to have a hearing impairment or uneven response to sound
  • Difficulties following instructions or may only follow 1 out of a 2 step instruction
  • Preference in playing alone or desire to play with much younger children or older people
  • Lack or limited imaginative / pretend play
    • Play is more functional than imaginative
  • Stereotypic or repetitive motor movements, use of objects, or speech.
    • Simple motor stereotypes (ex: hand flapping, finger flipping).
    • Lining up toys or flipping objects (ex: spinning coins).
    • Repetition in speech (ex: Echolalia, delayed or immediate parroting of heard words, and/ or using the word “you” when talking about self)
  • Difficulties with inflexibilities and adherence to routine or ritualized patterns of verbal and/ or non-verbal behaviours.
    • Extreme distress over small changes.
    • Difficulties with transitions.
    • Rigid thinking patterns.
    • Greeting rituals.
    • A need to take the same route or eat the same food everyday
  • Restricted and fixated interests.
    • Strong attachment or preoccupation with unusual objects (ex: elevators, escalators).
    • Excessive interests
  • Hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment.
    • Apparent indifference to pain/ temperature.
    • Adverse response to specific sounds or textures.
    • Excessive smelling or touching of objects.
    • Visual fascination with lights or movements.
    • Oral sensitivity (ex: refusal for eating spices, crunchy, sticky, or gooey foods).
  • Toiletting Difficulties
  • Chronic gastrointestinal problems
  • Repeated infections


American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Eilan, N., Hoerl, C., McCormack, T., &Roessler, J. (Eds). (2005). Joint-attention: communication and other minds. Great Clarendon Street, Oxford : Oxford University Press.

Lloyd, M., MacDonald, M., & Lord, C. (2011).Motor skills of toddlers with autism spectrum disorders. Autism. 17, 133-146.

Piek, J.P., Dawson, L., Smith, L.M., &Gasson, N. (2008). The role of early fine and gross motor development and later motor and cognitive ability. Motor Control and Coordination Across the Lifespan 8th Motor Control & Human Skill Conference. 27(5), 668-681.

Provost. B., Lopez, B.R., &Heimerl. S. (2007). A comparison of motor delays in young children: autism spectrum disorder, developmental delay, and developmental concerns. Journal Autism Developmental Disorders. 37, 321-328.

Provost. B., Heimerl, S., & Lopez, B.R. (2007). Levels of gross and fine motor development in young children with autism spectrum disorder. Physical and Occupational Therapy in Pediatrics. 27(3), 21-36.

Rutter, M., Le Couteur, A., & Lord, C. (2005).Autism Diagnostic Interview-Revised. Los Angeles : Western Psychological Services.

Samango-Sprouse, C.A. et al. (2014). Identification of infants at risk for autism spectrum disorder and developmental language delay prior to 12 months. Autism. 19(3), 327-37.doi: 10.1177/1362361314521329

Sroufe, L.A. (1997). Emotional development: the organization of emotional life in the early years. Cambridge, United Kingdom : Cambridge University Press.