The main features of autism spectrum disorder (ASD) are problems with social communication and interaction.

See your GP or health visitor if you notice any of the following signs of ASD in your child or if you’re concerned about your child’s development.

Signs of ASD in pre-school children

Spoken language

delayed speech development (for example, speaking less than 50 different words by the age of two), or not speaking at all

frequent repetition of set words and phrases

speech that sounds very monotonous or flat

preferring to communicate using single words, despite being able to speak in sentences

Responding to others

not responding to their name being called, despite having normal hearing

rejecting cuddles initiated by a parent or carer (although they may initiate cuddles themselves)

reacting unusually negatively when asked to do something by someone else

Interacting with others

not being aware of other people’s personal space, or being unusually intolerant of people entering their own personal space

little interest in interacting with other people, including children of a similar age

not enjoying situations that most children of their age like, such as birthday parties

preferring to play alone, rather than asking others to play with them

rarely using gestures or facial expressions when communicating

avoiding eye contact

Behaviour

having repetitive movements, such as flapping their hands, rocking back and forth, or flicking their fingers

playing with toys in a repetitive and unimaginative way, such as lining blocks up in order of size or colour, rather than using them to build something

preferring to have a familiar routine and getting very upset if there are changes to this routine

having a strong like or dislike of certain foods based on the texture or colour of the food as much as the taste

unusual sensory interests – for example, children with ASD may sniff toys, objects or people inappropriately

Signs and symptoms of ASD in school-age children

Spoken language

preferring to avoid using spoken language

speech that sounds very monotonous or flat

speaking in pre-learned phrases, rather than putting together individual words to form new sentences

seeming to talk “at” people, rather than sharing a two-way conversation

Responding to others

taking people’s speech literally and being unable to understand sarcasm, metaphors or figures of speech

reacting unusually negatively when asked to do something by someone else

Interacting with others

not being aware of other people’s personal space, or being unusually intolerant of people entering their own personal space

little interest in interacting with other people, including children of a similar age, or having few close friends, despite attempts to form friendships

not understanding how people normally interact socially, such as greeting people or wishing them farewell

being unable to adapt the tone and content of their speech to different social situations – for example, speaking very formally at a party and then speaking to total strangers in a familiar way

not enjoying situations and activities that most children of their age enjoy

rarely using gestures or facial expressions when communicating

avoiding eye contact

Behaviour

repetitive movements, such as flapping their hands, rocking back and forth, or flicking their fingers

playing in a repetitive and unimaginative way, often preferring to play with objects rather than people

developing a highly specific interest in a particular subject or activity

preferring to have a familiar routine and getting very upset if there are changes to their normal routine

having a strong like or dislike of certain foods based on the texture or colour of the food as much as the taste

unusual sensory interests – for example, children with ASD may sniff toys, objects or people inappropriately