Top tips to support Autism in 2023

Autism Spectrum Disorder is a neurodevelopmental problem, that can cause significant social, communication and behavioural challenges. People will say Autism or ASD for Autism Spectrum Disorder.

The word spectrum in this context refers to the wide range of symptoms and severity. This means different people with ASD will display or experience different symptoms.

Signs and symptoms

Some of the difficulties associated with ASD can be social, emotional and communication skills difficulties. They may have difficulties with repetitive activity and behaviour.  

Many people with ASD may also have different ways of learning, paying attention or reacting to things. These difficulties of ASD begin during early childhood and might persist for long time.

With right kind of therapy support and intervention at the right time, some of the difficulties and symptoms of ASD could be minimised.  

In my experience as a paediatric speech and language therapist, I have seen these signs of Autism Spectrum Disorder in children as young as 18 months. Anecdotally, parents have reported that they have observed signs as young as 12 months old e.g., not responding to their name or significantly reduced eye contact.

Some of the difficulties you might see in Autism:

not point at objects to show interest (for example, not point at an aeroplane flying over)

not look at objects when another person points at them

have trouble relating to others or not have an interest in other people at all

avoid eye contact and want to be alone

have trouble understanding other people’s feelings or talking about their own feelings

prefer not to be held or cuddled, or might cuddle only when they want to

appear to be unaware when people talk to them, but respond to other sounds

be very interested in people, but not know how to talk, play, or relate to them

repeat or echo words or phrases said to them, or repeat words or phrases in place of normal language

have trouble expressing their needs using typical words or motions

not play “pretend” games (for example, not pretend to “feed” a doll)

repeat actions again and again

have trouble adapting when a routine changes

have unusual reactions to the way things smell, taste, look, feel, or sound

lose skills they once had (for example, stop saying words they were using)

may not respond to their name

There are two key areas that are important when looking into an ASD:

Restrictive and repetitive behaviour

Lines up toys or other objects and gets upset when order is changed

Repeats words or phrases over and over (i.e., echolalia)

Plays with toys the same way every time

Is focused on parts of objects (e.g., wheels)

Gets upset by minor changes

Has obsessive interests

Must follow certain routines

Flaps hands, rocks body, or spins self in circles

Has unusual reactions to the way things sound, smell, taste, look,, or feel

Avoids or does not keep eye contact

Does not respond to name by 9 months of age.

[Note: children with the hearing problems may not respond to name; in this case, hearing must be tested]

Does not show facial expressions like happy, sad, angry, and surprised by 9 months of age

Does not play simple interactive games like pat-a-cake by 12 months of age

Uses few or no gestures by 12 months of age (e.g., does not wave goodbye)

Does not share interests with others (e.g., shows you an object that he or she likes by 15 months of age)

Does not point or look at what you point to by 18 months of age  [children with muscle weakness may not be able to point; children with a vision problem or a visual impairment, may not be able to look at your point; your doctor will check these when he or she undertakes an assessment]

Does not notice when others are hurt or sad by 24 months of age

Does not pretend in play (e.g., does not pretend to “feed” a doll by 30 months of age)

Shows little interest in peers

Has trouble understanding other people’s feelings or talking about own feelings at 36 months of age or older

Does not play games with turn-taking by 60 months of age

Speak to your therapist or GP if you see of the above difficulties:
Additional symptoms you might see:

Delayed language skills

Delayed movement skills

Delayed cognitive or learning skills

Hyperactive, impulsive, and/or inattentive behaviour

Epilepsy or seizure disorder

Unusual eating and sleeping habits

Gastrointestinal issues (e.g., constipation)

Unusual mood or emotional reactions

Anxiety, stress, or excessive worry

Lack of fear or more fear than expected


Diagnosing ASD can be sometimes difficult since there is no medical test, like a blood test, to diagnose the disorder. Often a diagnosis may involve an MDT (Multi-disciplinary team) e.g., paediatrician, speech and language therapist, occupational therapist, specialist health visitor and psychologist.

ASD can sometimes be detected at 18 months or younger. By age 2, a diagnosis by an experienced professional can be considered very reliable. However, many children do not receive a final diagnosis until much older. This delay means that children with ASD might not get the early help they need.

Early intervention:

To date, there is no “cure” for ASD, but research has successfully shown that early intervention is key and can improve the functional skills of the individual. Hence it is so important to speak to your GP or therapist if you have any concerns.  

If your child is on the Autism assessment pathway and he or she is having difficulties with attention, listening, language delay etc, you can still seek help from the speech and language therapist. You do not need a formal diagnosis to receive support from a speech and language therapist.

Iman Omar, Specialist Speech and Language Therapist.

Specialist Speech and Language Therapist.