Table of ContentsView AllTable of ContentsWhat Are the Developmental Milestones?Why Children Miss Developmental MilestonesWhen Developmental Delays May Suggest AutismWhy Monitoring for Autism This Way Can Be MisleadingIf Your Child Has Developmental Delays
Table of ContentsView All
View All
Table of Contents
What Are the Developmental Milestones?
Why Children Miss Developmental Milestones
When Developmental Delays May Suggest Autism
Why Monitoring for Autism This Way Can Be Misleading
If Your Child Has Developmental Delays
Children diagnosed withautism spectrum disorder(ASD) often have developmental delays, defined as reaching their social, emotional, communication, cognitive, and physical milestones in different ways than neurotypical people do.
But “developmental delays” is an oversimplification that fails to capture the breadth of development in autistic people. Most autistic children reach some of their developmental milestones on time or early—sometimes extraordinarily so. Others may be late, lose ground over time, or not develop at all.
This article seeks to present a comprehensive and accurate view of developmental milestones and what they can mean in the lives of autistic children. It explains some of the traits to watch for, but also why the idea of “delays” in people who simply learn and live differently can be misleading.
Alita Ong / Stocksy United
The Centers for Disease Control and Prevention (CDC) divides developmental milestones into groups: movement/physical, cognitive, language/communication, social/emotional. They list specific levels of achievement for each age, starting with 1 month and moving through adolescence.
While they make it clear that children may not reach any given milestone at the precise age outlined, they also suggest that parents keep an eye out to be sure their child is at or close to what’s expected.
Social and Emotional
Language/Communication
Cognitive (Learning, Thinking, Problem Solving)
There are many reasons why children miss developmental milestones. In most cases, there’s no particular cause for concern.
That’s because:
With that said, there are times when developmental delays may indicate a concern such as autism.
The CDC provides a list of issues that are consideredearly traits of autism, though they may also occur in those without a spectrum disorder.
Autism is more likely when children have more than one of these issues or have other related issues in the social/emotional or communication realms:
Sometimes, autistic children miss multiple milestones and have clear and obvious developmental delays. Often, however, missed milestones can be masked or even invisible.
This is because autistic children aren’t simply delayed; they learn and behave differently from their typical peers.
In addition, autism is rarely obvious from birth. Many autistic children develop like their neurotypical counterparts for a period of time and then either slow down, develop in small ways, or actually regress.
How Autism in Children Is Diagnosed
Masked or Hidden Delays in Autism
Some autistic children have severe cognitive delays, behavioral challenges, or physical"stims"(rocking or flapping) that make clear they are developing differently. But many don’t. When that’s the case, developmental delays may be hard to spot.
There are a few groups of children whose developmental delays may not be obvious until social, emotional, or communication demands increase (usually after grades 1 or 2).
Girls
Autism generally causes children to be quiet, socially withdrawn, and less likely to raise their hands or speak out. They may appear “dreamy” or inattentive.
These behaviors are social expectations of girls in many parts of the world. Thus, young autistic girls who are not meeting developmental milestones may slide under the radar. They are often labeled as “shy and quiet,” and, perhaps, not terribly bright.
It may take quite a while for parents and teachers to notice other autism traits in girls.
Children, and especially autistic girls with lower support needs, are sometimes able to hide or overcome developmental delays, which can make milestones an unreliable measure to use for diagnosis.
Autism Traits in Girls
Black Children
Delays in diagnosis and treatment may play a role in the higher rates of co-occurring intellectual disability seen in Black children.Autistic black children also tend to be misdiagnosed more often, with conditions including behavioral problems or attention deficit disorder. It’s important for caregivers to advocate for access to care and appropriate therapies and resources.
Children With Impressive Intelligence or Splinter Skills
Quite a few autistic children are very bright or have surprising skills that are far beyond their years.
For example, some autistic children can solve complex puzzles, read at a very young age, or show impressive math, music, or computer skills. They may also have advanced vocabularies in their areas of special interest.
When this is the case, parents and teachers may not notice that the same child who can solve complex math equations is unable to play imaginatively or catch a ball. They also may not be able to identify the difference between a grasp of facts, and meaningful understanding and knowledge.
Sometimes, autistic children can appear to gain important skills but they are unable to use them in real-world situations. Many have so-called “splinter” skills, which can be very advanced but not useful in daily life. Up to 10% of autistic people may have splinter skills.
Splinter Skills in Autism
Children With Empathetic Siblings or Peers
In some families and classrooms, empathetic siblings or peers can actually mask another child’s autism.
These children take it upon themselves to learn to understand their autistic peer and speak for them. While this is undoubtedly kind and caring, it’s also a form of enabling that can make it hard to know what the autistic child really can do for themself.
Children of Parents With Autistic Traits
It’s not unusual for autistic children to have parents who could be diagnosable as autistic with lower support needs, or who have so-called “shadow” traits of autism.
When this is the case, parents may see their children as developing typically (just like they did). Some parents may not want their child to be labeled as autistic because they struggle with the idea that the same could be said about them.
If you think your child has developmental delays and may be autistic, take action. Ask your child’s healthcare provider to screen for delays, with a special emphasis on social, communication, and emotional skills.
If your intuition was incorrect, you can put a potential diagnosis out of mind. If your child does, indeed, have developmental delays, you’ve taken prompt action to get to the bottom of why they are occurring and what can be done to help them overcome any challenges.
A Checklist of Autism Traits
13 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.CDC’s developmental milestones.Centers for Disease Control and Prevention (CDC).Healthy habits: child development.Centers for Disease Control and Prevention (CDC).Signs and symptoms of autism spectrum disorder.Madipakkam AR, Rothkirch M, Dziobek I, Sterzer P.Unconscious avoidance of eye contact in autism spectrum disorder.Sci Rep. 2017;7(1):13378. doi:10.1038/s41598-017-13945-5Feige E, Mattingly R, Pitts T, Smith AF.Autism spectrum disorder: investigating predictive adaptive behavior skill deficits in young children. Rossignol D, ed.Autism Research and Treatment. 2021;2021:1-9. doi:10.1155/2021/8870461Rynkiewicz A, Schuller B, Marchi E, et al.An investigation of the ‘female camouflage effect’ in autism using a computerized ADOS-2 and a test of sex/gender differences.Mol Autism. 2016;7:10. doi:10.1186/s13229-016-0073-0Fombonne E, Zuckerman KE.Clinical profiles of Black and White children referred for autism diagnosis.J Autism Dev Disord. 2022 Mar;52(3):1120-1130. doi:10.1007/s10803-021-05019-3Maenner MJ, Warren Z, Williams AR, et al.Prevalence and characteristics of autism spectrum disorder among children aged 8 years - Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2020.MMWR Surveill Summ. 2023 Mar 24;72(2):1-14. doi:10.15585/mmwr.ss7202a1Constantino JN, Abbacchi AM, Saulnier C, et al.Timing of the diagnosis of autism in African American children.Pediatrics. 2020 Sep;146(3):e20193629. doi:10.1542/peds.2019-3629Čolić M, Araiba S, Lovelace TS, Dababnah S.Black caregivers' perspectives on racism in ASD services: Toward culturally responsive ABA practice.Behav Anal Pract. 2021 Jun 2;15(4):1032-1041. doi:10.1007/s40617-021-00577-5Happé F.Why are savant skills and special talents associated with autism?World Psychiatry. 2018;17(3):280-281. doi:10.1002/wps.20552Marques JG, Pires S.Psychosis in Autistic Patients With Splinter Skills (Savant Syndrome) Presenting Abnormal Cerebellar Anatomy Misdiagnosed as Disorganized (Hebephrenic) Schizophrenia.Prim Care Companion CNS Disord. 2019 Sep 12;21(5):18l02421. doi:10.4088/PCC.18l02421.American Academy of Pediatrics.3 early signs of autism spectrum disorder (ASD).
13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.CDC’s developmental milestones.Centers for Disease Control and Prevention (CDC).Healthy habits: child development.Centers for Disease Control and Prevention (CDC).Signs and symptoms of autism spectrum disorder.Madipakkam AR, Rothkirch M, Dziobek I, Sterzer P.Unconscious avoidance of eye contact in autism spectrum disorder.Sci Rep. 2017;7(1):13378. doi:10.1038/s41598-017-13945-5Feige E, Mattingly R, Pitts T, Smith AF.Autism spectrum disorder: investigating predictive adaptive behavior skill deficits in young children. Rossignol D, ed.Autism Research and Treatment. 2021;2021:1-9. doi:10.1155/2021/8870461Rynkiewicz A, Schuller B, Marchi E, et al.An investigation of the ‘female camouflage effect’ in autism using a computerized ADOS-2 and a test of sex/gender differences.Mol Autism. 2016;7:10. doi:10.1186/s13229-016-0073-0Fombonne E, Zuckerman KE.Clinical profiles of Black and White children referred for autism diagnosis.J Autism Dev Disord. 2022 Mar;52(3):1120-1130. doi:10.1007/s10803-021-05019-3Maenner MJ, Warren Z, Williams AR, et al.Prevalence and characteristics of autism spectrum disorder among children aged 8 years - Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2020.MMWR Surveill Summ. 2023 Mar 24;72(2):1-14. doi:10.15585/mmwr.ss7202a1Constantino JN, Abbacchi AM, Saulnier C, et al.Timing of the diagnosis of autism in African American children.Pediatrics. 2020 Sep;146(3):e20193629. doi:10.1542/peds.2019-3629Čolić M, Araiba S, Lovelace TS, Dababnah S.Black caregivers' perspectives on racism in ASD services: Toward culturally responsive ABA practice.Behav Anal Pract. 2021 Jun 2;15(4):1032-1041. doi:10.1007/s40617-021-00577-5Happé F.Why are savant skills and special talents associated with autism?World Psychiatry. 2018;17(3):280-281. doi:10.1002/wps.20552Marques JG, Pires S.Psychosis in Autistic Patients With Splinter Skills (Savant Syndrome) Presenting Abnormal Cerebellar Anatomy Misdiagnosed as Disorganized (Hebephrenic) Schizophrenia.Prim Care Companion CNS Disord. 2019 Sep 12;21(5):18l02421. doi:10.4088/PCC.18l02421.American Academy of Pediatrics.3 early signs of autism spectrum disorder (ASD).
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Centers for Disease Control and Prevention.CDC’s developmental milestones.Centers for Disease Control and Prevention (CDC).Healthy habits: child development.Centers for Disease Control and Prevention (CDC).Signs and symptoms of autism spectrum disorder.Madipakkam AR, Rothkirch M, Dziobek I, Sterzer P.Unconscious avoidance of eye contact in autism spectrum disorder.Sci Rep. 2017;7(1):13378. doi:10.1038/s41598-017-13945-5Feige E, Mattingly R, Pitts T, Smith AF.Autism spectrum disorder: investigating predictive adaptive behavior skill deficits in young children. Rossignol D, ed.Autism Research and Treatment. 2021;2021:1-9. doi:10.1155/2021/8870461Rynkiewicz A, Schuller B, Marchi E, et al.An investigation of the ‘female camouflage effect’ in autism using a computerized ADOS-2 and a test of sex/gender differences.Mol Autism. 2016;7:10. doi:10.1186/s13229-016-0073-0Fombonne E, Zuckerman KE.Clinical profiles of Black and White children referred for autism diagnosis.J Autism Dev Disord. 2022 Mar;52(3):1120-1130. doi:10.1007/s10803-021-05019-3Maenner MJ, Warren Z, Williams AR, et al.Prevalence and characteristics of autism spectrum disorder among children aged 8 years - Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2020.MMWR Surveill Summ. 2023 Mar 24;72(2):1-14. doi:10.15585/mmwr.ss7202a1Constantino JN, Abbacchi AM, Saulnier C, et al.Timing of the diagnosis of autism in African American children.Pediatrics. 2020 Sep;146(3):e20193629. doi:10.1542/peds.2019-3629Čolić M, Araiba S, Lovelace TS, Dababnah S.Black caregivers' perspectives on racism in ASD services: Toward culturally responsive ABA practice.Behav Anal Pract. 2021 Jun 2;15(4):1032-1041. doi:10.1007/s40617-021-00577-5Happé F.Why are savant skills and special talents associated with autism?World Psychiatry. 2018;17(3):280-281. doi:10.1002/wps.20552Marques JG, Pires S.Psychosis in Autistic Patients With Splinter Skills (Savant Syndrome) Presenting Abnormal Cerebellar Anatomy Misdiagnosed as Disorganized (Hebephrenic) Schizophrenia.Prim Care Companion CNS Disord. 2019 Sep 12;21(5):18l02421. doi:10.4088/PCC.18l02421.American Academy of Pediatrics.3 early signs of autism spectrum disorder (ASD).
Centers for Disease Control and Prevention.CDC’s developmental milestones.
Centers for Disease Control and Prevention (CDC).Healthy habits: child development.
Centers for Disease Control and Prevention (CDC).Signs and symptoms of autism spectrum disorder.
Madipakkam AR, Rothkirch M, Dziobek I, Sterzer P.Unconscious avoidance of eye contact in autism spectrum disorder.Sci Rep. 2017;7(1):13378. doi:10.1038/s41598-017-13945-5
Feige E, Mattingly R, Pitts T, Smith AF.Autism spectrum disorder: investigating predictive adaptive behavior skill deficits in young children. Rossignol D, ed.Autism Research and Treatment. 2021;2021:1-9. doi:10.1155/2021/8870461
Rynkiewicz A, Schuller B, Marchi E, et al.An investigation of the ‘female camouflage effect’ in autism using a computerized ADOS-2 and a test of sex/gender differences.Mol Autism. 2016;7:10. doi:10.1186/s13229-016-0073-0
Fombonne E, Zuckerman KE.Clinical profiles of Black and White children referred for autism diagnosis.J Autism Dev Disord. 2022 Mar;52(3):1120-1130. doi:10.1007/s10803-021-05019-3
Maenner MJ, Warren Z, Williams AR, et al.Prevalence and characteristics of autism spectrum disorder among children aged 8 years - Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2020.MMWR Surveill Summ. 2023 Mar 24;72(2):1-14. doi:10.15585/mmwr.ss7202a1
Constantino JN, Abbacchi AM, Saulnier C, et al.Timing of the diagnosis of autism in African American children.Pediatrics. 2020 Sep;146(3):e20193629. doi:10.1542/peds.2019-3629
Čolić M, Araiba S, Lovelace TS, Dababnah S.Black caregivers' perspectives on racism in ASD services: Toward culturally responsive ABA practice.Behav Anal Pract. 2021 Jun 2;15(4):1032-1041. doi:10.1007/s40617-021-00577-5
Happé F.Why are savant skills and special talents associated with autism?World Psychiatry. 2018;17(3):280-281. doi:10.1002/wps.20552
Marques JG, Pires S.Psychosis in Autistic Patients With Splinter Skills (Savant Syndrome) Presenting Abnormal Cerebellar Anatomy Misdiagnosed as Disorganized (Hebephrenic) Schizophrenia.Prim Care Companion CNS Disord. 2019 Sep 12;21(5):18l02421. doi:10.4088/PCC.18l02421.
American Academy of Pediatrics.3 early signs of autism spectrum disorder (ASD).
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