The way a child uses language and physical movement to communicate verbally and non-verbally offers one of the best early alerts to developmental disorders such as autism, which can hamper a child's social and cognitive development. Disorders like autism (which are called pervasive developmental disorders) are the result of neurological problems that affect certain areas of the brain. Autism is a complex developmental disability that makes it hard for those who have it to communicate with others and relate to the outside world. The disease usually appears during the first three years, and for reasons we don't yet understand, it's four times more prevalent in boys than in girls. More than a half million people in the United States today have autism or some form of pervasive developmental disorder.
Recent advances in brain research have shown us how the environment sculpts a young child's brain. These advances have also pointed to the importance of early intervention: Since the brain operates on what experts call a "use it or lose it" basis, early experiences can actually "shape" brain structure – so it's important to get help as soon as you realize your child might need it. Trust your instincts, and if something seems wrong to you, ask your pediatrician about it or call your county's early intervention program for an evaluation. The following are possible warning signs of a social or cognitive delay. Feel free to print out this form and use it for reference.
Age: 13 to 18 months
- Does not smile and laugh when looking at you
- Does not vocalize frequently
- Does not produce more than one consonant sound in strings of babbling or jargon
- Does not point to or show you things that interest him / her
- Does not respond to his / her name
- Doesn't respond to familiar sounds (phone ringing, dad's voice, etc) with recognition
- Doesn't gesture to communicate (for example, wave bye-bye)
- Doesn't let you know what he / she wants or doesn't want
- Doesn't engage in social games (for example, patty-cake)
- Doesn't imitate actions or attempt to imitate speech or songs
- Does not play with a variety of toys such as blocks, books, dolls, cars, etc.
Age: 19 to 24 months
- Does not interact with others during play (for example, showing, giving, looking up for a reaction)
- Does not recognize pictures of familiar objects or persons by pointing or verbally labeling
- Does not engage in pretend play (for example, feeding dolls or animals, stirring)
Age: 25 to 30 months
- Does not listen to stories with pictures
- Does not name pictures
- Does not follow simple directives
Age: 30 to 36 months
- Does not answer questions about recent experiences
- Does not express physical states (for example, I'm hurt, hungry)
- Does not follow two- or three-part directives
- Does not engage in symbolic play (for example, using a banana for a phone, or a block for a car)
- Does not engage in short conversational interchanges but rather uses language solely to get needs met
- Does not maintain attention to a specific activity for at least 10 minutes
Also see our warning signs of a physical delay, warning signs of a hearing delay, and warning signs of a language problem.
Read more on toddler development and developmental delays.