Understanding autism
Understanding autism

Start this free course now. Just create an account and sign in. Enrol and complete the course for a free statement of participation or digital badge if available.

1.2 12 to 24 months

It is often in the second year of life (12–24 months), when language, communication and play are beginning to take off in TD children, that important differences start to emerge, and are picked up by parents. They may notice difficulties with speech and language development, apparent indifference to others, dislike of change, or eating and sleeping issues. They may also notice that the child plays unusually, for instance repeatedly tipping bricks out of their container and then putting them back, rather than building with them. These possible signs may be particularly evident in children later diagnosed as ‘lower-functioning’. The more subtle symptoms of ‘high-functioning’ autism may go unnoticed for much longer, especially if, rather than showing developmental delays, a child seems particularly precocious. For instance, some parents report that their child showed strikingly early skills in reading or naming things.

Between 12 to 24 months, children subsequently diagnosed with autism may show little response to what is said to them (known as difficulty with receptive language), and may not use their few words in a meaningful way (known as difficulty with expressive language). Often this will lead to a hearing check before autism is considered. Children may also exhibit echolalia – simply repeating what has been said to them instead of responding in a typical way. For instance if asked ‘Do you want a drink?’, a child may just repeat that rather than saying ‘Yes please’. This may indicate a lack of reciprocity, the two-way use of language. Another example of poor reciprocity is difficulty taking turns in conversation, such that the person may seem to be in a monologue rather than a dialogue. Even if a child shows no delay or difficulty in developing grammar, vocabulary and other language features, this difficulty in turn-taking may be indicative.

Also in this second year, children subsequently diagnosed with autism may show little eye contact (looking directly at another person), or joint attention, whether looking towards something that another person is looking at, or engaging another person to look where they are looking. One way that TD children do this is by protodeclarative pointing, that is, pointing simply to indicate or share with others their interest in something. Another noticeable difference in an autistic toddler is absence of pretend play, such as ‘driving a vehicle’ consisting of a large cardboard box (Barbaro and Dissanayake, 2013).

Take your learning further

Making the decision to study can be a big step, which is why you'll want a trusted University. The Open University has 50 years’ experience delivering flexible learning and 170,000 students are studying with us right now. Take a look at all Open University courses.

If you are new to University-level study, we offer two introductory routes to our qualifications. You could either choose to start with an Access module, or a module which allows you to count your previous learning towards an Open University qualification. Read our guide on Where to take your learning next for more information.

Not ready for formal University study? Then browse over 1000 free courses on OpenLearn and sign up to our newsletter to hear about new free courses as they are released.

Every year, thousands of students decide to study with The Open University. With over 120 qualifications, we’ve got the right course for you.

Request an Open University prospectus371