7 Signs of Autism that Doctors Might Miss
Rushed visits and a lack of training in autism spectrum disorder can lead to late diagnoses for autistic children. Here are some lesser-known signs that may be overlooked:
1. Non-Typical Play
Preferring to play with non-toy objects or focusing on specific parts of a toy (e.g., spinning the wheels of a car) can be a sign of autism. Autistic children may find lining up toys more enjoyable than playing with them in a conventional way.
2. Difficulty Playing with Peers
Autistic children may prefer playing alone rather than engaging with other kids. While many autistic individuals avoid eye contact, some have great eye contact and enjoy socializing but may need support in learning how to play with peers and interpret nonverbal communication.
3. Preference for Routine
Autistic children can become upset by minor changes to their routines and may struggle with transitions. Introducing something new—especially unexpectedly—can be distressing.
Examples of challenging changes:
- Going somewhere new (e.g., a dentist appointment)
- Having guests at home
- Trying a new food
- Not being able to finish an activity
- Having a substitute teacher
4. Sensory Processing Disorder (SPD)
Sensory Processing Disorder (SPD), which often co-occurs with autism, affects how a child responds to sensory input. Some children are over-sensitive (e.g., distressed by loud sounds like a vacuum) while others are under-sensitive (e.g., seeking intense movement or pressure).
Signs of sensory differences may include:
- Being a picky eater
- Disliking face-touching or haircuts
- Fascination with spinning objects or flashing lights
- Repeating a specific part of a song or video over and over
5. Intense, Narrow Interests
Autistic children often develop deep interests in specific topics. A verbal child may talk exclusively about dinosaurs, space, or train schedules, while a preverbal child might have a strong attachment to a specific object (toy or non-toy) and become very upset if it is lost or removed.
6. Hyperlexia (Early Reading Skills)
Hyperlexia—reading before age five—can be a sign of autism. Since early reading is often seen as a gifted trait, it can be overlooked. However, studies show that over 80% of children with hyperlexia are also autistic. These children may decode words well but struggle with comprehension and social language.
7. Speech Delay
Speech delays can occur with or without autism, but some autistic children have a limited vocabulary or may not use speech functionally. Others may repeat phrases from TV or YouTube without fully understanding them (echolalia). Alternatively, some autistic children have an advanced vocabulary but struggle with social communication.
Since autism presents differently in every child, early signs are often missed or misunderstood. If you have concerns, seeking an evaluation with an experienced provider can help ensure the right support is in place.
