Early Communication Milestones: When Should You Consider an Autism Evaluation?
By Michelle McGuinness, M.A., CCC-SLP | Aldea
Communication develops in ways beyond spoken words. It includes how children use gestures, make sounds, respond to others, understand language, and interact during everyday moments.
A missed milestone doesn’t always mean a child has autism or another developmental condition. Some children develop certain skills later, while others may benefit from extra support to strengthen communication, language, or social interaction skills.
This guide will help you understand early communication milestones from birth to age 3, recognize signs that may suggest your child needs further evaluation, learn how speech delay differs from autism-related communication differences, and understand what happens during an autism evaluation.
Understanding early communication milestones
When looking at your child’s early communication milestones, consider the full range of skills your child is developing, not just the number of words they can say. A child’s communication development includes:
Expressive language: how your child uses sounds, words, gestures, and sentences to share thoughts, needs, and ideas.
Receptive language: how your child understands words, questions, instructions, and information from others.
Social communication: how your child connects with people, shares attention, responds, and participates in interactions.
A baby who smiles when spoken to, turns toward a familiar voice, or reaches toward a toy is already communicating, even before using spoken words. As children grow, these early skills develop into babbling, gestures, first words, phrases, and conversations.
Children's language develops at their own pace, but milestones provide a helpful guide for understanding whether communication skills are developing as expected. Looking at patterns over time can help you recognize your child’s strengths, notice areas where they may need support, and know when it may be helpful to speak with a professional.
The sections below outline common communication milestones from birth to age 3 and explain the skills parents can observe during each stage of development.
Communication milestones from birth to age 3
The milestones below provide general guidance on what communication development may look like at different ages. Children may reach skills at slightly different times, but noticing patterns in your child’s development can help you understand when additional support may be useful.
Communication milestones for kids within 0–6 months
During the first six months, babies begin building the foundations of communication through sounds and social interaction.
They learn that their voices, facial expressions, and movements can help them connect with others.
You may notice your baby:
Responding to sounds: turning toward familiar voices, reacting to loud noises, or showing awareness when someone speaks.
Making early sounds: cooing, smiling, laughing, and experimenting with different sounds.
Engaging during interactions: making eye contact, smiling back, and showing interest when caregivers talk or play with them.
These early responses are the building blocks for later communication skills. A baby doesn’t need to say words at this stage, but they’re already learning how communication works through back-and-forth interactions.
Communication milestones for kids within 6–12 months
Between six and twelve months, babies begin to communicate more intentionally. They start using sounds, gestures, and actions to get attention and express their interests.
You may notice your baby:
Babbling with different sounds: combining sounds such as “ba,” “da,” or “ma” and experimenting with their voice.
Using gestures: reaching, waving, pointing, or using movements to communicate wants and interests.
Responding to their name: looking toward you or reacting when you call them.
Showing shared attention: looking at an object, then looking back at you to share interest or enjoyment.
Shared attention, like showing you a toy or looking where you point, is an important part of early social communication development.
Communication milestones for kids within 12–18 months
During the second year of life, many children begin using their first words and become more intentional about communicating their needs and interests.
You may notice your child:
Using first words: saying familiar words for people, objects, or actions.
Understanding simple language: responding to familiar requests or identifying common objects.
Using gestures with communication: pointing, showing objects, or combining gestures with sounds or words.
Trying to express needs: using sounds, words, or actions to request help, food, toys, or attention.
Some children develop spoken language earlier or later than others. However, if a child has very few words, limited gestures, or difficulty using communication to interact with others, it may help to discuss these concerns with a professional.
You can learn more about signs that may require closer attention in our guide on red flags for speech delay parents should not ignore.
Communication milestones for kids within 18–24 months
Between 18 and 24 months, children expand their vocabulary and combine words to communicate more detailed ideas.
You may notice your child:
Combining words: using simple phrases such as “more juice,” “mommy come,” or “want toy.”
Following simple instructions: understanding everyday directions such as “bring your shoes” or “give me the ball.”
Learning new words: gradually increasing the number of words they understand and use.
Communicating preferences: using words, gestures, or short phrases to express choices and needs.
A child who isn’t using expected communication skills at this stage may benefit from a speech screening to better understand their strengths and areas where support may help.
Communication milestones for kids within 2–3 years
Between ages two and three, children usually begin developing more advanced language and social communication skills. They move from simple phrases to longer sentences and more interactive conversations.
You may notice your child:
Using short sentences: combining several words to describe needs, actions, or experiences.
Asking questions: using words to seek information and engage with others.
Participating in conversations: responding to questions, sharing ideas, and taking part in simple back-and-forth exchanges.
Using pretend play: creating stories, acting out familiar activities, or using toys in imaginative ways.
If, after reading this checklist, you notice your child isn’t reaching expected communication milestones, losing skills they previously developed, or having difficulty with social interaction, it may be worth discussing your concerns with a healthcare or developmental professional.
Early support can help families better understand their child’s communication profile and identify appropriate next steps.
Early signs that may suggest your child needs further evaluation
While children develop skills at different rates, it helps to seek an evaluation at the early stage of your observations.
An evaluation doesn’t only look for concerns. It also identifies your child’s strengths, understands how they learn and communicate, and determines whether additional support may be useful.
Some signs to pay attention to include:
1. Communication signs
Communication differences may appear in how your child uses sounds, words, gestures, or language to connect with others.
You may consider seeking guidance if your child:
Uses fewer sounds or words than expected: your child may have limited babbling, few spoken words, or difficulty combining words as they grow.
Does not use gestures to communicate: your child rarely points, waves, shows objects, or uses movements to share interests or needs.
Loses communication skills they previously had: your child stops using words, gestures, or social responses they previously developed.
Has difficulty communicating needs: your child becomes frustrated because they cannot express what they want, need, or feel.
3. Social interaction signs
Autism-related communication differences often involve how a child connects and interacts with others, not only how they speak.
You may want to discuss your concerns with a professional if your child:
Does not consistently respond to their name: your child may appear not to notice when someone calls them or attempts to get their attention.
Shows limited shared attention: your child may not point to show you something interesting, look back and forth between an object and another person, or share experiences with others.
Has difficulty with back-and-forth interaction: your child may find it challenging to respond to others, imitate actions, or participate in simple social exchanges.
Shows limited interest in social play: your child may prefer playing alone or may have difficulty joining play activities with others.
3. Behavioral signs
Some behaviors may also provide important information when they appear alongside communication and social differences.
You may consider an evaluation if your child:
Repeats certain movements or actions: such as repetitive hand movements, spinning objects, or arranging toys in the same way repeatedly.
Has strong difficulty with changes: your child may become highly distressed when routines change or when activities happen differently than expected.
Shows unusual patterns of play: your child may focus intensely on parts of toys, repeat the same actions during play, or have difficulty with imaginative play.
A single sign doesn’t determine whether a child has autism. What matters is the overall pattern of development, including how your child communicates, interacts, plays, and responds to the people around them.
If you’re noticing several of these signs or have ongoing concerns about your child’s development, our guide on early signs of autism in toddlers before age 3 can help you understand what behaviors may be worth discussing with a professional.
You can also explore our autism evaluation checklist for parents to understand when an evaluation may be helpful.
What happens during an autism evaluation?
If you're unsure what an autism evaluation involves, here’s what to expect.
The evaluation may include several parts:
1. Parent interview
The process often begins with a conversation about your child’s development and your concerns. Your observations provide important information because you see how your child communicates and behaves during everyday activities.
A clinician may ask about:
Developmental history: when your child reached early milestones such as babbling, first words, walking, and using gestures.
Communication skills: how your child expresses needs, responds to others, and uses language.
Social interaction: how your child plays, connects with family members, and responds during interactions.
Current concerns: behaviors, changes, strengths, and situations where your child may need additional support.
2. Developmental history review
Understanding your child’s development over time helps the evaluation team identify patterns. They may review information about language development, learning, behavior, sensory responses, and any skills your child may have gained or lost.
A child’s developmental history helps professionals understand whether concerns are isolated to one area, such as speech development, or whether they involve broader areas of communication and interaction.
3. Child observation and assessment
During the evaluation, the clinician observes how your child communicates and responds in different situations. Depending on your child’s age, this may involve play-based activities, structured tasks, and interactions with the evaluator.
The assessment may look at:
Communication skills: how your child uses sounds, words, gestures, and other forms of communication.
Social communication: how your child responds to others, shares attention, and participates in interactions.
Play skills: how your child uses toys, imitates actions, and engages in pretend play.
Behavior patterns: whether repetitive behaviors, sensory responses, or difficulty with changes are present.
4. Recommendations and next steps
After gathering information, the evaluation team will explain their findings and discuss possible next steps. Recommendations may include speech therapy, early intervention services, developmental support, or additional evaluations depending on your child’s needs.
An autism evaluation helps clarify your child’s strengths and challenges. It gives families information they can use to choose appropriate support and create a plan that matches their child’s development.
If you are preparing for an evaluation and want to understand the questions professionals consider, our guide on does my child need an autism evaluation? can help you review common signs and next steps.
What parents can do to support communication development at home
There are certain practices and exercises you can adopt at home to strengthen your child’s communication; they involve small changes in how you talk, respond, and interact with your child and can help strengthen their communication skills.
Try these approaches during everyday moments:
Talk through daily activities: describe what you and your child are doing during routines such as getting dressed, preparing meals, or playing together. Simple phrases like “washing hands,” “big ball,” or “open the door” help connect words with actions.
Respond to all communication attempts: acknowledge your child’s sounds, gestures, facial expressions, or movements as meaningful attempts to communicate. Responding teaches your child that communication helps them connect with others.
Create opportunities to communicate: pause during play or routines and give your child time to respond, make a choice, point, gesture, or use words. Waiting gives them space to participate instead of only listening.
Follow your child’s interests: join activities your child already enjoys and talk about what captures their attention. If your child is playing with cars, for example, you can introduce words like “go,” “stop,” “fast,” or “car.”
Read and sing together: books, songs, and nursery rhymes expose children to new words, sounds, and patterns while creating opportunities for interaction.
Use repetition naturally: repeating familiar words and phrases during everyday activities helps children understand meaning and build confidence using language.
For children with communication differences, progress may look different from child to child. The goal is not to pressure your child to speak before they are ready, but to create consistent opportunities for connection, understanding, and communication.
How Aldea helps families understand their child’s development
Aldea helps families in Florida turn those questions into a clearer path forward through professional evaluations and developmental support.
Our team brings together speech-language professionals and psychologists who help families:
Understand what is happening: explore your child’s communication, social interaction, and developmental patterns to better understand their strengths and areas where support may help.
Identify the right next step: determine whether your child may benefit from speech therapy, an autism evaluation, or other developmental services.
Receive guidance tailored to your child: access recommendations based on your child’s individual needs instead of relying on general advice or comparisons.
Feel supported throughout the process: get answers from professionals who understand early childhood development and the concerns families often face.
Every child develops differently, and having concerns does’t mean you already know the answer. Sometimes the most helpful first step is gaining a clearer picture of your child’s development.
If you have questions about your child’s communication milestones or developmental progress, Aldea can help you understand what support may be appropriate.
Explore Aldea’s speech therapy services.
FAQs about early communication milestones
1. Does speech delay always mean autism?
No. Speech delay does not always mean autism. Some children may have difficulty with speech or language development without having autism. An evaluation can help identify what support your child may need.
2. What are early signs of autism in toddlers?
Early signs may include limited response to their name, fewer gestures, difficulty with social interaction, reduced shared attention, repetitive behaviors, or differences in communication development.
3. When should my child have an autism evaluation?
Consider an evaluation if you notice ongoing concerns with communication, social interaction, behavior, or if your child loses skills they previously developed. A professional evaluation can provide clearer guidance.
4. Can a child have speech delay without autism?
Yes. A child can have speech delay without autism. Speech delays may involve difficulties with using words, producing sounds, or expressing thoughts, while autism involves broader differences in communication, interaction, and behavior.