One of the first things Dr. Soorya impressed upon me is that normal development happens in a "huge range" but told me that "the signs parents most often are concerned about when they come to their primary care physicians or even specialists like us, they usually come to us when their child isn't speaking." Research has shown that children with autism are also less likely to babble as infants or do so at lower frequency than children without autism.
Dr. Soorya noted that parents have many ways of rationalizing a child not speaking (like they have an older sibling who is speaking for them, boys speak later, etc.) and that it's true that it doesn't always mean a child has autism. Still, when a child does have autism, typically that's the symptom that has led to parents bringing the child to the doctor.
Dr. Soorya told me that often this occurs if a child is between 2 and 3-and-a-half years old and not speaking. Just like not speaking doesn't automatically indicate autism, autism doesn't always require a speech delay or lack of speech development. "Many kids develop speech in some form other another. Some develop first words and don't get to phrases. Some go from no babbling straight to phrases. It's a wide range what [speech delay] is. Early on, it's usually a kid who is not speaking that we see sooner."
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