Early Communication Milestones and When to Consider an Autism Evaluation

By Michelle McGuinness, M.A., CCC-SLP | WellChild Center for Development

Why Early Communication Matters

The first few years of life are a critical period for brain and language development. Babies are constantly learning how to communicate — first through eye contact, cooing, and gestures, and later with words and sentences.

When parents understand early speech and communication milestones, they can encourage growth, track progress, and recognize when to seek extra support — including an autism evaluation if certain red flags appear. At WellChild Center for Development, our team of psychologists and speech-language pathologists helps families navigate these early years with confidence through autism, ADHD, and speech delay evaluations.

Early Speech and Communication Milestones (Birth to Age 3)

Every child develops at their own pace, but most follow a predictable sequence of communication milestones. Here’s a quick overview:

• 0–6 months: Reacts to sounds, smiles when spoken to, coos and babbles.
• 6–12 months: Responds to their name, uses gestures like pointing or waving, and says simple words like “mama” or “dada.”
• 12–24 months: Uses 5–50+ words, follows simple directions (“Get the ball”), and combines words (“More milk”).
• 2–3 years: Puts words into short sentences (“I want cookie”), asks questions, and is understood by parents most of the time.

When children fall behind on these milestones, it can indicate a speech delay — or, in some cases, early signs of autism spectrum disorder (ASD).

It’s never too early to check in if you’re concerned about your child’s speech or social skills. You may want to request an autism evaluation or speech and language screening if your child:

• Isn’t babbling or making sounds by 6–9 months
• Has no words by 15 months
• Doesn’t use two-word phrases by age 2
• Avoids eye contact or doesn’t respond to their name
• Rarely uses gestures (like waving or pointing)
• Repeats words or phrases without meaning (echolalia)
• Has difficulty interacting, sharing attention, or playing with others
• Becomes upset by changes or has repetitive movements (hand flapping, spinning, lining up toys)

These behaviors don’t always mean autism — but they do signal the need for a developmental or psychological evaluation. Early identification makes a big difference.

An autism evaluation looks at your child’s social, language, and behavioral development. At WellChild, our psychologists and speech therapists use standardized tools and play-based assessments to understand your child’s strengths and challenges. We assess key developmental areas such as:

• Communication and speech
• Social interaction and play
• Attention and behavior regulation
• Motor skills and sensory responses

Early identification allows families to access speech therapy, occupational therapy, or behavioral supports (like ABA) sooner — helping children reach milestones faster and with less frustration.

While you’re waiting for an evaluation or starting therapy, small daily interactions can make a big difference in your child’s language and connection skills:

• Narrate your day: Talk about what you’re doing — “We’re putting on socks!”
• Use repetition: Repeat simple, meaningful words like “up,” “go,” or “more.”
• Pause and wait: Give your child time to respond, even with gestures.
• Follow their lead: Talk about what your child is looking at or interested in.
• Sing and read: Songs and picture books build rhythm, attention, and vocabulary.

The earlier a child receives an autism evaluation, the sooner families can access the right therapies and supports. Studies show that children who begin intervention before age 3 make the greatest gains in communication, social interaction, and learning. At WellChild Center for Development, we make the process easy with:

• Affordable diagnostic evaluations for Autism and ADHD
• Licensed clinical psychologists and speech-language pathologists
• Interest-free payment plans
• Fast scheduling and virtual options statewide in Florida

If you’re unsure whether your child’s speech or social skills are on track, trust your instincts. You don’t have to wait for school or a pediatrician referral — you can request a developmental screening or autism evaluation near you directly through WellChild.