Nonverbal communication in two- and three-year-old children with autism.

Researchers watched the toddlers with autism and 24 matched controls during play.

They counted every point, show, gaze shift, and hand movement for 20 minutes.

Kids were 24-36 months old and played with a parent and an examiner.

Autistic toddlers pointed and showed objects half as often as typical kids.

They looked at faces less and spent more time spinning or rubbing toys.

Hand-manipulation replaced social gestures in most play turns.

Sun et al. (2024) pooled 43 studies and found autistic children reach and point more slowly across all ages.

Fyfe et al. (2007) showed preschoolers with autism have strong visual skills but weak abstract thinking, extending the same profile to older kids.

Lemons et al. (2015) found no sign that eye contact hurts autistic preschoolers, which seems to clash with the reduced gaze seen here. The difference: the 2015 study used pupillometry to check for stress, while the 1997 study only counted looks. Less looking may reflect skill gaps, not avoidance.

Zhao et al. (2023) later confirmed reduced mouth and face gaze in school-age Chinese children, showing the pattern lasts into middle childhood.

When you see a toddler spinning a car instead of pointing, teach pointing first. Model the gesture, wait, then gently prompt the child’s hand. Track daily counts of points, shows, and eye contact to watch early intervention gains.