Which early marker is commonly observed in toddlers with autism?

• A. Strong nonverbal communication in toddler years.
• B. Delayed onset of walking alone.
• C. Lack of joint attention, showing, and pretend play.
• D. Early literacy skills by age three.

Answer: (C)

The main idea being tested is how social-communication milestones appear in toddlers with autism. A hallmark early sign is difficulty with joint attention—the shared focus between a child and another person on an object or event. This also often shows up as not showing or pointing to share interest and a lack of pretend or imaginative play. These behaviors require responding to others’ social cues and using communication to engage someone else, which is a foundational part of language development. When a toddler consistently misses these social-communication steps, it stands out as an early marker of autism because it points to how the child processes social information and interacts with others.

Other options don’t fit this pattern because they involve areas that aren’t as specifically tied to autism’s early social-communication profile. Strong nonverbal communication, for instance, would not align with the typical social-communication challenges seen in autism. Delayed walking is a motor milestone and can occur for various reasons, not specifically autism. Early literacy by age three is not a typical marker and would not usually indicate autism since literacy skills depend on language and social interaction that are often delayed rather than advanced in autism.