Of all the early autism signs researchers have studied, the absence of pointing stands out as one of the most diagnostically significant. Pointing seems so simple — a finger extended toward something interesting — but it reflects a sophisticated social cognition that children with autism often struggle to develop. If your 14-month-old isn’t pointing, that’s worth taking seriously.
When not pointing is a red flag for autism
Researchers distinguish between two types of pointing that develop in the second year of life. Proto-imperative pointing (pointing to request — “I want that cracker”) tends to develop first and is less specific to autism. Proto-declarative pointing (pointing to share interest — “Look at that airplane!”) is the one that most clearly reflects joint attention — the uniquely human ability to share mental focus with another person. This sharing point, typically present by 14 months in neurotypical development, requires a child to understand that other people have attention and perspectives that can be shared. Children with autism frequently develop the requesting point but not the sharing point — because sharing a moment of interest with another person is precisely the kind of social motivation that is affected in ASD. Our page on early autism signs explains how pointing fits into the broader diagnostic picture.
The research literature is consistent: absence of proto-declarative pointing by 14 months is one of the strongest early predictors of autism diagnosis. It is also an M-CHAT item, meaning pediatricians are trained to ask about it at the 12- and 18-month well visits. If your child is 14 months or older and not pointing to show you things — even if they point occasionally to request — that is a meaningful red flag. Pair it with other signs (name response, eye contact, waving) to get the full picture, and request an evaluation through a developmental pediatrician or start the process with an autism evaluation in NJ.
What to do if you’re worried — and how ABA can help
If your toddler isn’t pointing, the next step is a conversation with your pediatrician that goes beyond the standard well-visit checklist. Be specific: “My child points to ask for things but never to show me something interesting.” Or: “My child doesn’t point at all.” Ask for an M-CHAT-R/F screening and a referral to a developmental pediatrician. In New Jersey, you can also self-refer to the Early Intervention system for children under 3 — you don’t need to wait for your doctor to initiate the process. More on this at our autism evaluation guide.
Joint attention — the social cognitive skill underlying declarative pointing — is a core intervention target in early ABA therapy. Building joint attention skills has downstream effects on language, social connection, and learning, making it one of the most valuable early intervention targets. At Autumn ABA, our NJ-based in-home therapists use naturalistic and play-based ABA strategies specifically designed for toddlers to build joint attention from the ground up. Reach out for a free consultation, or learn more about our early intervention ABA programs.
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Schedule a free consultation Our ABA programs →Frequently asked questions
My toddler grabs my hand and leads me to things — is that the same as pointing?
Leading by the hand (sometimes called “hand leading”) is actually a behavior that clinicians pay close attention to as a potential autism sign, because it can indicate that the child is treating you as a tool to get something rather than as a social partner to share experience with. It is not the same as pointing. Pointing involves the child directing your attention with their finger and checking to make sure you’ve looked — that check-in is the social act. If your child leads you by the hand rather than pointing and also doesn’t point declaratively, discuss this specifically with your pediatrician.
When exactly should pointing develop, and when should I be worried?
Pointing to request typically emerges around 10–12 months; pointing to share (declarative) develops by 12–14 months. By 14 months, most clinicians consider absent declarative pointing a clear red flag that warrants evaluation. Don’t wait until 18 months if you’re already noticing this at 13–14 months — earlier referral means earlier intervention.
This page is general educational information, not medical advice. Every child is different — a BCBA can assess your child’s specific needs. Autumn ABA serves families in all 21 NJ counties; see where we provide ABA therapy.