What are the signs of autism in twins?

If you are on this website, you may already be wondering if you have autistic twins. When you have twins, triplets or quadruplets, it’s natural to make comparisons between them. You may feel like you are constantly watching to see who does what first and what is delayed.  Additionally, multiples are often born early, so there may be some delays to development. It’s only natural to wonder if you should be concerned about the signs of autism in your twins.

Before the age of three, it can be really hard to know what is a delay that they might outgrow. Autism is rarely diagnosed before the age of two. But, here are signs to watch for that mean your twins might be autistic.

What should I look for?

One of the earliest signs of autism in twins is inconsistent or unexpected eye contact.  It is a myth that all autistic people avoid eye contact!  You may notice that one or both twins don’t look you in the eyes when you speak to them. For example, twin mom Liz shared that in her fraternal twin boys, one made eye contact, while the other didn’t. They were both later diagnosed autistic.

Studies have shown that autistic children and adults either miss the social cues that eye contact is meaningful to others. Additionally anxiety or stress may make it uncomfortable for some autistics. If one or both don’t make eye contact or look when you say their name, it might be an early sign of autistic twins.

Delayed speech is frequently associated with signs of autism in twins. By 16 months your twins should be using single words. Around age two, your twins should be combining two words into sentences. When my triplets were little, I noticed wide gaps in their speech. My non-autistic children were speaking in short sentences, while my autistic son was still just saying single words. 

Another sign to watch for is repetitive behaviours. This means things such as hand flapping, spinning objects or rocking back and forth. As a baby and toddler, my autistic son was fascinated with spinning wheels and ceiling fans, and my other two were just not interested in the same things.  Most toddlers want things their own way! But if your child has a fixation on a particular object or activity and struggles to move on from it, this could be an early sign of autism.

Autistic people may have sensory issues, such as being sensitive to loud noises, bright lights, or certain textures. They may also seek out certain sensory experiences, such as spinning or jumping.  This also can show up as restrictive diets. For example, only eating or drinking preferred items and avoiding certain food textures or smells all together. 

Autistic toddlers may struggle with social interactions and may not show interest in playing with other children. They might not engage in imaginative play or pretend play with toys or dolls.  Your child might ignore other children or choose to play on their own. They may have difficulty understanding social cues or respond unexpectedly to others’ emotions. 

This can be especially challenging for parents of multiples, who from the moment of pregnancy dreamed about the special bond they envisioned for their children. Mom Karla shared that her twin boys “cried and screamed constantly. They bit one another mercilessly from the time they could crawl…they didn’t play imaginatively or interact with one another other than to bite each other…”

If I think it’s autism, what should I do?

If you are wondering about autism and twins, keep a list of your concerns and speak with their doctor.  Regardless of whether they end up getting an autism diagnosis or something else, getting the right support in place will help your child grow and develop.

These twin brothers are both autistic, but very different! Learn more about their family at the video.

How common is autism in twins?

If your twins are identical and one of them is autistic, they are more likely to both be autistic.  Researchers frequently study autism in identical twins to try to understand more.  It’s been estimated for autism in identical twins, 96% of the time both twins will be autistic. This is not always the case though, and even if they are both autistic, their autism might look very different. 

Fraternal twins have just as much chance of being autistic as any other set of siblings. One mom shared that just one of her twins “didn’t start sitting, rolling over, crawling or walking on time…he was always far behind his twin brother….he doesn’t like food with texture and will flap his hands.” So, it is definitely possible for one twin to be autistic and the other not. My triplets are fraternal, and just one of my boys is autistic while his sister and brother are not.

If your twins are autistic, it’s also important to know you are not alone!  This website and our community are full of parents with questions and experiences just like yours. Are your twins, triplets or quadruplets autistic? Share your stories in the comments below.  

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