Troy and Beth Smith, of Holly Springs, said they noticed that early in life, their daughter, Grace, had trouble looking people in the eye or answering when called.
"We called her name a million times, and she wouldn't even look at us," Beth Smith said.
"It's hard to get a shot of her looking at the camera and smiling, all at the same time," Troy Smith said.
As professional educators, the Smiths knew that Grace's developmental delays, even at age one, required evaluation and special therapy. They suspected she might have autism, but the official diagnosis didn't come for three more years.
"Your brain develops a lot between birth and (age) 5. That's a real critical period," said Jill Hinton, clinical director for Easter Seals UCP North Carolina and Virginia.
Physicians ask parents about developmental milestones during children's regular check-ups
Generally, a child should be babbling by 12 months, using single words between 12 and 15 months, and putting two and three words together by 2 years old.
Signs of autism include a lack of eye contact, infrequently smiling at people, a fixation on certain objects and difficulty shifting attention.
Concerned parents should contact a developmental pediatrician who specializes in recognizing when children aren't meeting their development milestones. They can begin an evaluation to diagnose the cause and connect children with services and therapy.
Easter Seals helps nearly 1,000 people with autism in North Carolina get services.
Grace, for example, gets help from trained professionals at home and school.
"(She) is helping Grace learn to bathe herself, brush her teeth, get ready for bed," Beth Smith said. "The little gains she made were huge gains."
Grace parents' credit the earliest intervention, even before she was diagnosed with autism, for her progress.
"For those kids, I think their long-term outcomes will be much better in terms of how they socialize, how they're able to communicate," Hinton said.
Grace's father said they still treasure the rare moments when she looks straight at the camera.
"That's something we can frame," Troy Smith said. "We put it up. We keep a hold of it, and we don't let it go."