Autism Spectrum Disorder Basics


Autism: What to Look For

Children with autism spectrum disorder are characterized by a combination of two unusual kinds of behaviors: deficits in communication and social skills, and restricted or repetitive behaviors. These symptoms may vary greatly in severity.

Social communication and social interaction: Signs of social deficits you might notice in a developing child include aversion to displays of affection like cuddling and hugging and a preference for solitary play. In younger kids, say under 3, failure to respond to their own name is a red flag, as is disinterest in giving, sharing, or showing objects of interest. In older children, warning signs include difficulty carrying on a reciprocal conversation, lack of eye contact, and difficulty using and reading body language. These children may have difficulty recognizing others’ emotions, responding appropriately to different social situations, and understanding social relationships.

Some children with autism don’t talk; others talk in a stilted, “robotic” tone, or in an exaggerated singsong. A child with autism may also repeat certain phrases without appearing to understand their significance, or possess what experts call “non-functional knowledge”—information he can recite, but not use to solve problems or carry on a conversation. Young kids with autism don’t point at objects of interest, don’t make eye contact, and don’t use gestures to communicate a need or describe something. As kids with autism age and acquire language, their tone or pattern of speech can be odd; some have a habit of reversing pronouns—a youngster asking his mom for water might say “You want water” instead of “I want water.” High-functioning children with autism may monopolize conversations while showing little capacity for reciprocity, or understanding what the other party wants or feels.

Restricted or repetitive behaviors: Key behavioral signs include the performance of repetitive actions and rituals, and fixation on minute details to the point of distraction. Children with autism can be upset by the slightest change in daily routine. In young kids, signs of autism include ordering toys instead of playing with them. In older children, the repetitive behavior can manifest as a consuming interest in a specific topic or object.

The new DSM-5 behavioral criteria include what are often called sensory processing problems. Many children with autism are unusually sensitive to sounds, lights, textures or smells. They may be overwhelmed by too much sensory input, or be disturbed and uncomfortable because of a lack of sensory input, which they may try to get by bumping into things, and excessively touching and smelling things.