As a parent, you may notice differences in your child’s development that are making you wonder whether they may be autistic. In this article, Jo Condon, Clinical Expert outlines the signs and characteristics of autism in children and when you should seek professional support.
Autism is not indicated by a single difference or behaviour but involves a distinct pattern of behaviours that impact the way a child interacts with others and engages with the world around them.
The diagnostic criteria for autism outline the core differences experienced by children with autism but the way in which autism presents can vary by age, sex and other individual factors.
The only way to know for certain whether your child has an autism spectrum disorder or not is to have them assessed by a specialist autism service, however understanding the signs of autism can help you to understand whether an autism assessment is needed.
All autistic children experience
- Difficulties with social interaction and communication
- Restricted, repetitive interests, activities or behaviours
A) Difficulties with social interaction and communication
Autistic children have difficulties in these three areas of social interaction and communication:
- Social interaction
- Non-verbal communication
- Shared play, friendships and relationships
Difficulties or differences in reciprocal social interaction
All autistic individuals will show some difficulties with social interaction. The difficulties can vary in presentation and often change over time. The differences or difficulties can include:
- Showing little interest in others
- Not responding to name
- Using another’s hand to reach or move things
- Delayed speech development or using speech in an unusual way
- Having no interest or enjoyment in to and fro social games such as ‘pat a cake’
- Not responding to other’s social approaches
- Only responding to people that they know very well
- Appearing shy around others
- Unable to make or sustain conversation
- Only engaging in conversation about personal issues or interest, not engaging in to and fro social chat
- Not showing empathy or offering comfort to others
Differences in, or lack of, non-verbal communication
Differences in non-verbal communication can range from not utlising non-verbal communication to compensate for a lack of speech, not using non-verbal communication alongside speech or using a limited amount of non-verbal communication. Behaviours include:
- Struggling to make eye contact with others
- Not integrating eye contact with other communication
- Eye contact is intense or fleeting
- Not showing emotion through facial expression, or only showing extreme emotions through facial expression
- Not moving the head to indicate ‘yes’ or ‘no’
- Only waving goodbye or blowing kisses when prompted to do so
- Not using hands to describe movement or size
- Not pointing to objects or only pointing to indicate needs or wants
Difficulties with friendships and relationships
- Lack of interest in peers
- Inability to share imaginative play with others, or only shares play when directing actions or following other’s directions
- Lack of friendships, only able to manage one or two friends at a time
- Trying to control friendships
- Struggling to understand social relationships or hierarchy
- Unable to play in groups of children
- Making comments or asking questions that appear rude to others
B) Restricted, repetitive interests, activities or behaviours
To meet diagnostic criteria for autism children must also demonstrate behaviours related to 2 of the following 4 areas:
- Repetitive body movements or use of objects
- Insistence on sameness or routines or difficulties managing changes
- Highly focused, limited interests
- Sensory seeking or avoiding behaviours
Repetitive body movements or use of objects
Behaviours that fit into this category include:
- Finger flicking and twisting
- Hand flapping
- Rocking or bouncing body
- Spinning selves or objects
- Enjoying stacking, filling and emptying
- Lining up toys or objects
- Being focused on a part of toys, for example, more interested in spinning wheels on a car than playing with it
- Enjoying collecting, ordering and categorizing objects
- Spending more time setting up play scenarios than engaging in play
- Watching the same television programme over again
Insistence on sameness or routines or difficulties managing changes
These issues may be seen as:
- Insistence on your doing or saying things in a certain way or order
- Having specific routines that must be followed at home
- Struggling when things change, such as a different teacher in school
- Insistence on having the same items, such as a specific cup or plate at home
- Finding the change from school days to non-school days difficult
- Struggling to settle into nursery or school, or with class/school changes
- Disliking holidays or time away from home
Highly focused, limited interests
A child may have unusual interests or circumscribed interests.
Unusual interest is a term used to describe interests that are unusual for the child’s age or developmental level, for example, being fixated on vacuum cleaner parts or collecting juice bottles.
Special interests usually involve a child spending most of their spare time engaging in an age-appropriate activity or interests, but in a more intense way than peers. They may only choose to engage in the same activity or interest, learning facts and developing an in-depth knowledge around a specific subject area.
Sensory seeking or avoiding behaviours
Autistic children may have differences in the way they perceive and respond to sensory stimuli such as:
- Smells
- Tastes
- Touch
- Sound
- Visual stimulation
- Movement
- Internal body sensations
They may find sensory stimuli overwhelming, annoying or anxiety provoking. If this is the case they may display behaviours or distress or avoidance.
Other children may seek sensory stimuli and may display sensory seeking behaviours such as sniffing, licking or touching items in their environment.
