Friday, April 06, 2012

Treatments for Autism.....Pt.3

Treatment Approaches

Clinical Therapies
Complementary Therapies

Biomedical Treatments
Family Support
Service Delivery Models
 I know I have talked about some of these already, this is just a more comprehensive list as there are sooooo many treatments these days for autism. Here is a list of what we have tried since Nick was diagnosed.

*GF/CF diet. This was back in the very beginning. We did not see any significant changes in him, at least not enough to warrant spending the money on special foods.
* Cod Liver Oil. This was taken to help with speech. I thought I noticed a very slight increase, but not enough to be able to tell whether or not it was the supplement or just maturing.
* DHA vitamins
* Magnesium with calcium and D3-I did notice that he was less anxious with this. It reminds me that I need to get another bottle.
*Melatonin-this was a godsend to help him fall asleep. We still use this every once in a while.
*ABA therapy-This has been the biggest help for Nick.
*Occupational Therapy-this has helped him with fine motor skills like holding pencils, and writing.(although we still have a hard time with this!)
*Risperidone (Risperdal)-This has helped him to become more manageable, less mood swings, and able to function daily.
*Hippotherapy-It was wonderful while we got it! I would do this again in a heartbeat as Nick LOVED it. However, insurance does not pay for this, and it is expensive!
*Chiropractor-He offered Nick treatment for FREE. He seemed to like it, but after about a year it was difficult to tell whether or not it was really helping. Our schedules were also getting busier, and it was getting tougher to make the weekly appointments.
*Clay baths, Epsom Salt Baths-supposedly to help 'draw' out toxins
*Pro-biotics-once again, these did help with his stool issues, I just need to get more of them.
*Mainstream Educational setting-Did not work for Nick. Even in the autism class he was failing. We have since enrolled him an a special school for disabled kids. He is thriving there, and we are happy.  I now have a rule for every therapy/supplement we decide on. It has to have a WOW factor. If we notice a drastic change in him, we keep doing it. Some therapies, like the Hippotherapy, are just kept because Nick has fun. If he can have fun, even though changes may be negligible, I will keep a therapy. We go through periods where we are packing his schedule with all this stuff in order to help him, but then it interferes with actual family life and we scale things back. As of right now, we are happy with our status-quo.

I got the info above from this link:

Wednesday, April 04, 2012

Autism Therapies Pt.2......

Autism Teaching Methods: DIR®/Floortime

Dr. Stanley Greenspan, a child psychiatrist, developed a form of play therapy that uses interactions and relationships to reach children with developmental delays and autism. This method is called the Developmental, Individual-Difference, Relationship-Based model, or "DIR®/Floortime" for short. Floortime is based on the theory that autism is caused by problems with brain processing that affect a child's relationships and senses, among other things.
With Floor Time, the child's actions are assumed to be purposeful. It is the parent's or caregiver's role to follow the child's lead and help him develop social interaction and communication skills.
For example, a boy may frequently tap a toy car against the floor. During a Floortime session, his mother may imitate the tapping action, or put her car in the way of the child's car. This will prompt the child to interact with her. From there, the mother encourages the child to develop more complex play schemes and incorporate words and language into play. Floortime is more child-directed than some teaching methods. Its goal is to increase back-and-forth interaction and communication between child and adult.
Some school systems are incorporating this strategy into their programs, but usually do not make this their primary means of educating preschool-aged children with autism or PDD. With its strong emphasis on social and emotional development, the Floor Time method may be a natural complement to a behavioral teaching program -- such as Applied Behavior Analysis or Verbal Behavior -- or to a TEAACH program.
Floortime is being used by some families who prefer a play-based therapy as a primary or secondary treatment, especially for toddlers and preschoolers. Floortime advocates say it can be used along with other therapies.
Research into Floortime is continuing. A randomized, controlled study is underway in Canada to determine the effectiveness of intensive DIR/Floortime treatment for one year and two years.
In a 2005 study, Dr. Greenspan and Serena Wieder Ph.D. reported on 16 teens who had responded favorably to DIR/Floortime therapy in their early childhoods. Ten to 15 years later, these boys had "healthy peer relationship and solid academic skills," according to the Interdisciplinary Council on Developmental and Learning Disorders (ICDL), which Dr. Greenspan chaired. Dr. Greenspan died in 2010.
Floortime DVD Training Series. Set 1 The Basics: Relating and Communicatingfloortime by Stanley Greenspan M.D. and Serena Wieder Ph.D. This two-disk set teaches the basics of using the Floortime Method to teach your child or student. Floortime DVD Training Series. Set 2 Sensory Regulation and Social Interactionfloortime for families who've moved beyond the basics. FloortimeDVD Training Series. Set 3: Symbolic and Logical Thinkingfloortime completes their training series.

If you would like to know more, you can just click on this link:
We have not personally used the Floortime approach, but have heard great things about this program as well. I think the type of therapy used depends a lot on the personality of the child. For some kids, ABA just doesn't work. For some, it does. Whatever the therapy you use, if your kid is happy and making progress-then stick with it. That is what really matters.

Tuesday, April 03, 2012

Autism Therapies...Pt. 1

Autism Teaching Methods: Applied Behavior Analysis and Verbal Behavior

Applied Behavior Analysis, or ABA, is a method of teaching children with autism and Pervasive Developmental Disorders. It is based on the premise that appropriate behavior – including speech, academics and life skills – can be taught using scientific principles.
ABA assumes that children are more likely to repeat behaviors or responses that are rewarded (or "reinforced"), and they are less likely to continue behaviors that are not rewarded. Eventually, the reinforcement is reduced so that the child can learn without constant rewards.
Research shows that ABA works for kids with autism. "Thirty years of research demonstrated the efficacy of applied behavioral methods in reducing inappropriate behavior and in increasing communication, learning, and appropriate social behavior," according to a U.S. Surgeon General's Report.
The most well-known form of ABA is discrete trial training (DTT). Skills are broken down into the smallest tasks and taught individually. Discrete, or separate, trials may be used to teach eye contact, imitation, fine motor skills, self-help, academics, language and conversation. Students start with learning small skills, and gradually learn more complicated skills as each smaller one is mastered.
If a therapist is trying to teach imitation skills, for example, she may give a command, such as "Do this," while tapping the table. The child is then expected to tap the table. If the child succeeds, he receives positive reinforcement, such as a raisin, a toy or praise. If the child fails, then the therapist may say, "No." The therapist then pauses before repeating the same command, ensuring that each trial is separate or discrete. The therapist also will use a prompt - such as physically helping the child tap the table - if the child responds incorrectly twice in a row. This "no-no-prompt" method is used in some traditional ABA programs.
However, many ABA programs now use prompts for every trial, so the child is always correct and always reinforced by praise or a toy. This technique is called "errorless learning." The child will not be told "no" for mistakes but rather will be guided to the correct response every time. The prompts will be gradually reduced (or "faded," in ABA language), so the child will learn the correct response on his own.
ABA may take place in the home or a school. A consultant or board certified behavior analyst -- usually someone with a master's or doctoral degree in psychology -- often supervises the therapy.
Some people incorrectly assume that ABA only describes the method developed by Dr. O. Ivar Lovaas, a pioneering researcher in the Psychology Department at UCLA. Lovaas developed one form of ABA. In 1987, he published a study showing that nine of the 19 preschoolers involved in intensive behavioral intervention -- 40 hours per week of one-on-one therapy -- achieved "normal functioning" by first grade. Note: Several decades ago, Lovaas described using mild physical punishment for severe behaviors during therapy sessions. He later rejected punishment, and modern behavior therapists do not use it. Dr. Lovaas, 83, died in 2010.
ABA programs usually draw upon Lovaas's decades of research, but they also may incorporate different methods and tools.
Applied Verbal Behavior or VB is the latest style of ABA. It uses B. F. Skinner'sverbal behavior 1957 analysis of Verbal Behavior to teach and reinforce speech, along with other skills. Skinner described categories of speech, or verbal behavior:
  • Mands are requests ("I want a drink.")
  • Echoes are verbal imitations, ("Hi")
  • Tacts are labels ("toy," "elephant") and
  • Intraverbals are conversational responses. ("What do you want?")
A VB program will focus on getting a child to realize that language will get him what he wants, when he wants it. Requesting is often one of the first verbal skills taught; children are taught to use language to communicate, rather than just to label items. Learning how to make requests also should improve behavior. Some parents say VB is a more natural form of ABA.
Like many Lovaas ABA programs, a VB program will use errorless teaching methods, prompts that are later reduced, and discrete trial training. Behavior analysts Dr. Vincent Carbone, Dr. Mark Sundberg and Dr. James Partington have helped popularize this approach.
One drawback to ABA/VB: some school districts and insurance companies do not pay for it, and it can be expensive for parents to fund. If you decide to pay for it yourself, carefully research the credentials of anyone claiming to be an ABA or VB consultant or experienced therapist. A consultant should have, at a minimum, a master's degree in psychology or ABA, or should be closely supervised by someone who does. When hiring therapists, some families find volunteers or students willing to work for lower pay in order to gain experience with autism.

ABA and VB Web resources

I can't say enough about ABA. This has been the one treatment that has given Nick the most gains. It can also be done just about anywhere. We can (and HAVE!) walked around in stores labeling things he saw, he can do small chores around the house, and put things away. Often he actually listens better than his older brother! Nick went through 6 weeks of a free Verbal ABA program at the University of Washington. His therapist there got him to follow a point, look for things around the room, bring him things, etc. All of his therapists have been willing to change their styles on any given day to accommodate his ever-changing moods, as well as to prevent him from getting bored. A good therapist will do that. One of them would even bring in his guitar and play for Nick; which got Nick to interact with him in a more normal environment. If you would like more info on ABA, just click HERE.

Monday, April 02, 2012

The History of Autism and Types of Autism

Today is World Autism Awareness Day. Time for a little history on the disorder; which I found HERE.

In the year 1912, a Swiss psychiatrist named Eugene Bleuler was the very first to identify a particular pattern in schizophrenia afflicted individuals who seemed to be “self-absorbed.”  It was at this point when Dr. Bleuler labeled this particular form of self-absorbed behavior as autism, and became the first to coin the term.  While this is true, he was not the first to identify and recognize autism as being a completely different and separate entity from schizophrenia as well as other mental illnesses.
It was not until the year 1943 when autism became its own specific condition.  An Australian-American psychologist for children, Leo Kanner, was the very first to recognize the condition of autism as its own individual mental disorder.  Kanner was able to identify and label similar characteristics and conditions in a group of approximately 11 children.  These children exhibited symptoms such as sensitivity to stimulants such as sound or food, having trouble with spontaneous tasks or events, and a noticeable lack of average intellect.  Once he had properly observed these children he had diagnosed them with having early infantile autism.
An Austrian scientist and pediatrician Hans Asperger also described, in detail, his trials and tribulations with a group of autistic children in 1944.  A great portion of the signs and symptoms Kanner’s children where exhibiting also happened in Asperger’s group as well.  Asperger made great note of their clumsy motor skills as well as the difference in speech.  While Kanner’s group seemed to lack necessary conversational and language skills, Asperger’s group spoke like little adults.  Today children who have high functioning autism are generally diagnosed with Asperger’s Syndrome.
From the 1970’s and pushing forward, autism research and studies began to pick up pace rapidly.  Both education and therapy for autistic children are still in development today, as research has found that autism is far more complex than any scientist had originally thought.  This complexity then led researchers to the conclusion that there are various causes for autism, as the condition is highly complex in the first place.



A particular type of pervasive developmental disorder, generally characterized by the issues in the development of social skills and behaviors, is known as Asperger Disorder.  Many doctors, in the past, have misdiagnosed those children that have Asperger Disorder as being autistic or other disorders similar to autism.  The similarities between both Asperger’s Disorder and autism are there, but there are significant differences that doctors sometimes overlook.  Because of this misdiagnosis and the closeness in both the conditions, it is important for those children suspected of having Asperger Disorder or even autism be carefully monitored and evaluated in order to provide the proper diagnosis so the right treatments can be carried out.
Generally those children who have Asperger’s Disorder tend to function at a much higher level than those children who are diagnosed with autism.  Those with Asperger Disorder commonly possess a normal intelligence level, while those who suffer from autism tend to lack the proper development in language skills, or even motor skills.  Children who are diagnosed with Asperger’s Disorder use their speech at the proper ages, although their patterns in speech may differ from those of a normal child.  Many parents or other adults find the children that have Asperger Disorder use speech that is odd for each individual child’s particular age group.
While the cause and root of Asperger’s Disorder is still a mystery to doctors, there is strong research which suggests that the condition of Asperger Disorder is genetic and may run in families.  Those children who suffer from Asperger Disorder are also at a risk for a variety of other psychiatric issues such as depression, attention deficit disorder, obsessive compulsive disorders, as well as schizophrenia.
There are many child and adolescent psychiatric professionals that have received the necessary training in order to properly evaluate children who may have a disorder such as Asperger’s Disorder.  These particular individuals are also able to work one on one with families in order to design and obtain the most effective and appropriate treatment plans available for each particular child.  A common and effective method of treatment for those children who suffer from Asperger’s Disorder includes a combination of special education, behavior modification, psychotherapy as well as a strong support system.  There are even those cases where children with Asperger’s Disorder may benefit greatly from a medication regime.
The overall outlook for those children who have Asperger’s Disorder rather than autism is much more promising.  Because of their normal intelligence levels and raised levels of functioning, many of these children are projected to not only finish high school but also seek out a higher education in a great number of cases.  While the issues with social interaction and being aware of their social surroundings may be difficult, those children with Asperger’s Disorder are able to learn to cope with their condition far more easily than those with autism.  It is not uncommon for people and children with Asperger’s Disorder to develop long lasting relationships with both family members and friends.  Even those with Asperger Disorder can lead a very normal life.

Childhood disintegrative disorder is a condition where children have a completely normal development until around the ages of 2 to 4, and then seem to demonstrate or experience a dramatic increase in the loss of communication, social, and other skill sets that they may have acquired.  Whether the other skills include items such as language, motor skills, or non-verbal communication vary from child to child.  Unfortunately those scientists researching childhood disintegrative disorder have yet to determine the cause of the disorder.
Childhood disintegrative disorder is very similar to autism; many doctors say childhood disintegrative disorder is a less detrimental form of autism.  Once the child has started a normal growth, the noticeable side effects of childhood disintegrative disorder can be seen between the ages of 4-10, where the regression is suddenly much stronger.  In some cases the symptoms of childhood disintegrative disorder have been so severe even the child begins to voice concern over what is happening.  This is most scary for the child, as the aggressive regression is confusing and often times leads to a more hostile child at times.
There are various signs and symptoms to watch out for in way of childhood disintegrative disorder.  The normal growth happens up until the age of approximately two years of age, and then continues to progress up until the age of ten.  Each and every skill the child has acquired may be lessened or completely lost all together.  There are six distinct functional areas where the child will lose such skills.  The skills they lose are as follows expressive language skills (basically being able to produce a speech and communicate a message), receptive language skills (the understanding of language understanding and listening what is communicated), social skills and self-care skills, the control over bowel and bladder, play skills, and motor skills. The lack of normal function or deterioration also occurs in at least in one of these two areas Social interaction, communication, and repetitive behavior and interest patterns.
The causes of childhood disintegrative disorder are still unknown, childhood disintegrative disorder surfaces from within days or weeks while in other cases it matures over a longer period of time. A Clinic report specifies that: “Comprehensive medical and neurological examinations in children diagnosed with childhood disintegrative disorder occasionally uncovers a fundamental medical or neurological cause. Although the happening of epilepsy is higher in children with childhood disintegrative disorder, experts don’t know if epilepsy plays a major role in the causing of the disorder. Childhood disintegrative disorder is linked to other conditions such as lipid storage, subacute sclerosing panecepphaliyis , tuberus sclerosis. Although the causes are unknown childhood disintegrative disorder is very well linked to other conditions.
There is no treatment for childhood disintegrative disorder. The loss of language and skills related to social interaction and self-care stand rather severe. The affected children face long-lasting disabilities in definite areas and are required to be in long term care. Treatment of Childhood Disintegrative Disorder includes both behavior therapy and medications.
Watching for the symptoms for childhood disintegrative disorder can beneficial to both the child and the parent  to try and help and get treatment for this horrible disease.


Classic Autism, Autistic Disorder or Kanner’s Syndrome
Since the late 1930’s and early 1940’s, studies in regard to Kanner’s Syndrome in both Australia as well as America at the same time.  The unusual behaviors in children were somewhat of a puzzle to two scientists.  Unknown to them, they were both coming to the same conclusions but they were also using the same words in way of describing the happenings and behaviors of the children.  Ironically enough they were both using the same word, autism, even though the degree of behaviors they were both seeing differed vastly in way of severity.
The scientist known as Dr. Leo Kanner dubbed the disorder he was researching Kanner syndrome, otherwise known as autism.  While it is more common to hear the term autism or autistic, Kanner Syndrome is still a widely used name today.  In the 1940’s, Dr. Kanner was conducting research with a large group of children many thought were exhibiting the signs and symptoms of the condition known as schizophrenia.  Delving much deeper into his research he found that the children were not actually showing signs of schizophrenia, but something entirely different.  Autism was the term used to affiliate the conditions with the new disorder he had discovered.
To this day, Kanner’s breakthrough in way of autism and its signs or symptoms hold true today.  The earliest conclusions of his research are also still true to this day.  Throughout the 1950’s and the 1960’s children were being properly diagnosed with autism due to Kanner’s earlier discoveries.  A research paper on his works was being published throughout the world, in English, making it easier for more to learn about this new condition.  Due to this work, more children around the world were being treated properly for their conditions rather than being labeled as something they were not, receiving detrimental treatments.
There are many indications of autism early on in a child’s life.  First is the delayed speech or even lack of speech altogether.  This is possibly the largest sign of autism or Kanner’s syndrome.  It is a very strong indicator.  Next are repetitive movements of body parts.  Whether the part of the body is the head, arms, or feet, repetitive and same movement motions are another strong indication of autism.
Later on in a child’s life if they experience impaired social skills, the child may be slightly or even completely autistic.  They tend to shy away from those they are completely unfamiliar with and even have a hard time socializing with those close to them.  In line with this, having a limited interest in activities or playing with toys is another sign of autism.  Children who are autistic often show these signs quickly on in life, so it is easy to spot them.
Understanding the background as well as the signs of autism is extremely important.  There is no doubt that autism is affecting a large portion of today’s youth, and is something that should be taken very seriously.


A pervasive developmental disorder is a diagnosis which is categorized by a group of disorders that have delays in the development of both socialization and communication skills.  There are many cases where parents are able to identify and notice symptoms very early on throughout the infant life of a child.  While this is sometimes the case, the pervasive developmental disorders are most noticeable in children between the ages of three and five years old.  It is important to immediately seek out medical attention if one notices any signs and symptoms of a pervasive developmental disorder in their child at any given time.
There are various prominent signs and symptoms which may occur that are most noticeable when attempting to identify pervasive developmental disorder.  First and foremost there is language.  A child will either have a loss of or a lack of understanding language.  This is the most common and sought after sign in way of pervasive developmental disorders as it is the most easy to identify.  The lack of understanding may not be large, and often times can be subtle at first, but it is a huge indicator that there may be a pervasive developmental disorder.
Some other signs and symptoms parents should be aware of include repetitive body movements or behaviors, unusual choices in way of playing with toys and objects, difficulty adjusting to new environments, difficulty socializing or relating to people, as well as being uncomfortable with large and busy events.  Autism is the most studied and widely known form of pervasive developmental disorders, and has a variety of similar conditions very close to it.  Some of the most commonly known pervasive developmental disorders include Rett’s Syndrome, Childhood Disintegrative Disorder, and Asperger’s Syndrome.  The various forms of pervasive developmental disorder lead to children varying in way of skills, intelligence, and behavioral levels.  There are those children who do not speak at all, and there are those who possess a relatively normal speech pattern.  Those impairments that are seen in most every case include repetitive forms of play and limited social skills; strange response to sensory information such as loud noises and light are also common.
For each of the pervasive developmental disorders there are no known cures.  While there are no cures, there are forms of treatment that work depending on their severity and how often the treatments are carried out.  Proper forms of treatment often aid the children enough to lead normal lives in a social and school setting with the proper support.  Those who have severe cases of pervasive developmental disorders often need regular one on one care and attention in order to function properly in larger settings.
Currently vast amounts of research are being carried out in way of pervasive developmental disorders to find cures and possible prevention methods to protect against these disorders.  Neurology has made vast strides in understanding how to properly diagnose and treat the various d pervasive developmental disorders known throughout the medical fields.


A neurological development disorder, seen mostly in girls, is known as Rett’s Syndrome.  Rett’s Syndrome is categorized by the normal development of the brain followed by slower development, loss of coordination or hand use all together, distinguishable hand movements, having issues with walking, intellectual disabilities, and even seizures.  The individual who discovered this particular syndrome is known as Dr. Andreas Rett from Austria, who had first brought this disorder into the medical world through a journal article in the year 1966.  This disorder was not recognized until 1983 when a Swedish researcher, Dr. Bengt Hagberg, also wrote an article on it.
Those children who are diagnosed with Rett’s Syndrome generally exhibit symptoms similar to those of autism.  Some of the most common symptoms found in those who have Rett’s Syndrome include items such as walking on toes, issues with sleeping, having a difficult time chewing, grinding of the teeth, growth is slowed, seizures, hyperventilation, apnea, cognitive disabilities as well as a wide-based gait.
With Rett’s Syndrome there are various stages to this disorder; four in total.  The first stage, known as an early onset, starts between the ages of 6 and 18 months old.  Many doctors overlook this stage due to the disorder being vague at times.  Both parents and doctors may not instantaneously notice the subtle slow of development happening with the child.  Whether it is less eye contact from the infant or they seem to be uninterested in their toys, it is not enough to draw attention to this particular diagnosis.  This particular stage generally lasts only a few months but is able to continue on for greater than one year.
Stage two is the destructive stage known as the rapid destructive stage.  This generally takes place between ages 1 and 4 lasting for any number of weeks or months.  The signs of this stage or generally loss of movement in hands or the child’s language skills; hand gestures such as clapping, tapping, or washing then moving hands to mouth are key points at the early stages
Stage three is the plateau stage, also known as the pseudo-stationary stage.  This general occurs between the ages of 2 and 10 sometimes lasing for many years.  Both motor issues as well as seizures are prominent during this particular stage.  On the other hand, there will be a significant improvement in behavior such as less irritability, crying, or autism-like symptoms.
Stage four is known as the motor deterioration stage lasting for either years or even decades.  The curving of the spine, even more reduced mobility, weak muscles, spasticity, or rigidity are all signs and symptoms of this stage.
There is currently no cure for Rett’s Syndrome, and is generally treated by focusing on the management of the symptoms exhibited by the individual.  Generally there is medication needed for breathing, as well as regular monitoring for other possible illnesses such as scoliosis and heart abnormalities.  Despite how difficult it may be at times, individuals with Rett’s Syndrome can live well into their late 40’s, 50’s, and even beyond.

Sunday, April 01, 2012

April is Autism Awareness Month.......

Since today is the first day of Autism Awareness Month; I thought I would start it off with the signs and symptoms of Autism found from the CDC website:

Signs and Symptoms

Autism spectrum disorders (ASDs) are a group of developmental disabilities that can cause significant social, communication and behavioral challenges.  People with ASDs handle information in their brain differently than other people.
ASDs are "spectrum disorders."  That means ASDs affect each person in different ways, and can range from very mild to severe.  People with ASDs share some similar symptoms, such as problems with social interaction.  But there are differences in when the symptoms start, how severe they are, and the exact nature of the symptoms.

Example of Range of Symptoms

Following the chart below - a person might have average intelligence, have little interest in other people, use limited verbal language, experience intense self-stimulatory behaviors such as hand-flapping, under-react to pain and over-react to sounds, have very good gross motor skills, and have weaknesses in fine motor skills. These syptoms may vary widely from person to person.
Graphic: Graph of Range of Symptoms for ASDs
ASDs begin before the age of 3 and last throughout a person's life, although symptoms may improve over time. Some children with an ASD show hints of future problems within the first few months of life. In others, symptoms may not show up until 24 months or later. Some children with an ASD seem to develop normally until around 18 to 24 months of age and then they stop gaining new skills, or they lose the skills they once had. Studies have shown that one third to half of parents of children with an ASD noticed a problem before their child’s first birthday, and nearly 80%–90% saw problems by 24 months of age.
It is important to note that some people without an ASD might also have some of these symptoms. But for people with an ASD, the impairments make life very challenging.

Possible "Red Flags"

A person with an ASD might:
  • Not respond to their name by 12 months of age
  • Not point at objects to show interest (point at an airplane flying over) by 14 months
  • Not play "pretend" games (pretend to "feed" a doll) by 18 months
  • Avoid eye contact and want to be alone
  • Have trouble understanding other people's feelings or talking about their own feelings
  • Have delayed speech and language skills
  • Repeat words or phrases over and over (echolalia)
  • Give unrelated answers to questions
  • Get upset by minor changes
  • Have obsessive interests
  • Flap their hands, rock their body, or spin in circles
  • Have unusual reactions to the way things sound, smell, taste, look, or feel

Social Skills

Social issues are one of the most common symptoms in all of the types of ASD.  People with an ASD do not have just social "difficulties" like shyness. The social issues they have cause serious problems in everyday life.
Examples of social issues related to ASDs:

  • Does not respond to name by 12 months of age
  • Avoids eye-contact 
  • Prefers to play alone
  • Does not share interests with others
  • Only interacts to achieve a desired goal
  • Has flat or inappropriate facial expressions
  • Does not understand personal space boundaries
  • Avoids or resists physical contact
  • Is not comforted by others during distress
  • Has trouble understanding other people's feelings or talking about own feelings

Typical infants are very interested in the world and people around them. By the first birthday, a typical toddler interacts with others by looking people in the eye, copying words and actions, and using simple gestures such as clapping and waving "bye bye".  Typical toddlers also show interests in social games like peek-a-boo and pat-a-cake.  But a young child with an ASD might have a very hard time learning to interact with other people.
Some people with an ASD might not be interested in other people at all. Others might want friends, but not understand how to develop friendships. Many children with an ASD have a very hard time learning to take turns and share—much more so than other children. This can make other children not want to play with them.
People with an ASD might have problems with showing or talking about their feelings. They might also have trouble understanding other people's feelings. Many people with an ASD are very sensitive to being touched and might not want to be held or cuddled. Self-stimulatory behaviors (e.g., flapping arms over and over) are common among people with an ASD.  Anxiety and depression also affect some people with an ASD. All of these symptoms can make other social problems even harder to manage.


Each person with an ASD has different communication skills. Some people can speak well. Others can’t speak at all or only very little. About 40% of children with an ASD do not talk at all. About 25%–30% of children with an ASD have some words at 12 to 18 months of age and then lose them.1 Others might speak, but not until later in childhood.
Examples of communication issues related to ASDs:
  • Delayed speech and language skills
  • Repeats words or phrases over and over (echolalia)
  • Reverses pronouns (e.g., says "me" instead of "I")
  • Gives unrelated answers to questions
  • Does not point or respond to pointing
  • Uses few or no gestures (e.g., does not wave goodbye)
  • Talks in a flat, robot-like, or sing-song voice
  • Does not pretend in play (e.g., does not pretend to "feed" a doll)
  • Does not understand jokes, sarcasm, or teasing

People with an ASD who do speak might use language in unusual ways. They might not be able to put words into real sentences. Some people with an ASD say only one word at a time. Others repeat the same words or phrases over and over. Some children repeat what others say, a condition called echolalia. The repeated words might be said right away or at a later time. For example, if you ask someone with an ASD, "Do you want some juice?" he or she might repeat "Do you want some juice?" instead of answering your question.  Although many children without an ASD go through a stage where they repeat what they hear, it normally passes by three years of age. Some people with an ASD can speak well but might have a hard time listening to what other people say.
People with an ASD might have a hard time using and understanding gestures, body language, or tone of voice. For example, people with an ASD might not understand what it means to wave goodbye. Facial expressions, movements, and gestures may not match what they are saying. For instance, people with an ASD might smile while saying something sad.
People with an ASD might say "I" when they mean "you," or vice versa. Their voices might sound flat, robot-like, or high-pitched. People with an ASD might stand too close to the person they are talking to, or might stick with one topic of conversation for too long. They might talk a lot about something they really like, rather than have a back-and-forth conversation with someone. Some children with fairly good language skills speak like little adults, failing to pick up on the "kid-speak" that is common with other children.

Unusual Interests and Behaviors

Many people with an ASD have unusual interest or behaviors.
Examples of unusual interests and behaviors related to ASDs:
  • Lines up toys or other objects
  • Plays with toys the same way every time
  • Likes parts of objects (e.g., wheels)
  • Is very organized
  • Gets upset by minor changes
  • Has obsessive interests
  • Has to follow certain routines
  • Flaps hands, rocks body, or spins self in circles

Repetitive motions are actions repeated over and over again. They can involve one part of the body or the entire body or even an object or toy. For instance, people with an ASD might spend a lot of time repeatedly flapping their arms or rocking from side to side. They might repeatedly turn a light on and off or spin the wheels of a toy car. These types of activities are known as self-stimulation or "stimming."
People with an ASD often thrive on routine. A change in the normal pattern of the day—like a stop on the way home from school—can be very upsetting to people with an ASD. They might "lose control" and have a "melt down" or tantrum, especially if in a strange place.
Some people with an ASD also may develop routines that might seem unusual or unnecessary. For example, a person might try to look in every window he or she walks by a building or might always want to watch a video from beginning to end, including the previews and the credits. Not being allowed to do these types of routines might cause severe frustration and tantrums.

Other Symptoms

Some people with an ASD have other symptoms. These might include:
  • Hyperactivity  (very active)
  • Impulsivity (acting without thinking)
  • Short attention span
  • Aggression
  • Causing self injury
  • Temper tantrums
  • Unusual eating and sleeping habits
  • Unusual mood or emotional reactions
  • Lack of fear or more fear than expected
  • Unusual reactions to the way things sound, smell, taste, look, or feel

People with an ASD might have unusual responses to touch, smell, sounds, sights, and taste, and feel.  For example, they might over- or under-react to pain or to a loud noise. They might have abnormal eating habits. For instance, some people with an ASD limit their diet to only a few foods.  Others might eat nonfood items like dirt or rocks (this is called pica). They might also have issues like chronic constipation or diarrhea. 
People with an ASD might have odd sleeping habits. They also might have abnormal moods or emotional reactions. For instance, they might laugh or cry at unusual times or show no emotional response at times you would expect one. In addition, they might not be afraid of dangerous things, and they could be fearful of harmless objects or events.


Children with an ASD develop at different rates in different areas. They may have delays in language, social, and learning skills, while their ability to walk and move around are about the same as other children their age. They might be very good at putting puzzles together or solving computer problems, but they might have trouble with social activities like talking or making friends. Children with an ASD might also learn a hard skill before they learn an easy one.  For example, a child might be able to read long words but not be able to tell you what sound a "b" makes.
Children develop at their own pace, so it can be difficult to tell exactly when a child will learn a particular skill. But, there are age-specific developmental milestones used to measure a child’s social and emotional progress in the first few years of life. To learn more about developmental milestones, visit "Learn the Signs. Act Early," a campaign designed by CDC and a coalition of partners to teach parents, health care professionals, and child care providers about early childhood development, including possible "red flags" for autism spectrum disorders.

  I am also posting Nick's results from his ADOS evaluation back in 2006 HERE.It will give you an idea of what a developmental pediatrician sees, as well as what we as the parents informed them of. His evaluation took about 3 hours and we saw a team of specialists during that time.