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.
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.
Communication
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.
Development
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.
.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.
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
Interaction
for families who've moved beyond the basics.
FloortimeDVD Training Series. Set 3: Symbolic and Logical Thinking
completes their training series.
