What are the signs of autism?
Autism is a neurodevelopmental condition, which means that there are differences in the way an autistic person’s brain develops in comparison to the way neurotypical person’s brain develops.
Autism is formally called Autism Spectrum Disorder (ASD) and is sometimes referred to as Autism Spectrum Condition (ASC). Some years ago, another condition known as Asperger’s Syndrome was seen as separate to autism, but now we understand that Asperger’s Syndrome is part of the autism spectrum and the term Asperger’s Syndrome is no longer used as a diagnosis.
What do we mean by the autism spectrum?
Every autistic child is a brilliantly unique individual. They will have core characteristics that are associated with autism, but the way in which these characteristics impact them will vary from one person to another. One autistic child may have no speech and may spend their days living in their own world, whereas another child may have good speech but experience debilitating anxiety in social situations.
Females often experience different characteristics than males and a child’s differences will change as they grow and develop.
What are the Characteristics or Signs of Autism?
The core characteristics of autism are:
- Difficulties with social interaction
- Lack of interest in, or difficulties with relationships
- Communication differences
- Highly focussed interests
- Repetitive behaviours
- Sensory differences
Not all autistic people will experience all these characteristics, and they may change over time.
Autism may not be obvious. Sometimes autism is missed and issues that individuals are experienced are put down to behaviour problems or anxiety and depression.
Examples of the signs of autism can be found below
Using eye contact to initiate and maintain social interaction
Many parents of autistic children find they cannot ‘catch their eye’ when they are amongst other children or cannot give their child a behaviour warning with their eyes.
Adults and children may feel uncomfortable looking people in the eye; they may avoid this completely or use a different focal point such as looking at the bridge of the nose to mask their difficulties.
Smiling socially to acknowledge other people
This is often an instinctual behaviour for neurotypical children and adults, they will smile when greeting their parents or friends and will return a smile to a stranger in certain situation. Autistic children and adults may not do this.
Directing facial expressions
Often autistic children and adults will have a reduced range of facial expressions which express their emotional or cognitive (thinking) state. Or they may have a range of facial expressions but they do not direct them to others to support their communication, or do not coordinate facial expression with other communication.
Not understanding the need to, or how to, comfort others
Autistic children and adults may miss out on the social cues that let them know when someone is hurt or upset, or they may pick up on the cues but be unsure of how to respond or how to offer comfort to others; they may do this but feel awkward about it.
Differences in joint play
Autistic children may have differences in the way they play with others. They might prefer to play alone, or if playing with others they may not take an equal role trying to control the play or letting others control their play
Difficulties with group play
Autistic children may not like to play in groups of children, they may play alongside the other children rather than join in or may only join in with encouragement or support
Limited friendships
Autistic children and adults may not want friends, they may prefer to spend time alone. They may find it difficult to manage lots of relationships and will only have one or two friends at a time
Friendships that are based on a shared interest
Autistic people may find it easier to manage friendships that are based on shared interests such as gaming, the interaction is often limited to only this interest
Superficial friendships
Sometimes autistic children want to make friends but find it difficult and so learn to copy their peer’s behaviours and pretend to like what they like so that they will be accepted into a friendship group. Adults may do this at work, to fit in with others, many adults tell us that they struggle to work out who they really are after copying others for so long.
Late speech and language development
Typically developing children will develop phrased speech way before the age of 33 months. Some autistic children develop speech much later, and some do not develop speech at all. Other autistic children develop phrased speech within the expected time frame
Repetitive speech
Some autistic children will repeat other’s words (known as echolalia), say the same things over again, repeat words and phrases from the television or make a running commentary over their actions. Adults may also repeat phrases, or use phrases from films and TV during conversations.
‘Little professor’ speech
Some autistic children are extremely articulate, and sound a lot older than their years when they talk
Reduced non-verbal communication
Autistic children and adults tend to use less gesture (such as pointing, clapping or waving), facial expression and eye contact than neurotypical children and adults.
Special interests
They may pursue a topic of interest such as Thomas the Tank Engine, the Grand Prix, make up, gaming or drawing in a really focussed way, wanting to research facts, engage in the activity for long periods of time and talk about their interests to others
Unusual preoccupations
They may be interested things that other children typically aren’t such as lawn mower parts, looking out for wheelie bins or collecting empty juice bottles
Interest in the non-functional elements of things
Such as enjoying sorting their toys into shapes and colours rather than playing with them, or lining toys up in specific patterns or lines; they may enjoy spinning wheels on cars rather than playing with imaginatively with them . Adults may like to order things such as sorting clothes by colour, or collecting and storing make up but not using it.
Verbal or behavioural rituals
The child or adult may have a compulsion to say the same phrases in the same sequence or they may need to do things in the same way, such as the way they get washed or dressed. They may have other rituals such as having to move things or touch things in a certain way or sequence.
Difficulties with changes in routines
Children or adults may find it difficult if there is a change to the daily routine, if there is a different person leading an activity or if the route they usually travel needs to be changed.
Mannerisms
These are repetitive hand and finger movements (such as finger flicking or twisting) or whole body movements (such as bouncing or spinning whilst walking on tiptoes)
Some examples include:
- Placing hands over their ears in response to loud noises
- Being a very fusser eater, sticking to a few favourite foods
- Smelling things others can’t
- Disliking the feel of seams or labels in clothes
- Wanting to spin or bounce
- Enjoying watching patterns of light such as looking at lava lamps or sequins
How Is Autism Diagnosed?
There is no single test for autism. A formal autism diagnostic assessment must be undertaken before an autism diagnosis can be made.
During a gold standard autism diagnostic assessment a multi-disciplinary team (a team of different professionals) will gather a range of information through questionnaires, interview and direct observation. This information will provide the team with an understanding of the child, adolescent or adult currently and also how they have presented in the past.
The team will review the information and will use DSM 5 criteria to decide whether the child, adolescent or adult is autistic.
If you suspect you or your child is autistic, you will need a formal assessment to clarify this.
Local NHS diagnostic services have varying criteria for accepting referrals, you should speak to your school or GP for support with a referral for assessment.
Many NHS services have long waiting lists, if you would like an assessment sooner (or if your school or GP will not refer you for an assessment) you have the right to seek a private assessment.
At Veritas we provide gold standard autism assessments for anyone over the age of 30 months.
Find out more about our assessment process, contact us today.
