Autism Spectrum Disorder

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Autism is primarily a disorder of social interaction. People with autism struggle to make and keep friends. Their struggle with “social reciprocity” means they do not understand the give-and-take of social relationships. They struggle to communicate, and social interactions tend to feel awkward. Individuals with autism might not get jokes, analogies, or metaphors. When an adult says, “button your lip,” a child with autism might think, “uh, no thank you. That would hurt.” Humorous and sarcastic comments are often misunderstood. Some individuals with autism sound a little odd when they talk. For example, they might use lots of big words or sound very formal. An individual with autism might use a robotic, sing-song, or high-pitched voice. People with autism tend to have favorite topics. They might go on and on about their favorite video game or movie, sometimes inserting quotes from that movie in their everyday speech. For example, a child might say “to infinity and beyond” after every question on a test. Often, children with autism do not play the way other children do. They might struggle to take on the part of a doll or an action figure. People with autism may need to be reminded to tune in with the conversation or to come join others in a game.

What are Autism Spectrum Disorder?

Children who have significant problems in this area may have any of the following potential disability. *Note, this does not serve as a diagnosis in any way. See Where to Go for Help With Autism for professionals who can diagnose or provide a referral.

An autism spectrum disorder is a neurodevelopmental disability that is present from birth but may not be detected and diagnosed until 12 to 30 months of age. That is, people are born with their autism, but sometimes the symptoms are not evident until much later. Studies show that motor delays may be the first precursors as they have been identified in sibling studies at ages as young as 6 months old. This motor delay means that the first signs of autism might be that the child does not sit up, crawl, or walk as expected developmentally. At times, autism is not diagnosed until much older, even into adulthood. Autism is characterized by social communication deficits and restricted or repetitive interests and behaviors. People with autism struggle to form relationships with other people and tend to be hyper-focused on, even obsessed with, certain interests, ideas, or behaviors. Autism is a disability that impacts a variety of individuals over a broad spectrum of characteristics and traits, hence the term Spectrum. The old adage, “if you have met one person with autism, you have met one person with autism” highlights the wide range of symptom profiles. Some individuals with autism may have cognitive (intellectual) and language (communicative) deficits. Some individuals may be nonverbal or may have trouble communicating their wants and needs. Other individuals with autism may be extremely bright or gifted (IQ scores that fall in the top 5% of individuals). Some people with Autism may have exceptional fluid reasoning (solving new problems), visual spatial skills (seeing how objects fit together) or verbal knowledge.

What are the signs and symptoms of Autism Spectrum Disorder?

The primary deficits in autism are in social communication. Social communication is a term that refers to social perspective taking, social emotional awareness, conversational speech and communication with others.

Social Reciprocity. An individual with autism may have difficulty sustaining a reciprocal back-and-forth conversation about an area that he or she finds uninteresting. When an individual with autism is interested in the topic, he or she may monologue on that topic. For example, he or she may provide lots of information in a professorial manner without allowing for a back-and-forth exchange and dialogue between two people. As individuals with autism have trouble taking others’ perspectives, they don’t always know how to engage and interact with other people in a way that is smooth and socially appropriate.

Restricted or Repetitive Behaviors and Interests. The other component of an Autism Spectrum Disorder diagnosis is the restricted and repetitive behaviors and interests. Many people think of more obvious behaviors, such as rocking, hand flapping, avoiding gaze and completing repetitive body movements. In reality, these behaviors can be much more subtle. A person with restricted interests might talk about nothing but dinosaurs, might know every type of Lego that Mattel has created or might tell you everything about World War II. A repetitive behavior could include wiggling one’s pencil or chewing on the sleeves of a shirt or flipping fingers back and forth ever so subtly. Individuals who speak very formally or use language in a manner that is stilted or isn’t appropriate to the situation also meet the criteria for autism even without some of the more obvious traits.

Sensory Sensitivities. Another characteristic of restricted and repetitive behavior relates to sensory sensitivities or differences in sensory processing, such as smelling or licking things in a way that is unusual (e.g., licking a doll or smelling Play-Doh). Sensory challenges can also refer to extreme sensitivities to sounds, textures or smells. Individuals with autism tend to have different sensory perceptive systems. When your child covers his or her ears and moves away from sound, it’s not just a dramatic reaction. This behavior may in fact be evidence of a true difference in sensory perception. These differences can make certain experiences quite uncomfortable.

Severity Levels. Autism is characterized as having three different severity levels. Severity level 1 is the mildest level. Traits are subtle and may not be obvious to those who are not trained to diagnose, but the challenges in social settings are significant enough to lead to a referral. Severity level 2 is noted for individuals who might have more challenges communicating, speaking in simple sentences, and may be more obviously impaired. Severity level 3 is for individuals who have significant deficits in language and communication, adaptive skills and social interaction.

How is Autism Spectrum Disorder treated?

It was mentioned earlier that children can be diagnosed with autism as young as 12 months of age. It is important to explore and consider an assessment as concerns arise. The services that diagnosed young children qualify for can enable them to make great gains and strides in developing the social reciprocity, social skills, and emotional awareness that these children will need as they get older. Many children make significant progress, and some do make a recovery, obtaining what we call “Optimal Outcomes.” This term means that after treatment the child’s skills are approximately on track with peers and that the child no longer meets criteria for the disorder. Taking all this assistance into consideration, it is important to assess children at a young age and to determine whether services are warranted.

Although autism presents a myriad of challenges to children and families, it is reasonable to have hope. Deborah Fein’s research out of the University of Connecticut finds that as many as 20% of children who are diagnosed young and provided treatment and services may no longer meet criteria for the diagnosis at a later assessment. The other 80% of children can make considerable gains, particularly if they have strengths in language and adaptive skills. Children with autism often can be educated effectively in the general education classroom, although different levels of support may be needed based on the child’s symptoms. Taken together, it is valuable to obtain a diagnosis and to engage in the appropriate therapies as early as is feasible. With these supports in place, it is possible to see growth in skills, the ability to form friendships, and the potential to live a fulfilling life.

How can Clear Child Psychology help with Autism Spectrum Disorder?

If your child is struggling with this symptom to the point that it is getting in the way of his learning, relationships, or happiness, it’s time to seek professional help.

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