Autism Spectrum Disorder

Autism is called a “spectrum” disorder because its symptoms and behaviors are different for every child. However, all children with ASD display:

1. Social challenges communicating and interacting with others
2. Repetitive patterns of behavior, interests or activities

To be diagnosed with ASD, a child must display symptoms in both of these areas.

Social challenges communicating and interacting with others

Children who find it challenging to communicate and interact with others socially may not be able to maintain a back-and-forth conversation when they talk with other people. They also may not pick up on nonverbal communication coming from other people, and they may struggle to maintain and understand relationships.

ASD challenges in social-emotional exchanges may look like:

• Unusual approaches to interacting with others, such as ignoring someone or climbing on them
• Avoiding sharing their interest, emotions or facial expressions with others
• Lack of response to social interactions from others
• Inability to engage in back-and-forth conversation

ASD challenges in nonverbal communication may look like:

• Decreased or unusual eye contact
• Problems using or understanding gestures
• Decreased or absent facial expressions
• Difficulty combining verbal and nonverbal communication at the same time, like speaking while making eye contact

ASD challenges in developing, maintaining and understanding relationships can include:

• Difficulty adjusting behavior to match the social context, such as using a quiet voice in a library
• Little or no interest in other kids their age
• Difficulty making or keeping friends
• Difficulty with pretend play with another person

Repetitive patterns

Children with ASD often show limited or repetitive patterns in their behavior, interests or activities. This may show up as repetitive movements or being inflexible in their routines and interests. Children with ASD may insist on sameness, and they may also feel reactive to sensory input, like loud noises or crowded stores.

Repetitive movements or speech may look like:

• Repeated physical movements, such as hand flapping or walking on toes
• Unusual play with toys, such as tapping or flipping toys
• Lining up, sorting or otherwise organizing toys and objects
• Repeating what other people say or speaking in an unusual way

An insistence on sameness, inflexibility with routines, and repetitive of behavior may look like:

• Extreme distress with small changes
• Difficulty with transitions, like going from the classroom to lunch
• Attachment to routine
• Rigid thinking patterns that do not change

Very fixated interests may look like:

• Strong attachments to unusual objects, such as a child who must always carry a particular toy with them
• Preoccupations with certain objects or events
• Unusually narrow interests or getting “stuck” on a topic or activity

Reactivity to sensory input may look like:

• High tolerance for pain or extreme temperatures
• Negative response to sounds, textures and foods
• Excessive smelling, touching or licking objects
• Visual fascination with lights and movement

Assessment

When you meet with a specialist at Riley Children’s Health, they will speak with you about your child’s behavior to better understand what symptoms your child may be experiencing. This will include a structured observation of your child’s social communication skills and play skills along with questionnaires completed by the family.