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Autism Spectrum Disorders: Signs and Symptoms (Part 1)

Autism spectrum disorder (ASD) is a developmental disability caused by differences in the brain. Scientists do not know yet exactly what causes these differences for most people with ASD. However, some people with ASD have a known difference, such as a genetic condition. There are multiple causes of ASD, although most are not yet known.

There is often nothing about how people with ASD look that sets them apart from other people, but they may communicate, interact, behave, and learn in ways that are different from most other people. The learning, thinking, and problem-solving abilities of these individuals can range from gifted to severely challenged. Some people need a lot of help in their daily lives; others need less.

A diagnosis of ASD now includes several conditions that used to be diagnosed separately: autistic disorder, pervasive developmental disorder not otherwise specified (PDD-NOS), and Asperger syndrome. These conditions are now all called autism spectrum disorder.

ASD begins before the age of three and lasts throughout a person's life, although symptoms may improve over time. Some children with ASD show hints of future problems within the first few months of life. In others, symptoms may not show up until age 24 months or later. Some children with 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 ASD noticed a problem before their child's first birthday, and nearly 80 to 90 percent saw problems by 24 months of age.1

It is important to note that some people without ASD might also have some of these symptoms, but for people with ASD, the impairments make life very challenging.

Possible "Red Flags"

A person with 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 age 14 months
  • Not play "pretend" games (pretend to feed a doll) by age 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 atypical 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 ASD do not have just social difficulties like shyness. The social issues they have cause serious problems in their everyday life. Examples of social issues related to ASD include that a person

  • Does not respond to their 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 their 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 interest in social games like peek-a-boo and pat-a-cake. In contrast, a young child with ASD might have a very hard time learning to interact with other people.

Some people with ASD might not be interested in other people at all. Others might want friends, but not understand how to develop friendships. Many children with 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 ASD might have problems with showing or talking about their feelings. They might also have trouble understanding other people's feelings. Many 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 ASD. Anxiety and depression also affect some of these individuals. All of these symptoms can make other social problems even harder to manage.

Reference

  1. Johnson, C.P. (2004). Early clinical characteristics of children with autism. In V.B. Gupta (Ed.), Autistic Spectrum Disorders in Children (pp. 85–123). New York: Marcel Dekker, Inc.

U.S. Centers for Disease Control and Prevention (CDC), National Center on Birth Defects and Developmental Disabilities (NCBDDD). (Reviewed 2019, August 27). Autism spectrum disorders: Signs and symptoms. Retrieved February 1, 2021, from https://www.cdc.gov

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