Autism can manifest in a child with a variety of signs and symptoms that may suggest the prognosis of the disorder. From specific facial features to divergent social behavior, there are multitudinous indications one can look out for when it comes to identifying autism in individuals. That is to say, not everyone with autism may experience each and/or similar signs and symptoms.
Signs and Symptoms
Included among the general signs and symptoms of Autism Spectrum Disorder (ASD) one can look out for are restless sleep- studies show that about 80% of children with autism suffer from disturbed sleep patterns, resulting in lethargy, learning difficulties, and behavior problems; and self-abusive mannerisms- for instance banging their heads against a hard surface, forceful shaking of the head, biting, slapping and/or punching themselves, scratching or pinching, dislocating joints, pulling of the hair, teeth and/or fingernails, and keeping up a consistently non-nutritive diet.
Autistic children tend to fixate on certain mannerisms and/or objects with an atypical intensity. For example, they may display extreme passion for an activity or object or have an unnatural concentration on a select task or item. Additionally, children with autism repeat phrases and movements, like rocking back and forth, flapping their hands and/or spinning in circles.
They tend to dislike unpredictability, preferring to adhere to a familiar routine down to the most exhaustive details, such as the placement of items. This inflexibility is one of the major issues addressed by the Applied Behavior Analysis (ABA therapy) technique, which is why it is commonly employed as treatment in inclusion centers like Small Steps Big Dreams.
The neurodevelopmental condition can cause difficulty in learning, as well. That is why, to incorporate them into society, educational institutions catering solely to autistic children are greatly needed. In cities like Dubai, where social isolation is the general reaction to mental health problems, Small Steps Big Dreams aims to battle the exclusion faced by such children and their families.
Children may suffer from an intense focus on a single topic, unable to follow conventional academic techniques due to being preoccupied with particular subjects. They may also articulate in an unconventional manner, using words or phrases unintelligible by normative standards. To elucidate, it may help to view the very first diagnosis of autism, patient Daniel Triplett.
As a three-year-old, Triplett would pick words and phrases, but only by memory. In consequence, he would repeat what he would hear, without any understanding of what they meant. This made it clear that Triplett could remember, but he could not learn to comprehend. Moreover, children with autism can be unresponsive to instructions and commands.
While it is believed that in some cases autism may intensify memory collection, it conversely affects learning abilities. Therefore, children with autism face language comprehension issues. This may surface not only in repetitive yet seemingly meaningless use of language, but also in speech delays. Statistics suggest 40% autistic children do not talk at all, while 25% to 30% develop certain language skills during infancy only to lose them later. Furthermore, the autistic child may exhibit difficulties relevant to the appropriate use of pronouns, using them in reverse.
Such deficits can result in the inability to maintain a conversation. Art therapist Theresa Van Lith addresses the difficulty children with autism spectrum disorder face with conventional methods of expression by stating, “I have noticed that children with autism think in pictures.” Thus, standard speech and writing may typically elude them, resulting in awkward social interactions.
Children with Autism Spectrum Disorder may find difficulty in processing specific information. Majorly, according to Dr. John B Fotheringham, they are unable to comprehend emotional motivations and communicative intent. He connects this to the argument of psychologist, Simon Baron-Cohen, on how the deficit of “meta-representation” is the essential psychological challenge autistic individuals have to face. A concept relevant to the Theory of Mind, meta-representation is the inference of the mental topography of others through the acknowledgement of their capability of processing thought existing just as ours does.
We consequently form mental representations, making guesses and deductions about their beliefs, intentions and desires, etc. Baron-Cohen terms this as “mind-reading.” With autism, however, there is a lack of such inference, as individuals with ASD may be unable to enact empathy or form social connections. Fotheringham elaborates on this inability, connecting it to the difficulty posed by autism in communicating in a social environment with conventionally appropriate interactions and responses.
They do not enjoy ease in picking up social cues, such as tone of voice or body language, and face behavioral disturbances in a social setting. Moreover, individuals with autism may maintain poor eye contact, or avoid it altogether. They can also interact with non-normative facial expressions, body postures, or tone of voice. The lattermost of which is interpreted as flat or monotonous.
Babies and Toddlers
Social signs of autism can be witnessed in younger children fairly quickly.
They may reject physical contact, even if it is to comfort them when they are upset.
They may prefer to not play alone and not interact with other children. This can include sharing and talking to others, as well.
By the age of 12 months, they cannot respond to their name.
They constantly repeat the same phrases over and over, without a proper understanding of the meaning behind them. This sign is called echolalia.
They do not respond to their parents’ smile or other facial expressions.
They avoid eye contact.
They get excessively upset if they dislike a certain taste, smell or sound.
By the age of 14 months, they do not point at objects to display their interest. For example, pointing at a passing car or reaching out to a bird flying by.
They may react unusually to the way something smells, feels, looks, or tastes.
They do not shift their attention to an event or object someone else is pointing out.
By the age of 16 months, they do not say single words.
When starting to walk, they tiptoe instead. A study by the American Addiction Centers highlights this as “toe walking.”
By the age of 18 months, they do not play games of “pretend,” like pretending to feed a doll.
The signs and symptoms that can be found in older children may often be dismissed as subtle under the stereotypes associated with older children. However, it is helpful to be mindful of the following signs of autism:
They find difficulty in expressing their feelings.
They prefer to strictly adhere to a fixed routine, getting agitated by even minute changes.
They can have a focused interest in a particular activity or topic.
They may lack empathy, unable to use meta-representation to gauge what others may be feeling or thinking.
They find it hard to interact socially or make friends, preferring social withdrawal.
They can get excessively upset when told to perform a task.
They may take things too literal. They may, thus, misconstrue the actual meanings of metaphors or idioms. For instance, when told to “shake a leg,” they may not realize they are being asked to hurry up. They may not understand sarcasm or jokes, either.
Stoppler, Melissa Conrad. “Autism: Symptoms & Signs.” MedicineNet. https://www.medicinenet.com/autism_symptoms_and_signs/symptoms.htm
“What Are the Symptoms of Autism?” WebMD. https://www.webmd.com/brain/autism/symptoms-of-autism