Common Symptoms Of Autism

Explore common symptoms of autism, from early signs in toddlers to unique communication challenges.

Understanding Autism Symptoms

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that affects social interaction, communication, interests, and behavior. ASD is a spectrum, meaning that people with ASD can have a range of symptoms and may not all have the same experiences or difficulties. Here, we delve into two of the common symptoms of autism: executive function impairments and sensory sensitivities.

Executive Function Impairments

Executive functions are the cognitive skills that help us plan, focus attention, remember instructions, and juggle multiple tasks. Individuals with ASD often show significantly reduced performance in executive functions (EF) compared to typically developing control persons (TD). This includes impairments in planning, working memory, inhibition, and flexibility [1].

Research supports the link between executive dysfunction and autism. Abnormalities in the prefrontal cortex, a part of the brain that plays a major role in executive functioning, may contribute to these difficulties in individuals with autism [2].

However, it's important to note that executive function impairments in individuals with ASD are not specific to autism and can be found across various neurodevelopmental disorders. Furthermore, there is a heterogeneity in performance across different EF subdomains, suggesting individual differences in cognitive profiles.

Up to 80% of individuals with autism may suffer from executive function disorder. They often experience issues with flexibility, planning, and organization, which can manifest differently from one individual to the next.

Interventions, including visual systems and Applied Behavior Analysis (ABA) therapy, can help improve executive function skills and manage day-to-day challenges [2].

Sensory Sensitivities

Individuals with ASD often exhibit sensory sensitivities. These can include hypersensitivity (over-responsiveness) and hyposensitivity (under-responsiveness) to various stimuli such as bright lights, sounds, smells, textures, and tastes. Many individuals with ASD experience sensory avoidance behaviors as a result.

These sensory sensitivities can have a significant impact on an individual's daily life, affecting their ability to participate in everyday activities. For example, a person with autism may find certain sounds, lights, or smells overwhelming, leading to discomfort or distress.

It's important to remember that each individual with ASD is unique, and their sensory sensitivities can vary widely. For some, these sensitivities may be mild and easily managed, while for others, they can be severe and significantly affect their quality of life.

Understanding these common symptoms of autism can help us better support individuals with ASD and provide interventions that address their specific needs.

Repetitive Behaviors in Autism

One of the common symptoms of autism includes repetitive behaviors, which are divided into two categories: stereotyped behaviors and insistence on sameness. Both types of behaviors are part of the restrictive and repetitive behaviors (RRBs), which are hallmark features of autism spectrum disorder [4].

Stereotyped Behaviors

Stereotyped behaviors, also known as "lower-order" repetitive behaviors, refer to the persistent repetition of an act or speech. Individuals with autism spectrum disorder may engage in stereotyped and repetitive motor movements such as hand flapping or lining up items. They may also repeat words or phrases, a behavior known as echolalia.

According to Verywell Health, other examples of stereotyped behaviors include fidgeting and repeating words or phrases. Notably, such behaviors are not exclusive to autism, as they can be present in other neurological conditions as well.

Insistence on Sameness

Insistence on sameness, or "higher-order" repetitive behaviors, is another common symptom of autism. This behavior is characterized by a desire for sameness and a preference for routine. For instance, an individual may need to take the same route to school every day or require that activities be completed in a specific order each time [4].

An instance of autistic perseveration, a type of insistence on sameness, may not be obvious to the casual observer. For example, an autistic person may ask a question and upon receiving a response, they may repeat a memorized speech about a subject they're passionate about in exactly the same words and gestures [5].

These behaviors can have a significant impact on an individual's ability to engage in other activities and can also negatively affect social relationships. Understanding the nature of these behaviors is crucial in the process of diagnosing autism and creating effective treatment plans.

Communication Challenges in Autism

One of the common symptoms of autism relates to communication challenges. Individuals with autism often face difficulties with language development and social communication, which can impact their ability to interact with others.

Delayed Language Development

Almost all children on the autism disorder spectrum show delays in nonverbal communication and spoken language. Such difficulties may manifest as issues using labels and echoing or repeating speech. These challenges can limit a child's ability to express their thoughts, feelings, and needs effectively, which can subsequently impact their social interactions and learning experiences.

In addition to delayed speech, children with autism may also show differences in how they use their voice. For example, they might speak in a flat, monotonous tone or use an unusually high or low pitch. Furthermore, they may have difficulty understanding and using non-literal language, such as idioms, metaphors, and jokes, which can further complicate their communication with others.

Restricted Social Communication

Children on the autism spectrum usually demonstrate delayed or absent social communication skills in multiple stages of joint attention. Joint attention, an essential skill for social and communication development, is often delayed or lacking in children with autism spectrum disorder compared to those without ASD. This includes using and understanding gestures like pointing.

Most children exhibit the ability to point to out-of-reach objects they want by 12 months of age. However, a child on the autism spectrum may use alternative methods to direct attention to objects without making eye contact. This can make it more challenging for them to engage in shared experiences or interactions with others.

In a historical context, when Leo Kanner wrote his first paper on autism in 1943, his descriptions of the children he had observed included many problems with social communication. This included failures to make eye contact or respond to questions, and a tendency toward obsessive conversation [7].

These communication challenges can impact a child's ability to form relationships, understand social cues, and interact in social settings. However, with early intervention and targeted therapies, these skills can be improved over time. It's important to remember that every child with autism is unique, and their communication abilities can vary widely. Understanding these differences can help provide them with the support they need to navigate their communication challenges.

Early Signs of Autism

Recognizing the early signs of autism can be crucial for initiating early intervention, which is known to significantly improve outcomes for children on the autism spectrum. These early indicators can manifest as early as infancy and continue into the toddler years.

Signs in Babies

Early signs of autism in babies, typically from 6 months to one year, are often related to social and communication development. According to Autism SA, these may include:

Limited or no eye contact
Lack of social smiling
Difficulty with back-and-forth interactions
Difficulty responding to their name
Lack of interest in playing with others

Additional signs may include delays in nonverbal communication and spoken language, such as using labels and echoing/repeating speech, as noted by HealthyChildren.org.

Signs in Toddlers

As children grow into their toddler years (up to 24 months), the signs of autism may become more noticeable and diverse. These can include:

Not using gestures to communicate
Delayed language development
Repetitive movements or postures
Difficulty understanding simple directions
Unusual reactions to the way things sound, smell, taste, look, or feel

Autism SA also points out that about 25% of children later diagnosed with autism spectrum disorder may exhibit regression in developmental milestones and skills, typically between the ages of 15 and 24 months.

For children up to 36 months, additional signs may include persistent language delays, difficulty understanding the feelings of others, repetitive use of language or mannerisms, lack of interest in sharing enjoyment, and limited interests in activities or objects.

The early signs of autism can vary greatly among children. If parents or caregivers notice any of these signs, it's crucial to seek a professional evaluation. Early diagnosis and intervention can significantly improve a child's development and quality of life.

Diagnosis and Assessment

The process of diagnosing autism involves identifying a specific set of characteristics and behaviors that align with the common symptoms of autism. It's important to note that a diagnosis is not based on biological tests but rather on observed behaviors.

Diagnostic Process

Autism is typically diagnosed between 18 to 22 months of age, although some signs may become noticeable earlier. The process involves assessments conducted by trained specialists such as diagnostic specialists, general practitioners, nurses, or health workers. These professionals are skilled in recognizing the signs of autism in children and can provide an accurate diagnosis.

If concerns arise about a child's development, it's crucial to seek advice from medical professionals. Autism assessments play a vital role in determining whether an individual is on the autism spectrum or not. It's important to remember that early diagnosis can lead to more effective interventions and better outcomes for the individual.

Autism Characteristics

Individuals with autism display a range of characteristics that are typically grouped into two main categories: social communication/interaction, and restricted, repetitive patterns of behavior or interests.

Social Communication/Interaction: Individuals on the autism spectrum often face challenges with both verbal and nonverbal forms of communication. This includes difficulties with social cues, such as eye contact and facial expressions, and language skills, such as grammar and the correct use of pronouns. These challenges can often result in what others perceive as 'awkwardness' [7].
Restricted, Repetitive Patterns of Behavior or Interests: This includes stereotyped or repetitive movements, insistence on sameness, and highly restricted, fixated interests. These behaviors can vary greatly in their intensity and can interfere with daily functioning.

Autism Characteristics	Examples
Social Communication/Interaction	Difficulties with eye contact, facial expressions, and grammar
Restricted, Repetitive Patterns of Behavior or Interests	Stereotyped movements, insistence on sameness, fixated interests

These common symptoms of autism are used by healthcare professionals to guide the diagnosis and assessment process. By understanding these characteristics, individuals, families, and educators can gain a better understanding of autism and how it affects an individual's daily life.

Social Communication in Autism

Social communication involves both the verbal and nonverbal methods we use to interact with others. For individuals on the autism spectrum, these skills can present significant challenges. The common symptoms of autism often include difficulties with nonverbal skills and pragmatic communication.

Nonverbal Skills

Almost all children on the autism disorder spectrum show delays in nonverbal communication. This can manifest in various ways, such as difficulties in using and understanding gestures like pointing. While most children exhibit the ability to point to out-of-reach objects they want by 12 months of age, a child on the autism spectrum may use alternative methods to direct attention to objects without making eye contact.

Joint attention, an essential skill for social and communication development, is often delayed or lacking in children with autism spectrum disorder compared to those without ASD.

Differences in nonverbal communication, such as facial expressions and the tempo of speech, may account for what others perceive as 'awkwardness' in people with autism [7].

Pragmatic Challenges

Pragmatics, the appropriate use of language in social situations, can be a particular challenge for those with autism. Examples include the ability to stay on topic and take turns in a conversation, ask appropriate questions, and use a tone of voice suitable for the setting [7].

Individuals on the autism spectrum may also face challenges with a range of verbal skills, including grammar, the correct use of pronouns, and responding when spoken to.

In 2013, the DSM-5 added a new diagnosis called social communication disorder (SCD) which shares traits common among people with autism. However, individuals with SCD do not exhibit repetitive behaviors or restricted interests, distinguishing them from those with autism.

Understanding the challenges related to social communication in autism can assist in developing effective strategies and therapies to support individuals on the spectrum. Many autism therapies incorporate explicit training on these skills, helping individuals to better navigate social situations.