What is ASD?
Areas of Impairment | Autism and Related Disorders Handbook | How is ASD Diagnosed? | Links
Areas of Impairment
(1) Impairments in Social Interactions:
Social Interactions: How your child relates with you or other people in his or her environment.
In young children with autism, social behaviour is often delayed and unusual.14 This may range from aloofness (since the child may not seem to want to interact with others) to odd one-sided relationships.4 The degree of social difficulties will vary greatly depending on the child's level of development.5,17
Look for:
- A lack of desire to interact with others: (interpersonal responsiveness)9,14,17
Children with ASD may not initiate social contact and may seem to lack the desire to interact with others. Often they have difficulty understanding non-verbal social cues such as eye contact, facial expressions, body postures and gestures that regulate social interactions. Because of this, they may be unable to read facial expressions and body language. They may not engage in eye contact and may look through or past people.
Children with ASD may be oblivious to others around them, including their siblings. As a parent you may notice that your child has poor eye contact, that he/she does not like being held or stiffens when held. As your child gets older he /she may not be able to understand the needs of others and may have difficulty recognizing feelings in others. For example, your child may not notice when someone else is hurt or upset.
- Difficulty forming attachments: (reciprocal relationships)9,12,14,17
Children who have autism often do not look to play with other children their age. They may not develop normal attachments to others around them and may have little or no interest in making friends. Infants with autism may not smile or reach out to their caregivers. They may reject parents' affection by refusing to be held or cuddled.
Typically, children with autism are content to play alone, barely noticing what others around them are doing. Seldom do they seek to share their achievements, interests, or enjoyment with others.
(2) Impairments in Communication:
Communication: Your child's ability to share information and to let other people know what he/she wants or needs.
Research suggests that most children with autism are not using language for communication at the time of their initial diagnosis.3 For many children with autism, their use of language is often delayed and unusual.14 Children with ASD typically experience many language problems; some may not speak at all, others may learn to speak but their use of language may be unusual and not used for the purpose of communicating with others.
Look For:
- Failure to communicate: 12, 14,17,9,10,11
Some children with ASD may not attempt to communicate either verbally or through gestures. There may be a delay in, or a total lack of, the development of spoken language. A child with autism may not even attempt to compensate by trying to communicate in other ways; such as, pointing at objects to show interest, shaking their head to indicate yes or no, conveying emotion though facial expression, or using other gestures.
- Differences in spoken language: (differences in form, content or production)
When children with autism learn to speak, their speech is often peculiar. They may repeat back what they heard another person say (echolalia). These words or phrases may be frequently repeated regardless of their meaning. Due to echolalic speech, children with autism may refer to themselves as they have heard others speak of them - referring to themselves as "he" or "you" or by their own names; and to others as "I" or "me" (pronoun reversal).
Children with ASD often have an unusual way of talking. The pitch, rate, rhythm or volume of their spoken language may sound exaggerated. For example, they might sound squeaky or speak in a sing-song voice.
- Failure to use language for social purposes:
Even after children with ASD learn to speak they often lack verbal spontaneity. Using language to communicate may not come easily or automatically. They may be unable to use their language skills for social purposes, like starting and keeping a conversation. They may not understand simple questions, directions or jokes. They may be very literal in their use of words and unable to use language as a means of communicating with others.
(3) Restricted and repetitive patterns of behaviour, interests, and activities:
Behaviour: The way your child acts or responds to the world around him.
Children with autism often have behaviours that they want to do over and over again (repetitive patterns of behaviour), like saying the same sentence again and again.14 They may flap their hands to tell you they are happy, or they might hurt themselves to tell you they are not. Behaviours may range from simple, repeated activities to more complex preoccupation with routines or a specific interest. These behaviours vary in their form, intensity, frequency and persistence.
Look For:
- Repetitive motor acts: 9,10,11,14,17
Most children who have autism will repeat certain actions over and over. Children may, for example, flap their hands, bang their heads, rock, pace, spin on their feet, or use repetitive finger movements. In some children, these behaviours tend to occur primarily when the child is excited, stressed, or upset.
- A preoccupation with routines:
Many children with autism demonstrate a "compulsive adherence" to routines and may become extremely upset over changes in their daily routines and their surroundings. Rearranging the furniture or offering them a drink in a different cup may make them cry or bring on a temper tantrum. A child with autism may insist on always following the same routine. A change in this routine, no matter how small, might easily cause him or her to become frustrated and upset.
- Narrow range of interests or activities:
Children with autism have a tendency to be preoccupied with a small number of activities, interests, or objects. The way they play may seem repetitive or restricted. For example, a child with autism might prefer to line up cars in identical patterns rather than play with the cars using their imagination. They may seem fascinated by objects that move; the spinning of wheels on toys, the opening or closing of doors, a piece of string or a rubber band. Some children with ASD master one particular activity by developing a very elaborate academic or artistic skill.
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