Generally speaking, people with autism don’t look different than anyone else. However, the way that they behave, communicate or interact around other people might look a lot different than what we are used to.
There are a variety of features (listed below) that can make up a diagnosis of autism spectrum disorder (ASD). Each individual can have any combination - or any degree of severity - of those traits.
Autism is a structural difference in the brain that becomes identifiable in early childhood and lasts throughout a person's life. Some parents notice differences in their child within the first few months of life, other children may not show signs until they are two years or older. People with Asperger's/high-functioning autism are often more likely to receive a diagnosis later in life, sometimes not until adulthood, when their skills and development become noticeably different from that of their peers.
It's important to remember that autism is a "spectrum disorder". This means that, just as the features and symptoms of autism spectrum disorder (ASD) are extremely varied, the impact and severity of the symptoms experienced by each person will also vary significantly.
This contributes to why some people with Asperger's/high-functioning autism can experience very complex issues. While they may be highly functioning in some areas of life, they may also have what amounts to a learning disability in one or more other areas.
Because ASD is a developmental disorder, the characteristics presented may change with age, with certain symptoms becoming more or less pronounced throughout a person’s lifetime. Intervention and treatment often helps symptoms improve over time.
- Not responding to their name (by 12 months of age)
- Not pointing at objects to show their interest (by 14 months)
- Not playing "pretend" or imaginary games (by 18 months)
Other features of autism are the same for both children and adults, impacting different areas of development:
- Avoids eye contact
- Has trouble expressing their own feelings, or understanding other people’s feelings
- Delayed or compromised speech and language skills
- Upset by seemingly minor changes
- Has extremely obsessive interests
- Unusual or intense reactions to the way things sound, smell, taste, look, or feel
- Avoids or resists physical contact
- Flaps their hands, rock their body, or spin in circles (repetitive behaviour or self-stimulation, also known as “stimming”)
(For questions about autism assessment/diagnosis in the Edmonton area, please visit Autism Edmonton's Next Steps: Guide to Autism Resources and click on the relevant age group.)
Some people with ASD can speak very well, while others speak very little or with great difficulty. Recent figures show that roughly 25% of people with ASD do not speak at all.
It is essential to realize that there are many types of communication, both verbal and non-verbal. Just because someone with autism isn’t verbal, doesn’t mean that they aren’t able to communicate in other ways.
Another notable trend is that the number of non-verbal people with autism who stay non-verbal is dropping, as a result of direct intervention and the use of assistive technologies.
Some examples of ASD-related communication issues are:
- Delayed speech and language skills
- Repeating words or phrases over and over (known as “echolalia”)
- Reversing pronouns in speech (e.g. saying "you" instead of "I")
- Using few or no gestures (e.g., does not wave goodbye)
- Flat or inappropriate facial expressions
- Trouble regulating pitch or volume while speaking (such as a flat or “sing-song” voice)
- Not understanding jokes, sarcasm, or teasing (taking things too literally)
- Trouble with back and forth conversation
Social interaction involves the ability to recognize and understand emotional expressions (including one's own) and to reciprocate or adjust behaviour in a social context (such as taking turns, initiating or responding to interaction, sharing information). Social interaction is our basis for forming relationships.
Examples of social interaction issues related to ASD are:
- Does not understand personal space boundaries
- Only interacts to achieve a desired goal
- Difficulty learning to “take turns” and share
- Trouble understanding different types of relationships
- Appears unable to be comforted by others during distress
Often if a person with autism seems unable to be comforted during times of distress, it's because there are other sensory issues present. For example, someone with auditory sensitivity would not be calmed by someone speaking to them or gently saying, "ssshhhh". Someone with tactile sensitivity might not respond well to a hug, or even a soft touch.
PERCEPTION (IMAGINATION & BEHAVIOUR)
Imagination allows us to perceive our environment and surroundings, make sense of abstract ideas, and conceive of situations outside of our immediate daily routine. It also allows us to understand and predict the feelings and behaviours of others.
Some examples of issues related to imagination/perception include:
- Lining up their toys, books or other objects
- Plays with toys the same way every time, or focuses on very specific parts (e.g. wheels, doors)
- May see or hear things in a completely different way than those around them
- Unable to comprehend another person's perspective
- Has obsessive interests, or is unable to switch their attention to another topic
- Has to follow certain routines (which may seem unusual or unnecessary)
There are several other symptoms that may present themselves along with the more traditional features of autism, such as:
- Hyperactivity (unusually over-active)
- Impulsivity (acting without thinking)
- Short attention span
- Temper tantrums
- Anxiety or depression issues
- Unusual mood or inappropriate emotional reactions
- Unusual eating and sleeping habits