The signs and symptoms of autism vary depending on age, sex and severity. A 10-year-old male with severe autism will ‘look’ different to a 14-year-old female with high-functioning autism (what was previously labelled as Asperger Syndrome).
Across all children will be difficulties with social skills, along with unusual or repetitive behaviours. What is different across the ‘spectrum’ is how these difficulties and behaviours manifest. This makes identifying autism a complicated process.
There is also the added issue of interpreting these behaviours. It may be that they are due to anxiety or attachment, for example, rather than autism. Trust us, social difficulties caused by attachment disruption are different to those caused by autism.
For these reasons, we do not use questionnaires or online tests to screen for autism. They are over-simplistic and not sensitive enough to be helpful. You wouldn’t expect to be able to complete an online test for a less known developmental condition like Fragile X Syndrome, and it should be same for autism. It should be left to the specialists.
If you have concerns that your child has autism, they are best discussed in a consultation. Below is however a list of indicators of autism that you might want to consider in advance of any appointment:
- Delayed speech development, loss of language skills or unusual speech content
- Unusual tone, rate or volume of speech, including speaking in an American accent
- Repetition of other people’s speech (e.g. parents, TV characters)
- Difficulty using and reading non-verbal communication, such as eye contact, gesture and facial expression
- Failure to initiate contact with others for purely social purposes – they might initiate if they need help or if it is related to their interests
- Unusual response to social situations – they might not respond at all or their response might be limited
- Lack of reciprocity so interactions feel one-sided/not expressing interest in others
- Lack of interest in children and/or difficulty maintaining friendships
- Interests that are unusual in their topic or in their level of intensity
- Preference for routine and sameness, and anxiety if something unexpected happens
- Repetitive play, such as lining up toys or objects
- Unusual hand or body movements
- Sensitivity to sensory experiences (e.g. noise) or sensory-seeking behaviour
- Lack of imagination of creativity in play
In addition to the above, which are taken from the DSM-V diagnostic criteria for autism, we often see the following features in children with autism in clinical practice:
- Anxiety that presents as school refusal and/or emotional outbursts
- Low mood and deliberate self-harm
- Gender identity issues
- Difficulty falling or staying asleep
- Delayed toilet training and constipation issues
- Restricted eating
- Social withdrawal and isolation
Autism is NOT a behaviour problem. It is a developmental disorder that affects social communication and interaction.