These descriptions give a guide to many of the behaviors observed in children, teenagers and adults with an Autism Spectrum Disorder. It is important to remember that everyone is different and very few children or adults will show all of these characteristics. The three lists show a typical progression through childhood into adulthood.
- Food problems. The child can be resistant to solid foods or may not accept a variety of foods in their diet.
- Unusual responses to other people. A child may show no desire to be cuddled, have a strong preference for familiar people and may appear to treat people as objects rather than a source of comfort.
- The child tends not to look directly at other people in a social way. This is sometimes referred to as a lack of eye contact.
- There may be constant crying or there may be an unusual absence of crying.
- The child often has marked repetitive movements, such as hand-shaking or flapping, prolonged rocking or spinning of objects.
- Many children develop an obsessive interest in certain toys or objects whilst ignoring other things.
- The child may have extreme resistance to change in routines and/or their environment.
- The child may appear to avoid social situations, preferring to be alone.
- There is limited development of play activities, particularly imaginative play.
- The child may have sleeping problems.
- There may be an absence of speech, or unusual speech patterns such as repeating words and phrases (echolalia), failure to use ‘I’, ‘me’, and ‘you’, or reversal of these pronouns.
- There are often difficulties with toilet training.
- The child generally does not point to or share observations or experiences with others.
- The child may be extremely distressed by certain noises and/or busy public places such as shopping centers.
- There is no evidence of disability in the child’s physical appearance – many children with an Autism Spectrum Disorder are very attractive in appearance.
PRIMARY SCHOOL YEARS
- Parents may notice that much of the distressing behavior of the preschool years decreases.
- There can be a period of relative calm and adjustment, but resistance to the demands of others remains.
- There can be an increase in social interest; they better tolerate playing beside other children and may begin to show attachments to certain people (often adults or younger children).
- Echolalic speech, if present, decreases and spontaneous speech emerge. About half of the children who are non-verbal in the preschool years will acquire some speech.
- School behaviour problems can occur, often because the child finds it difficult to make social judgements about other children.
- Ritualistic and compulsive behavior patterns are very common.
- Hyperactivity and a poor attention span are often observed, usually because the child has trouble understanding instructions from the teacher and classroom ‘rules’.
- The child’s difficulty in understanding other people and interpreting what is going on around them leads to significant levels of anxiety.
- Many children will show a lack of motivation or desire to please others.
- These children have difficulty transferring skills learned in one setting to another setting, eg, school to home.
ADOLESCENCE TO ADULTHOOD
- The behaviour disturbance and mood imbalance so typical of teenagers seems to be exaggerated for those with an Autism Spectrum Disorder. It may start a little later, and continue into late teens and early twenties but eventually, there is a resumption of calmer behavior. A few adolescents show marked improvement in their behavior and skills and some may show serious behavior regression – but all survive adolescence!
- Sexual development and interest varies with physical development but in general is delayed.
- The commencement of menstruation and sexual drive are usually tolerated calmly but exhibitionism and masturbation are sometimes problems. This behaviour can usually be redirected using behaviour modification techniques.
- The presence of disability seems to become more obvious in the physical appearance of the older person, especially if they also have an intellectual disability.
- Epilepsy or seizures may develop in a number of adolescents with an Autism Spectrum Disorder.
- Increased levels of anxiety and the development of depressive symptoms often occur and carers need to be alert to this and seek professional help. Medication may be prescribed to help ‘take the edge’ off their anxiety levels.
- Adults with an Autism Spectrum Disorder, if they have received specialist intervention, are able to partly overcome their difficulties but continue to require sensitive and sustained support, usually from their families.
(Based on an earlier article “What Is Autism?”).
Why is Autism Spectrum Disorder so hard to understand?
Dr Lorna Wing, a very well known researcher, writer and clinician in the field of autism has developed a model to help us understand these complexities. She coined the term ‘Autism Spectrum Disorders’ to describe a ‘triad of impairment’, with each component depicted along a continuum. The following diagrams may help to illustrate this concept and further explain the characteristics of Autism Spectrum Disorder, and how they can vary from person to person.
What makes understanding Autism Spectrum Disorder so hard is that an affected person may have characteristics or behaviours from any point on each continuum in the triad.
IMPAIRMENT OF SOCIAL RELATIONSHIPS
|Aloof||-> Passive||-> Active but odd|
- The aloof type shows almost complete indifference to other people.
- The passive type will respond to interactions but not initiate them.
- The active but odd type will initiate interactions with others but in an odd, repetitive and often inappropriate way.
IMPAIRMENT OF COMMUNICATION
|Disordered or absent speech||-> Echolalic and repetitive speech||-> Reasonable communication with a limited range of topics|
- The Classic or Kanner type of Autism is characterized by little if any speech and a poor understanding of non-verbal communication.
- If speech develops, it is often characterized by echolalic and repetitive patterns and a limited understanding of non-verbal communication.
- Even well developed speech may often seem irrelevant to the social context with a general lack of understanding of what others are talking about.
IMPAIRMENT OF IMAGINATIVE THOUGHT
|Using of objects for sensation only||Unimaginative use of toys||Unable to copy and pretend play||Unable to invent an imaginary world|
- Mouthing, spinning, flicking and posting of toys and household objects.
- Lining up or color-coding blocks and toys.
- The child will often require support from an adult or trusted playmate.
- Thoughts and interests are concrete, rigid and stereotyped.
ALSO OBSERVED IS A PATTERN OF REPETITIVE BEHAVIOURS
The behavior of children and adults with an Autism Spectrum Disorder is often described as repetitive or obsessive. The nature of repetitive behaviours can also be viewed along a continuum.
|Repetitive Body Movements||Fascination with sensory stimuli||Routines involving objects||Verbal routines||Routines related to a special skill||Topics of special interest|
Adapted from “Autism – Perceptions & Reality” Presentation Kit, The Autism Foundation