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If you feel your child is presenting symptoms or signs of autism you need to see a suitably qualified professional and get a diagnosis. Diagnosis of autism is based on the interpretation of a child’s observed and reported symptoms and behaviours. Many children with autism also have severe learning difficulties, so a differential diagnosis (distinguishing between autism and other disorders that might present with similar symptoms) needs to be made. The first signs of autism can present in several ways (but none of the following necessarily mean your child has autism):
- Relates better to objects than people
- May only make, and tolerate approaches from familiar people
- Unaware of simple social rules
- May echo words and phrases of others
- Rarely uses eye contact or gesture
- Speech and language skills are delayed
- Words and phrases are repeated and/or used out of context
Social Imagination and flexibility of thought:
- Will not interact with other children
- Becomes very distressed at even small changes to a familiar routine
- May engage in repetitive body movements
- May lack imaginative play, just repeating the same sequences and using the same dialogue
- May be hypersensitive to sound, light and / or touch
These are just a few of many possible symptoms, and a child may display some of these symptoms and may not have autism (they could have hearing impairment or learning difficulties for instance). If you are concerned about your child’s development ask your doctor to refer you to a paediatrician for a proper evaluation. An early diagnosis is important because the relevant professionals can become involved and programs and strategies put in place to help the child and parents. It is important to involve a suitably experienced speech and language pathologist / therapist to focus on all aspects of communication.
The Triad of Impairments
A better understanding of the disorder developed when, in 1979, Lorna Wing and Judith Gould proposed that individuals on the autism spectrum generally presented with a ‘triad of impairments’.
These impairments may present as:
1) Difficulties with Social interaction: Individuals have difficulty making friends, understanding what others are feeling and thinking, and working co-operatively with others. Social interactions range from aloofness to unusual social behaviour. Individuals may not make eye contact or respond when spoken to.
2) Difficulties with Social communication: Individuals comprehension is much poorer than expression, and expression is often echolalic (repeating words or learned scripts). There are difficulties using and understanding gesture, facial expressions, body language and intonation appropriately. Other social communication skills such as turn-taking may also be a problematic concept to learn. Speech may be delayed and there is little attempt to communicate in other ways. Individuals with autism may rarely initiate communication.
3) Difficulties with Imaginative thought: Individuals have difficulties with empathy, imaginative play and become distressed when adjustments to a routine are made. Problem solving is difficult for individuals with autism and they may often take a literal perspective. Jokes, metaphor and sarcasm are not understood. Some individuals may display repetitive movements (hand flapping, or spinning objects etc) and have obsessions or attachments with certain objects. They may also have elaborate routines that they follow in certain environments.
Wing and Gould also noted that many individuals displayed sensory sensitivities to sound, light, smell, taste and touch. Some individuals were also more prone to inappropriate and challenging behaviour, especially if they become distressed.
Many individuals with ASD will have coexisting developmental difficulties which may include learning difficulties, speech and language delay, hyperactivity, and epilepsy.
Some individuals may only show mild examples of the above impairments.
When parents are first told that their child may have an autism spectrum disorder, it is usually a highly anxious time. Many people know very little about autism and are unaware of what to expect, or what they should do. Some parents may have already suspected that their child was different in some way, or that they did not reach normal milestones, but it is still a shock. Once parents come to terms with the diagnosis of autism they need to seek out information and support and find out about services and treatment.
After you have been given a diagnosis, you may want to request a second opinion. This is your right, and you should not be persuaded otherwise. It is important that you have a diagnosis from a suitable qualified professional such as a paediatrician and/or suitably experienced psychologist.
For more information about autism and other communication difficulties, and ideas and strategies to help communication, see our Resources, or for specific fact-sheets with helpful hints about Autism go to the Downloads section.
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