Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder, meaning that symptoms usually begin to show up in early childhood (usually before the age of 5). Symptoms are usually most apparent early in life, before a person is able to take the time to learn what comes naturally to children without ASD, but this is dependent on severity and many other factors. ASD is defined by both difficulty with social communication and consistently repetitive and restrictive behaviours or interests.
Symptoms of ASD typically start to become noticeable in a child’s second year, particularly in cases where there is language regression, and this has proven to be unfortunately timed with very common immunizations. Observing this pattern, scientists asked the question of whether or not ASD was linked to immunizations, and this question has been answered by a multitude of studies that have found no link between ASD and immunizations. While there are some minor risk factors that may be linked to ASD—older parents, fetal exposure to certain medications, and low birth weight—the greatest risk factor by far is genetic.
Verbal Social Communication
- They struggle to start conversations, or do not want to start conversations with others
- They struggle to pick up on verbal cues in conversation to expand on the conversation and ask questions of others, so they have fewer back-and-forth conversations
- They might not share much information about themselves with others
- They struggle to modulate vocal tone and/or volume, and so they may come across as monotone or louder than they think they are or than what is appropriate
- They can come across as blunt
- They have difficulty knowing what topics are appropriate in different contexts
- They often “info-dump,” or over-share about their own interests to the point of dominating conversation
- Children might not prefer to play in an imaginative way, or struggle to share their imaginative play with others in a collaborative way
- Adults, even those who have learned many social norms over the course of growing up, will still often struggle in new social situations
- Adults will also need to consciously figure out what is intuitive for people without ASD in social situations, and this ongoing processing makes socializing more tiring than it would be otherwise
Non-Verbal Social Communication
- They often do not show how they are really feeling with their facial expression
- They might struggle to make and/or maintain eye contact, or may make very intense eye contact
- They struggle to understand and use gestures
- They may have trouble forging new friendships
- They often prefer to spend time with either much younger or much older people
- They may struggle to understand and/or define relationships; for example, they may not know how to answer a question like: “What does it mean to be a friend?”
- Adults, even those who have learned many social norms over the course of growing up, may still have trouble integrating verbal and nonverbal communication and come across as either robotic or greatly exaggerated at times
Repetitive or Restrictive Behaviours
- Repetitive movements
- Repeated words or phrases
- Repetitive behaviour or play
- Rigid routines
- Difficulty with change or transitions
- Rigid thought patterns and all-or-nothing thinking
- Intense and specific interests
- Adults may not present with as overt repetitive behaviours because they often learn as children that these can be socially unacceptable
Other Common Symptoms
- Children under the age of 3 may demonstrate regression developmentally, often in the areas of speech and language
- They may be abnormally sensitive or insensitive to sensory stimulation, which can include light, sound, food texture, object texture, taste, scent, temperature, pain, and even social stimulation
- They struggle with emotion regulation to varying degrees, and may have very extreme reactions
- Adaptive skills are usually affected by rigidity and sensory sensitivities, and are often lower than expected for the person’s IQ
- Academic achievement is also often affected by symptoms of ASD, and is often under expectations for the person’s IQ, even in people with above-average intelligence
- They often struggle to understand what behavior is considered appropriate in one situation but not another, or what behaviour is appropriate in one kind of relationship but not another; for example, a child may hug a stranger but also not want to share any information about themselves with a close friend
Some people are able to very effectively compensate for many ASD symptoms, and they may not have a very obvious presentation until demand exceeds their capacity. For some, this looks like a child suddenly unable to keep everything together in the second grade, when they now have to manage social demand with greatly increased academic demand compared to earlier years. For others, symptoms may be effectively managed well into adulthood, and they may find that their special interests give them an advantage in learning about specific disciplines and/or occupations.