Signs of autism in children

Children with autism will often communicate differently or in unexpected ways with others. Some examples of these characteristics may include:

• A tendency to dominate conversations in which they are taking part, or to have trouble taking turns.
• Intense conversational focus on subjects that interest them, combined with a reluctance to engage in conversations on other topics.
• Speaking in unexpected or unusual ways, e.g., very formally or very informally, in a monotone, in an accent, etc.
• Some children on the spectrum may develop only limited speech, or remain non-speaking.
• Difficulty in responding to the tone of voice being used by others, or to non-verbal social cues such as facial expressions and body language.
• Difficulty in following conversations, with a tendency not to pick up on non-literal language like sarcasm or metaphor.
• Displaying a limited range of facial expressions, or using facial expressions that don’t match what a person is communicating.
• Difficulty in making or maintaining eye contact with others.
• Difficulty in following instructions that contain more than one or two steps.
• Talking about their feelings or answering questions about themselves can be difficult.
• Not responding consistently to their name, or referring to themselves as ‘you’ rather than ‘I’.
• Trouble initiating interactions with other children, or developing and maintaining friendships with peers.
• A tendency to try to dominate play when engaging with others.
• A preference for spending time with younger children or with adults, rather than with children of the same age.
• A tendency to prefer playing on their own rather than playing with others, or avoiding group activities.
• May be reluctant to develop close friendships.
• Rigidity with regard to setting and following rules, whether in the classroom or during play.
• Difficulty in recognising other people’s personal space.

Children on the spectrum can display unique or unexpected behaviours. These may include:

• An intense focus on unusual hobbies, such a keeping lists or memorising statistics, or on objects like toys, household objects or more unusual objects.
• Repetitive behaviour, such as arranging objects or toys in a precise, unchanging way.
• Repeating words or phrases constantly.
• Extreme sensitivity to a range of sensory experiences. For instance, they may object to wearing clothes made from certain fabrics, hate loud noises, or only eat certain foods based on their texture. A sensory overload can in some children provoke extreme reactions.
• Not responding to some sensory experiences, such as heat, cold or pain.
• Closely following routines, and getting upset when plans change or routines aren’t followed.
• Feeling anxious or upset when in social situations with which they aren’t familiar.
• Finding it difficult to solve problems or apply skills they have learnt in different contexts.
• Feeling overwhelmed or upset about going to school, or regularly refusing to go.
• Making unusual body movements, such as hand clapping, hand flapping or rocking.
• Finding it difficult to sit, stand or be still, or constantly fidgeting.
• Making unusual noises such as grunts or squeals, or frequently clearing their throat.
• Sleeping patterns that are irregular, such as staying awake long after bedtime, or waking up frequently during the night.

Communicating with peers and adults, developing friendships and creating support networks can be vital for teenagers, both in school and out, but these can be challenging for teenagers with autism. Some signs that teens may be on the spectrum may include:

• Difficulty in maintaining conversations, either through trying to dominate the talk at the expense of others, having problems staying on topic, responding to questions, or talking about themselves
• Having trouble making and maintaining eye contact with others
• Becoming intensely focussed on topics in which they are interested, to the exclusion of other subjects they are not interested in
• Difficulty in noticing, reacting or responding to non-verbal social cues, such as tone of voice or body language. This can make it difficult for people on the spectrum to understand non-literal uses of language, such as sarcasm, figures of speech, etc
• Difficulty in picking up on the facial expressions of others, meaning that they often have unexpected responses, or appear to lack empathy for the feelings of others
• Teenagers with autism may have a limited range of facial expressions, respond with unexpected expressions, or show no reactions
• Difficulty in understanding or maintaining the concept of personal space in their interactions with others
• It can be challenging for teens with autism to understand the unwritten rules of friendship, and so they can become isolated as a consequence
• Teenagers on the spectrum may also prefer to be friends with adults or younger children, rather than their peers
• A tendency to want to dominate activities in which they are participating, and difficult in taking turns
• Inflexibility when it comes to rules and routines, at school, at home or in social situations, and becoming upset if they are not followed or changed
• Speaking in an unusual manner, such as in a monotone, with an accent, extremely formally or very informally
• Some teenagers on the spectrum may speak very little or not at all
• Difficulty in following instructions that require more than a few steps.

A teenager on the autism spectrum may display repetitive or restricted behaviours, including:

• Adhering strictly to routines and becoming distressed when they change or are not followed
• Becoming upset or anxious when faced with new social situations, or being taken to places with which they are unfamiliar
• Regularly refusing to go to school when they are feeling anxious, upset or confused
• Becoming intensely interested in unusual hobbies, or forming very strong attachments to unexpected objects
• Difficulty in transferring their attention from one activity to another, particularly if it is not something they have great interest in
• Repetitive behaviour, such as constantly putting objects into groups or lining them up
• Exhibiting a high degree of sensitivity to sensory experiences, such as refusing to wear certain fabrics, becoming distressed by certain sounds, or only eating foods with a particular texture
• Some teenagers on the spectrum can develop eating disorders when feeling anxious or at times of significant stress
• Not responding to some sensory stimuli, such as heat, cold or pain
• Sensory overload can lead to unexpected responses or behaviours
• Performing unusual or unexpected body movements, such as flapping their hands, rocking, or flicking their fingers
• Making unusual or unexpected noises and sounds, such as grunting, squealing or constantly clearing their throat
• Unusual sleeping patterns, such as staying awake long into the night or waking up regularly at a particular time each night
• Feelings of isolation when they begin to understand that their development differs to their peers, and that this is beginning to be noticed by classmates and others
• Difficulty in being organised and managing their studies, friendships and other activities.