Signs/Characteristics
Core characteristics of Autism Spectrum Disorder (ASD) include:
- Differences in social interaction and communication
- Restricted, repetitive patterns of behavior, interests or activities.
These characteristics typically appear early on in development (18 to 24 months), often before children enter grade school, but may not become fully noticeable until social demands increase (24 months to 6 years). See below for additional signs and characteristics.
- Differences in interacting with other people and making or maintaining relationships.
- Differences with back-and-forth conversation
- Differences using eye contact, gestures, facial expressions, and body language.
- Differences between reading social cues.
- Limited meaningful or functional communication
- Avoid or do not keep eye contact.
- Does not respond to name by 9 months of age.
- Does not show facial expressions like happy, sad, angry, and surprised by 9 months of age.
- Does not play simple interactive games like pat-a-cake by 12 months of age.
- Uses few or no gestures by 12 months of age (for example, does not wave goodbye)
- Does not share interests with others by 15 months of age (for example, shows you an object that they like)
- Does not point to show you something interesting by 18 months of age.
- Does not notice when others are hurt or upset by 24 months of age.
- Does not notice other children and join them in play by 36 months of age.
- Does not pretend to be something else, like a teacher or superhero, during play by 48 months of age.
- Does not sing, dance, or act for you by 60 months of age.
Restricted, repetitive behaviors
People with ASD have behaviors or interests that can seem unusual. These behaviors or interests set ASD apart from conditions defined by problems with social communication and interaction only.
Examples of restricted or repetitive behaviors and interests related to ASD can include
- Lines up toys or other objects and gets upset when order is changed
- Repeats words or phrases over and over (called echolalia)
- Plays with toys the same way every time
- Is focused on parts of objects (for example, wheels)
- Gets upset by minor changes
- Has obsessive interests
- Must follow certain routines
- Flaps hands, rocks body, or spins self in circles
- Has unusual reactions to the way things sound, smell, taste, look, or feel
- Differences in speech patterns (ex: saying the same things over and over in exactly the same way)
- Repeating behaviors like hand-flapping, rocking, jumping, or twirling.
- Insistence on specific routines/strong resistance to minor changes
- Sensitivity to light, touch, and sound
- Strong interests in certain areas or objects
- Unusual interest in looking closely at objects, touching, smelling, or tasting objects.
Other Characteristics
Most people with ASD have other related characteristics. These might include
- Delayed language skills
- Delayed movement skills
- Delayed cognitive or learning skills
- Hyperactive, impulsive, and/or inattentive behavior
- Epilepsy or seizure disorder
- Unusual eating and sleeping habits
- Gastrointestinal issues (for example, constipation)
- Unusual mood or emotional reactions
- Anxiety, stress, or excessive worry
- Lack of fear or more fear than expected
It is important to note that children with ASD may not have all or any of the behaviors listed as examples here.
In very young children, the first characteristic of autism may include:
- Limited demonstration of emotions, eye contact, or gestures like waving or pointing
- No or inconsistent response to name.
- Limited interest in sharing or playing with others.
- Loss of speech
Identifying characteristics of autism in girls
Boys are four times more common to be diagnosed with autism than girls. Several factors may cause girls to be misdiagnosed or undiagnosed until much later in life, missing or delaying opportunities for early intervention services and supports. This can lead to girls internalizing their symptoms, which often leads to more anxiety or mental health concerns.
Autism presents itself differently in each person. Common misconceptions or stereotypes may lead girls to go undiagnosed. Examples include:
- Stereotypes about typical male and female behaviors. For example, people may think that girls are naturally quieter or prefer to spend time alone, compared to boys demonstrating these behaviors.
- The misconception that communication and social differences must be significant in order to meet the diagnostic criteria.
- Anxiety, depression, personality disorders and other mental health conditions can all share characteristics with autism, which may cause a professional to misdiagnose it.
Signs of autism for girls:
- May rely on others (usually other girls) to guide them and speak for them throughout the day. May find it difficult to join conversations, initiate or respond quickly to social situations.
- May have "passionate" and limited interests that are very specific and restricted. For example, while many girls may be fans of a particular TV show, a girl with autism may collect information and talk about the characters, locations, props, or actors, but know little or nothing about the plot or storyline of the show.
- May have a flat affect or be overly expressive. May speak with a high pitch voice or unusual intonation.
- Conversations may be restricted to her topics of interest. She may share her opinions and interests but have no interest in hearing another person's response. This may interfere with her ability to join groups or make friends.
Recommendations
- Listen to what your daughter is going through. Also, look for subtle clues in her body language and behavior.
- Therapists can help girls with co-occurring disorders such as anxiety and depression. Girls with obsessive-compulsive disorder (OCD), eating disorders, or who have experienced trauma, may need specialists on their team. Therapists may help them build resiliency, improve self-esteem and develop effective coping strategies.
- Find a support group of like-minded people who are experiencing similar things.
Do your research and speak to your doctor, therapist, counselor, or another health professional. Trust your intuition.