One of our jobs as parents is to understand our children and all of their unique quirks, but sometimes we notice things that don’t seem quite right. Perhaps our child is developing at a different rate to others, or they aren’t doing things in the same way that their siblings did. Perhaps they are showing some behaviours that feel unusual, or they are struggling in areas where you wouldn’t expect them to. One of the questions that might come up is ‘are they autistic?’ Perhaps someone else has mentioned this to you and you aren’t sure what it means, or perhaps you’ve thought it yourself and are now drowning in google searches? This blog is intended to be a brief guide and perhaps somewhere to start. It is not in any way meant to be diagnostic, and I would urge you to talk to a health professional if you have any concerns.
Autism, also known as autism spectrum disorder (ASD) or autism spectrum condition (ASC), is a complex neurodevelopmental condition that affects individuals in various ways. Diagnoses are often made on the presence of difficulties in certain areas including social interaction, communication, sensory difficulties and the presence of repetitive behaviours or restricted interests. While the exact causes of autism remain unknown, research suggests a combination of genetic and environmental factors contribute to its development. The ‘spectrum’ part of autism spectrum disorder, means that it encompasses a wide range of abilities and challenges but all will have some level of difficulty in these areas.
Social Communication Challenges
One of the hallmarks of autism is difficulties in social interaction and communication. Children with autism may struggle to understand and respond to social cues, such as facial expressions, tone of voice, or body language. They may find it challenging to initiate and maintain conversations, interpret sarcasm or jokes, and grasp the subtleties of social relationships.
Repetitive Behaviours and Restricted Interests
Repetitive behaviours and restricted interests are another significant aspect of autism. These behaviours can manifest in different ways, including repetitive movements (such as hand-flapping, spinning, or rocking), insistence on sameness and routines, and intense fascination with specific topics or objects. Children with autism may engage in repetitive play patterns or have a strong preference for order and predictability.
Many individuals with autism experience sensory sensitivities, meaning they may have heightened or diminished responses to sensory stimuli. Sensory avoidant individuals may be being bothered by loud noises, bright lights, certain textures, or strong smells. These sensitivities can cause distress or discomfort and may lead to specific behaviours like covering ears or avoiding certain environments. Those who are sensory seeking may engage in certain behaviours including repetitive movements, touching or rubbing things or making noises.
What You Might Observe
Early identification and intervention can be very helpful in supporting children with autism. While each individual with autism is unique, there are some common signs and symptoms that you might notice.
Please note this is a very brief list of behaviours and difficulties that may indicate that some assessment is needed. These are not intended to be diagnostic in any way, and some of these may be explained by other circumstances or conditions. However, in my experience if these thing are noticed and, the important bit, persist over time, weeks or months, then I would be encouraging you to speak to a health professional.
Infancy (0-12 months):
- Limited eye contact or reduced interest in social interactions.
- Delayed or atypical responses to their name or familiar voices.
- Unusual motor movements, such as repetitive rocking or arm flapping.
- Lack of shared attention, such as pointing or showing objects to others.
Toddlerhood (1-3 years):
- May start speaking earlier than typical, later than typical, or not at all.
- Difficulty engaging in back-and-forth communication, such as not responding to simple questions or comments.
- Lack of pretend play or imaginative play skills.
- Repetitive behaviours, including lining up toys, spinning objects, or fixating on specific parts of toys.
- Under or over sensitivity to sensory stimuli, for example, extreme reaction to loud noises.
Preschool Age (3-5 years):
- Persistent challenges in social interactions and difficulty making friends.
- Delayed or impaired language skills, such as using simple sentences or having difficulty understanding and following instructions.
- Difficulty in expressing feelings, needs and wants.
- Strong adherence to routines and resistance to changes in daily activities.
- Intense focus on specific interests, often accompanied by extensive knowledge in those areas.
- Preferring to play alone.
- Repetitive or copied language.
- Seeking sensory input or engaging in self-stimulating behaviours.
School Age (6-12 years):
- Continued difficulties with social communication, including challenges in understanding and appropriately responding to social cues, including facial expressions, body language, tone of voice and gestures.
- Difficulties with following instructions, particularly with multiple steps.
- Limited conversation skills, such as turn taking and staying on topic.
- Restricted and repetitive patterns of behaviour, such as needing to follow specific rituals or routines.
- Difficulty with transitions and adapting to new situations.
- Resistance to change.
- Specialized and intense interests in specific subjects, often beyond their peers’ level of knowledge.
- Difficulties with tasks involving organization, planning, or processing complex information.
- Using self regulating behaviours to manage sensory input such as hands over ears.
- Playing alone, social isolation.
- Sensory overwhelm.
Adolescence and Beyond (13+ years):
- Continued challenges in social communication, particularly in understanding and using nonverbal cues.
- Difficulties in peer relationships, often leading to a very small social circle.
- Increased awareness of differences and potential social isolation.
- Heightened sensitivity to sensory stimuli, such as textures, sounds, or light.
- Varied cognitive abilities, ranging from exceptional skills in specific areas to difficulties with executive functions like organization and planning.
It is important to note that these are general observations, and each child with autism is unique in their development and progression. Additionally, the age brackets are not fixed and some signs may become apparent earlier or later. It’s important to remember that these behaviours can vary among individuals with autism, and not all behaviours will be present in every individual.
Changes in presentation
A common query raised by both parents and schools is about children who present ok in school then struggle at home, or conversely struggle at school but seem ok at home. There are a number of reasons for this. Masking, where a young person subdues or hides their differences in order to fit in, often leads to schools and people outside of the family not seeing or understanding the extent of a young persons difficulties. Alternatively, the environment at school may be so overwhelming that a young person struggles to manage, however, at home, in a familiar, consistent place where there is accommodations made, a young person will find it much less challenging. This is why, information and perspectives from more than one setting are really important when undertaking an assessment.
Unique Perspectives and Strengths
When parents first start reading about autism, or talk to others, the picture can often be overwhelmingly negative. As listed above, there are often many things that people who are autistic will find challenging. However, autism is not a deficit or a disorder in the traditional sense; rather than being something that needs to be fixed, the word autistic represents a different way of perceiving and interacting with the world. Many individuals with autism possess unique strengths and talents. Some individuals may excel in areas like visual thinking, pattern recognition, or problem-solving. Some may have exceptional attention to detail or a remarkable memory for specific information. Most will have an ability to think outside the box, challenging norms and cutting through extraneous detail. By embracing and nurturing these strengths, individuals with autism can make significant contributions to various fields and industries.
What About Girls?
You may have read this far and felt that it doesn’t fully describe your child. It’s important to recognize that historically, diagnostic criteria and research on autism have focused primarily on boys, leading to an underrepresentation of girls being diagnosed. As a result, girls with autism often exhibit less commonly understood patterns of behaviour and may go undiagnosed or receive a delayed diagnosis. Boys who show a less typical presentation of autism are also underdiagnosed.
Here are some additional factors to consider when observing potential signs of autism in girls:
Social Masking and Mimicking
Girls with autism may engage in social masking, meaning they consciously or unconsciously mimic the behaviour of their peers to camouflage their difficulties. This can make it more challenging to identify their social communication challenges. They may observe and imitate social interactions and may be able to maintain superficial friendships, but they may struggle with deeper emotional connections.
Improved Social Camouflage
Girls with autism may demonstrate better social imitation and mimicry skills, making it more difficult to identify their social difficulties. They might actively observe and copy the behaviour of their peers, masking their social challenges by blending in with neurotypical children. However, this masking effort can be mentally exhausting, leading to increased stress and anxiety.
While girls with autism can develop intense and specific interests, their areas of focus may differ from boys. Rather than fixating on traditional stereotypical topics, they may develop interests that align more closely with those of their neurotypical peers. For example, they may become absorbed in animals, literature, or specific television shows, rather than the more typical preoccupations with trains or numbers.
Social Imagination and Play
Girls with autism may struggle with social imagination and pretend play, but these challenges may manifest differently from boys. They might engage in imaginative play but struggle with incorporating social roles, negotiation, and flexible storytelling. For instance, they may have difficulty initiating or sustaining collaborative play with others.
Girls with autism may be more likely to exhibit internalizing behaviours, such as anxiety or depression, as a response to their difficulties in social communication and fitting in. These internal struggles may be less visible but can have a significant impact on their overall well-being and functioning.
Recognizing the unique presentation of autism in girls is essential for early identification and appropriate support. It’s important for healthcare professionals, educators, and parents to be aware of these differences and consider a broader range of behaviours and characteristics when considering an autism diagnosis.
Common Autism Myths
When discussing autism, it’s important to dispel misconceptions and clarify what autism is not. Misinformation can perpetuate stereotypes and hinder our understanding of the condition.
Autism is caused by bad parenting
One of the most harmful misconceptions is the belief that autism is caused by poor parenting or a lack of love and nurturing. This notion is entirely false. Autism is a neurodevelopmental condition with a strong genetic basis. Parents cannot cause or prevent autism through their actions or parenting style. It’s crucial to approach parents of autistic people with empathy and support rather than blame.
Autism is caused by vaccines
Extensive research has shown no link between autism and vaccines. The notion that vaccines cause autism emerged from a now discredited study, and subsequent studies have thoroughly debunked this claim. Autism is a complex condition with genetic and environmental factors contributing to its development, but vaccines are not one of those factors.
Autism is the same for everyone
Autism is a spectrum disorder, meaning it encompasses a wide range of abilities and challenges. No two individuals with autism are exactly alike. Each person’s experiences, strengths, and difficulties will be unique to them. It’s essential to move away from generalizations and recognize the diversity within the autism community.
Autism is a form of learning disability
While some individuals with autism may also have an intellectual disability, it’s important to note that autism itself is not synonymous with intellectual disability. Autism exists across a wide range of intellectual abilities, and many individuals with autism have average or above-average intelligence. It’s crucial to separate the assessment of cognitive abilities from the diagnosis of autism.
Autism is something to be cured
Autism is not a disease or an ailment that needs to be cured. It is a neurodevelopmental difference that shapes an individual’s unique perspective and strengths. Instead of seeking a cure, the focus should be on providing support, interventions, and accommodations that help individuals with autism thrive and reach their full potential.
If after reading this, you remain concerned that your child may be autistic, the next step is to seek some professional advice. This may mean contacting your health visitor, GP or paediatrician and requesting an assessment or it may mean talking it though further with someone like me.
Understanding what autism is and being able to recognize its signs and symptoms can empower parents to seek the appropriate evaluations and support for their child. By gaining a deeper understanding of autism’s social communication difficulties, repetitive behaviours, sensory sensitivities, cognitive differences, and unique strengths, parents and caregivers can better support and advocate for individuals with autism.
Autism is a complex condition, but with early intervention and ongoing therapies, children with autism can make significant progress in their development and lead fulfilling lives. Although autism is a lifelong condition, autistic people make up a diverse spectrum, and each person’s journey is unique.
Understanding what autism is not is just as important as understanding what it is. By dispelling misconceptions and myths surrounding autism, we can create a more inclusive and supportive society for individuals on the autism spectrum. Autism is a natural variation of human neurobiology, and it should be embraced with acceptance, understanding, and respect. Let’s work together to promote accurate information and foster an environment where individuals with autism can flourish and be valued for their unique contributions.
Remember, you are not alone in this journey. Reach out to healthcare professionals, join support groups, and connect with other parents who share similar experiences. Together, we can provide the best possible care and support for our children on the autism spectrum.