Signs and Symptoms of ASD

Let me just preface this by saying that just because your child may exhibit some of these signs, does not mean that they necessarily have autism.  Many typical symptoms of autism are things we all do from time to time.  Often it’s the degree or severity to which one engages in them that separates those on the spectrum from neurotypical individuals.  I think that’s always important to keep in mind when going through a list like this.  Autism Spectrum Disorder is not one of those things that has a quick answer when people ask what it is.  I’ve created a (hopefully) easier reference below with a list of the earliest signs, as well as some examples of how the various criteria for Autism Spectrum Disorder may manifest in an individual.

Early Signs:

By 6 months:
  • Not smiling back
By 12 months:
  • No babbling
  • Not responding to sounds or name
  • No pointing or meaningful gestures
By 16 months:
  • Not saying single words
By 18 months:
  • Not engaging in pretend play
By 24 months:
  • Not saying 2-word phrases
  • Loss of skills
  • Poor eye contact

ASD Criteria:

If you’ve ever read the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) for ASD criteria, it can be a little hard to follow.  It’s a diagnostic manual for clinicians, so it reads as such.  Basically, there are 2 main domains for the criteria. With several sub-domains.  The first main category is social in nature and the second refers to the more rigid or repetitive interests and behaviors.  Below I’ve included bullets and examples for how these may manifest under each domain.

  1. Social
    • No back and forth in conversation
        • Only talking about one’s own interests
        • Answers question, but does not ask anything back
    • Lack of verbal communication
        • Limited or no language
    • Lack of understanding of body language or gestures
    • No facial expressions
    • No display of emotion
    • Not responding appropriately to others’ emotions
    • No initiation of social interaction
    • No response to social interaction
    • Lack of eye contact
    • No imaginary play
    • No interest in peers
        • Would rather play independently
        • Doesn’t notice peers
  2. “Restricted, repetitive patterns, interests or activities” (American Psychiatric Association, 2013)
    • Repetitive motor movements
        • Waving objects
        • Repetitive hand movements
        • Lining up toys
        • Flipping objects
    • Repetitive speech
        • Repeating vocal sounds over and over
        • Repeating others’ words or phrases
        • Repeating phrases from videos, tv shows, or movies
    • Inflexibility and routine
        • Refusal to do things differently
        • Difficulty with transition from activity to activity or place to place
        • Need to take same route
        • Needing to wear the same shirt everyday
        • Rigidity with rules
        • Getting extremely upset by small changes
    • Fixated Interests
        • Intense interest in unusual things (e.g., vacuums, fans, flight schedules, credit cards, etc.)
    • Hyper- or hypo-reactivity to sensory input
        • Fascination with lights or things that move
            • Likes watching things fall
            • Likes watching things spin (e.g., wheels)
        • Sensitivity to noise
        • Sensitivity to texture
            • Doesn’t like tags in clothes
            • Won’t eat certain food textures

For more detailed information on the diagnostic criteria, refer to the DSM-5 (full citation below).

Other Symptoms

Other symptoms that are very common and often occur as a result of some of the above, such as an inability to communicate or sensory needs, are listed below:

  • Crying
  • Screaming
  • Kicking
  • Hitting
  • Head-banging
  • Other self-injurious behavior

I can’t stress enough that if you see any of these things in your child, it does not mean he or she has autism.  If several of these things sound familiar, you may want to talk to your Pediatrician for further evaluation.

It’s unfortunate that the lists above sound so negative or just like a bunch of things an individual can’t do or is lacking.  Some of it is the nature or how we go about diagnosing things.  We notice the differences.  However, individuals with autism have a lot of skills, as well.  I’ve met the most awesome kids in working with children on the spectrum over the past 12 years.  These are simply signs to help point you in the right direction.  The earlier you can get help, the better life can be for you and your child.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.