ASDs begin before the age of 3 and last throughout a person's life, although symptoms may improve over time. Some children with an ASD show hints of future problems within the first few months of life. In others, symptoms might not show up until 24 months or later. Some children with an ASD seem to develop normally until around 18 to 24 months of age and then they stop gaining new skills, or they lose the skills they once had.
A Person With An Autism SpectrumDisorder (ASD) Might:
Not respond to their name by 12 months
Not point at objects to show interest (pointing at an airplane flying over) by 14 months
Not play "pretend" games (pretending to "feed" a doll) by 18 months
Avoids eye contact and wants to be alone
Having trouble understanding other people's feelings or talking about their own feelings
Having delayed speech and language skills
Repeats words or phrases over and over (echolalia)
Gives unrelated answers to questions
Gets upset by minor changes
Have obsessive interests
Flap their hands, rock their body, or spin in circles
Have unusual reactions to the way things sound, smell, taste, look, or feel
Social SkillsSocial issues are one of the most common symptoms in all of the types of ASD. People with an ASD do not have just social "difficulties" like shyness. The social issues they have cause serious problems in everyday life.
Examples of social issues related to ASD:
Does not respond to name by 12 months of age
Avoids eye-contact
Prefers to play alone
Does not share interests with others
Only interacts to achieve a desired goal
Has flat or inappropriate facial expressions
Does not understand personal space boundaries
Avoids or resists physical contact
Is not comforted by others during distress
Has trouble understanding other people's feelings or talking about own feelings
Typical infants are very interested in the world and people around them. By the first birthday, a typical toddler interacts with others by looking people in the eye, copying words and actions, and using simple gestures such as clapping and waving "bye bye".
Typical toddlers also show interests in social games like peek-a-boo and pat-a-cake. But a young child with an ASD might have a very hard time learning to interact with other people.
Some people with an ASD might not be interested in other people at all. Others might want friends, but not understand how to develop friendships. Many children with an ASD have a very hard time learning to take turns and share—much more so than other children. This can make other children not want to play with them.
People with an ASD might have problems with showing or talking about their feelings. They might also have trouble understanding other people's feelings. Many people with an ASD are very sensitive to being touched and might not want to be held or cuddled.
Self-stimulatory behaviors (e.g., flapping arms over and over) are common among people with an ASD. Anxiety and depression also affect some people with an ASD. All of these symptoms can make other social problems even harder to manage.
Each person with ASD has different communication skills. Some people can speak well. Others can’t speak at all or only very little. About 40% of children with an ASD do not talk at all. About 25%–30% of children with ASD have some words at 12 to 18 months of age and then lose them. Others might speak, but not until later in childhood.
Examples of communication issues related to ASD:
Delayed speech and language skills
Repeats words or phrases over and over (echolalia)
Reverses pronouns (e.g., says "you" instead of "I")
Gives unrelated answers to questions
Does not point or respond to pointing
Uses few or no gestures (e.g., does not wave goodbye)
Talks in a flat, robot-like, or sing-song voice
Does not pretend in play (e.g., does not pretend to "feed" a doll)
Does not understand jokes, sarcasm, or teasing
People with ASD who do speak might use language in unusual ways. They might not be able to put words into real sentences. Some people with ASD say only one word at a time. Others repeat the same words or phrases over and over. Some children repeat what others say, a condition called echolalia. The repeated words might be said right away or at a later time. For example, if you ask someone with ASD, "Do you want some juice?" he or she might repeat "Do you want some juice?" instead of answering your question. Although many children without an ASD go through a stage where they repeat what they hear, it normally passes by three years of age. Some people with an ASD can speak well but might have a hard time listening to what other people say.
People with ASD might have a hard time using and understanding gestures, body language, or tone of voice. For example, people with ASD might not understand what it means to wave goodbye. Facial expressions, movements, and gestures may not match what they are saying. For instance, people with an ASD might smile while saying something sad.
People with ASD might say "I" when they mean "you," or vice versa. Their voices might sound flat, robot-like, or high-pitched. People with an ASD might stand too close to the person they are talking to, or might stick with one topic of conversation for too long. They might talk a lot about something they really like, rather than have a back-and-forth conversation with someone. Some children with fairly good language skills speak like little adults, failing to pick up on the "kid-speak" that is common with other children.