Autism spectrum disorder (ASD) is one of the most heritable of neurodevelopmental conditions, still it continues to be defined as a behavioral syndrome that is based on clinical information from a child’s developmental history and current behavior. The diagnostic criteria are diverse, spanning not only the social domain, but also behaviors in the non-social domain.
Core Features Of Autism Spectrum Disorder
- Impairments in social communication, language and related cognitive skills
- Behavioral and emotional challenges
In autism there is an impact on a diverse range of development skills.
Impairments in Social Communication
Joint attention is the shared focus of two or more individuals on the same object or event. Deficits include:
- Difficulty adjusting toward people socially and determining emotional state of self and others
- Limited range of communicative functions to pursue engagement and comfort from others
- Limitations in distinguishing and describing another’s emotional state, intention, and perspective
Social reciprocity is the back-and-forth interaction between people, during which the behavior of each person influences the behavior of the other person. Deficits include:
- Difficulty initiating bids for interaction and maintaining talks in context and the interests of others
- Problems responding to interaction initiated by others and recognizing and mending breakdowns in communication
- Limitations with upholding turn-taking in interactions
Social cognition refers to the psychological processes involved in perceiving, attending to, remembering, thinking about, and making sense of the people in our social world. Deficits include:
- Challenges in social and emotional learning, including difficulty in understanding and regulating emotion, in appreciating the perspective of others, in developing pro-social goals, and in using interpersonal skills to handle tasks
- Difficulty differentiating one’s own feelings from the feelings of others, taking into perspective the language of another person, and modifying the speech accordingly
- Difficulty incorporating diverse information to construct meaning of the context
Impairments In Language and Related Cognitive Skills
1. Delayed or impaired acquisition of words, word combinations, and syntax, including
- Loss of earlier learned words
- Delayed attainment of words representing social stimuli such as actions and people’s names
- Use of echolalia (repetition of utterances produced by others)
2. Deficits in use and understanding of nonverbal and verbal communication, including
- Delayed use of facial expressions, body language, and gestures as forms of communication in the latter part of the first year of life, remaining unconventional throughout development
- Use of unconventional gestures (pulling a caregiver’s hand toward an item) prior to or in place of conventional gestures (giving, pointing, and head nods/headshakes)
- Partial understanding of gaze shifting, distal gestures, facial expressions, and rules of proximity and body language
- Delayed receptive language than expressive language
3. Vocal development deficits, including
- Atypical response to caregiver’s vocalizations and vocal productions
- Abnormal prosody (patterns of stress and intonation) once speech emerges
4. Symbolic play deficits, including
- Delayed acquisition of functional and conventional use of objects
- Repetitive, inflexible, and less sophisticated and inventive play
- Limited cooperative play in interactive situations
5. Conversation deficits, including
- Limitations in understanding and applying social norms of conversation
- Provision of inappropriate and unnecessary information or too little detail in conversation
- Difficulty initiating topics of shared interest and preference for topics of special interest
- Difficulties in recognizing the need for clarification or adequately repairing miscommunications
- Problems understanding figurative language, including idioms, multiple meanings, and sarcasm
- Lack of or limited question asking in conversation
6. Literacy deficits, including difficulty
- Reading for meaning or getting the main idea and summarizing
- Understanding narratives and expository text genres that require multiple perspectives (e.g., persuasive and comparative/contrastive)
- Providing sufficient information for the reader when writing
7. Executive functioning deficits, including
- Lack of or limited flexibility and lack of inhibition
- Poor problem solving, planning and organization
Behavioral and Emotional Challenges
- Problems dealing with changes in routine and/or changing from one activity to the next
- Problems generalizing learned skills and with self-management
- Using objects in unusual ways and uncommon attachments to objects
- Crying, becoming angry, or laughing for reason that are difficult to determine as well as difficulty sleeping
- Anxiety and/or social withdrawal and/or depression
- Using early-developing and/or idiosyncratic strategies for self-regulation (e.g., chewing on clothing, rocking, hand flapping, vocal play)
- Using unconventional behavioral strategies and emotional expressions
- Restricted, repetitive patterns of behavior, interests, or activities
Signs in Girls vs. Boys
Girls with ASD
- Stay in closer proximity to their peers and are better able to capitalize on social opportunity
- Spend more time in joint engagement
- Spend more time talking as a primary activity
- Appear to use compensatory behaviors to gain access into peer groups
Boys with ASD
- Tend to play alone rather than participating in organized games
- Spend more time alone
- Spend more time wandering as a primary activity