Children and teenagers with autism spectrum disorder (ASD) typically show difficulties in two main areas. The first is social communication, and the second is restricted, repetitive behaviors and interests.
Signs of autism spectrum disorder
Some of the main social communication and behavior signs of autism spectrum disorder (ASD) in middle childhood and adolescence are listed below.
These signs often become noticeable when a child reaches school age and has difficulty adjusting to new social situations in a school environment – for example, staying on task, understanding and following instructions, making friends, and having age-appropriate interests.
You might find that some of the signs sound a lot like your child. Others might not sound like your child at all. All children (and adults) have some of the difficulties below. It's only when enough of these signs are present that your child might get a diagnosis of ASD. A diagnosis of ASD is generally made only when other possible explanations have been ruled out.
If you're worried about your child, the best place to start is your child's GP. The GP will be able to refer your child to an appropriate professional.
Social communication signs of autism spectrum disorder.
Older children and teenagers with autism spectrum disorder (ASD) typically have trouble with both verbal and non-verbal communication for social purposes.
An older child or teenager with ASD might:
- have trouble when taking turns in conversations - for example, she might like to do all the talking or find it hard to answer questions about herself talk a lot about a favorite topic, but find it difficult to talk about a range of topics
- be confused by language and take things literally - for example, she might be confused by the expression "Pull your socks up!" and actually pull up her socks have an unusual tone of voice, or use speech in an unusual way - for example, she might speak in a monotone or with an accent have a very good vocabulary and talk in a formal, old-fashioned way
- find it hard to follow a set of instructions with more than one or two steps
- have trouble reading non-verbal cues, such as body language or tone of voice, to guess how someone else might be feeling - for example, she might not understand when an adult is angry based on tone of voice or gestures
- use eye contact in an unusual way - for example, she might make less eye contact than others, or not use eye contact when she's spoken to express few emotions on her face, or not be able to read other people's facial expressions
- uses very few gestures to express herself
- prefer to spend time on her own, rather than with friends
- need other children to play by her rules
- have trouble understanding the social rules of friendship
- have few or no real friends
- have difficulty adjusting her behavior in different social situations.
Behavior signs of autism spectrum disorder
There are some behavior signs that a child or teenager might have autism spectrum disorder (ASD). For example, the child might:
- have unusual interests or obsessions – for example, he might collect sticks or memorize the train timetable
- have compulsive behaviors – for example, he might line things up or have to close all the doors in the house
- be unusually sensitive and get upset easily
- have an unusual attachment to objects – for example, he might carry a toy around as a teenager, or collect unusual items like chip packets or shoelaces
- be easily upset by change and like to follow routines – for example, he might like to sit in the same seat for every meal or have a special order for getting ready in the morning
- repeat body movements or have unusual body movements, such as hand-flapping or rocking
- make repetitive noises - for example, grunts, throat-clearing or squealing
- be sensitive to sensory experiences – for example, he might be easily upset by certain sounds, or will eat only foods with a certain texture
- seek sensory stimulation – for example, he might like deep pressure, seek vibrating objects like the washing machine or flutter fingers to the side of his eyes to watch the light flicker.
Other signs of autism spectrum disorder
Older children and teenagers with autism spectrum disorder (ASD) often have other difficulties as well, which might include:
- difficulty with sleep – for example, they might have difficulty falling asleep, or might regularly wake up at 4 am
- anxiety or feeling overwhelmed – for example, they might feel anxious about going to a new place, or in social situations
- depression – older children and teenagers who are aware of their differences are also often aware of how others see them and can feel like outsiders. These feelings might be intensified by changing hormone levels during puberty
- aggressive behavior – they often have sensory sensitivities that can lead to sudden aggressive behavior. They might have difficulty understanding what’s going on around them, which can lead to frustration building up
- eating disorders – for example, they might have difficulty moving to secondary school and might develop an eating disorder to cope with feelings of anxiety
- school refusal or not wanting to go to school – they might feel overwhelmed or confused at school.
These signs might be the starting point for a late diagnosis of ASD. Although this can be a huge shock, having a diagnosis can help you get services and funding to support your child's development.