CHARACTERISTICS OF AUTISM
Autism is distinguished by a pattern of symptoms
rather than one single symptom. The main characteristics are impairments
in social interaction, impairments in communication, restricted
interests and repetitive
behaviors. Other aspects, such as atypical eating, are also
common but are not essential for diagnosis.
Individual symptoms of autism occur in the general population and
appear not to associate highly, without a sharp line separating
pathological severity from common traits.
effects Social development from autism
People with autism have social impairments and
often lack the intuition about others that many people take for
granted. Noted autistic Temple
Grandin described her inability to understand the social communication
of neurotypicals as leaving her feeling "like an anthropologist
Social impairments become apparent early in childhood
and continue through adulthood. Autistic infants show less attention
to social stimuli, smile and look at others less often, and respond
less to their own name. Autistic toddlers have more striking social
deviance; for example, they have less eye contact and anticipatory
postures and are less likely to use another person's hand or body
as a tool. Three- to five-year-old autistic children are less
likely to exhibit social understanding, approach others spontaneously,
imitate and respond to emotions, communicate nonverbally, and take
turns with others. However, they do form attachments to their primary
caregivers. They display moderately less attachment security
than usual, although this feature disappears in children with higher
mental development or less severe Autism Spectrum Disorder. Older children and adults
with Autism Spectrum Disorder perform worse on tests of face and emotion recognition.
Contrary to common belief, autistic children do
not prefer to be alone. Making and maintaining friendships often
proves to be difficult for those with autism. For them, the quality
of friendships, not the number of friends, predicts how lonely they
There are many anecdotal reports, but few systematic
studies, of aggression and violence in individuals with Autism Spectrum Disorder. The
limited data suggest that in children with intellectual
is associated with aggression, destruction of property, and tantrums.
Dominick et al. interviewed the parents of 67 children with Autism Spectrum Disorder
and reported that about two-thirds of the children had periods of
severe tantrums and about one-third had a history of aggression,
with tantrums significantly more common than in children with a
history of language impairment.
effects on communication from autism
About a third to a half of individuals with autism
do not develop enough natural speech to meet their daily communication
needs. Differences in communication may be present from the
first year of life, and may include delayed onset of babbling, unusual
gestures, diminished responsiveness, and the desynchronization of
vocal patterns with the caregiver. In the second and third years,
autistic children have less frequent and less diverse babbling,
consonants, words, and word combinations; their gestures are less
often integrated with words. Autistic children are less likely to
make requests or share experiences, and are more likely to simply
repeat others' words (echolalia) or reverse pronouns.
Autistic children may have difficulty with imaginative play and
with developing symbols into language. They are more likely
to have problems understanding pointing; for example, they may look
at a pointing hand instead of the pointed-at object.
In a pair of studies, high-functioning autistic
children aged 8–15 performed equally well, and adults better than
individually matched controls at basic language tasks involving
vocabulary and spelling. Both autistic groups performed worse than
controls at complex language tasks such as figurative language,
comprehension and inference. As people are often sized up initially
from their basic language skills, these studies suggest that people
speaking to autistic individuals are more likely to overestimate
what their audience comprehends.
Autistic individuals display many forms of repetitive
or restricted behavior, which the Repetitive Behavior Scale-Revised
(RBS-R) categorizes as follows.
* Stereotypy is apparently purposeless movement,
such as hand flapping, head rolling, or body rocking.
* Compulsive behavior is intended and appears to follow rules, such
as arranging objects in a certain way.
* Sameness is resistance to change; for example, insisting that
the furniture not be moved or refusing to be interrupted.
* Ritualistic behavior involves the performance of daily activities
the same way each time, such as an unvarying menu or dressing ritual.
This is closely associated with sameness and an independent validation
has suggested combining the two factors.
* Restricted behavior is limited in focus, interest, or activity,
such as preoccupation
with a single television program.
* Self-injury includes movements that injure or can injure the person,
such as biting oneself. Dominick et al. reported that self-injury
at some point affected about 30% of children with Autism Spectrum Disorder.
No single repetitive behavior seems to be specific
to autism, but only autism appears to have an elevated pattern of
occurrence and severity of these behaviors.
Other symptoms of autism
Autistic individuals may have symptoms that are
independent of the diagnosis, but that can affect the individual
or the family. A small fraction of individuals with Autism Spectrum Disorder show
unusual abilities, ranging from splinter skills such as the memorization
of trivia to the extraordinarily rare talents of prodigious autistic
Unusual responses to sensory stimuli are more
common and prominent in autistic children, although there is no
good evidence that sensory symptoms differentiate autism from other
developmental disorders. The responses may be more common in
children: a pair of studies found that autistic children had impaired
tactile perception while autistic adults did not. The same two studies
also found that autistic individuals had more problems with complex
memory and reasoning tasks such as Twenty Questions; these problems
were somewhat more marked among adults. Several studies have
reported associated motor problems that include poor muscle tone,
poor motor planning, and toe walking; Autism Spectrum Disorder is not associated with
severe motor disturbances.
Atypical eating behavior
Atypical eating behavior occurs in about three-quarters
of children with Autism Spectrum Disorder, to the extent that it was formerly a diagnostic
indicator. Selectivity is the most common problem, although eating
rituals and food refusal also occur; this does not appear to
result in malnutrition. Although some children with autism also
have gastrointestinal (GI) symptoms, there is a lack of published
rigorous data to support the theory that autistic children have
more or different GI symptoms than usual; studies report conflicting
results, and the relationship between GI problems and Autism Spectrum Disorder is unclear.
Sleep problems are known to be more common in
children with developmental disabilities, and there is some evidence
that children with Autism Spectrum Disorder are more likely to have even more sleep problems
than those with other developmental disabilities; autistic children
may experience problems including difficulty in falling asleep,
frequent nocturnal awakenings, and early morning awakenings. Dominick
et al. found that about two-thirds of children with Autism Spectrum Disorder had a history
of sleep problems.
Parents of children with Autism Spectrum Disorder have higher levels
of stress. Siblings of children with Autism Spectrum Disorder report greater admiration
of and less conflict with the affected sibling; siblings of individuals
with Autism Spectrum Disorder have greater risk of negative well-being and poorer sibling
relationships as adults.
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