The following are early signs of autism that appear in early childhood (ages 2-6) and a bunch of different strange and unexplainable beahviours. If you are worried about your child, or another child you take care of, educate or are involved with, watch out for these early signs of autism. These symptoms can be divided into five groups, in several important areas of life and child development.

The following list of characteristisc will help you not only to determine whether or not a child or an adult needs to get diagnosed or get special help, but more importantly – help you understand the child or adult who is suffering from autism, and be able to help them in your day to day interaction with them. Aristotle said that we cannot love something we don’t understand, so therefore I urge you to learn more about people in our community that are disabled. They deserve to be loved just like any other human being. Understanding, acceptance and love are really powerful things. They can bring reconciliation and peace to the hurt ones, and help them be at peace with who they are. In return, they become a contributing resource to our community, in many ways – some obvious - such as being able to work and pay taxes; and some more subtle - such as teaching us about our own weaknesses and strengths, and forcing us to be better people every day.

Verbal and Non-verbal Communication:

• Speech and language skills may begin to develop and then be lost, or they may develop very slowly or they may never develop.
• Preference for non-verbal communication such as gestures, pointing, or reaching.
• Difficulty or inability to imitate sounds and words.
• Echolalia (repeating what was last heard). For instance: repeating questions instead of answering them, or repeating the last choice when given two or more options to choose from.
• Words may be used without their usual meanings.
• Difficulty in understanding non-verbal communication gestures (i.e. waving goodbye, pointing, facial cues and expressions)
• Language Sound Patterns: Intonation may sound flat, or inability to control how loud or soft the voice is, irregular rhythm in speech.
• Extreme difficulty in initiating communication, maintaining a conversation
• Inability to understand personal boundaries (may stand or sit too close to people when communicating with them).
• Autistic people with more vocabulary and language skills may have hard time listening to other people and flowing with the conversation (may go on and on about what interests them rather than having a back-and-forth exchange of information.

Repetitive Behaviours:

• Ritualistic actions that they repeat over and over again (i.e.: spinning, rocking, staring, finger flapping, hitting self, etc.)
• They may be overactive or very passive and can show intense anxiety or an unusual lack of anxiety. Anxiety, fear and confusion may result from being unable to "make sense" of the world in the usual way.
• They may take unusual risks with no fear of real dangers.
• Unusual postures, walking or movement patterns.
• Extreme dependence on routines, insistence on keeping everything the same, and resistance to change. Even the smallest changes in the environment may throw them off balance and make them feel intensely threatened and insecure (which often triggers extreme stress, fear, or even a tantrum).
• Restricted interest: constantly talk about or obsess on one thing, idea, activity, person, etc.

Sensory Integration / Responses to Sensations:

• Auditory and/or visual processing problems. Sensory input my be scrambled and/or overwhelming to them. Sensory sensitivities vary all the way from mild to severe hyper or hypo sensitivities.
• Unusual sensitivities to sounds, sights, touch, taste and smells
• Unusually high or unusually low pain thresholds
• Effects on Learning
• Many of the characteristics and aspects of autism discussed above can strongly interfere with the ability to learn through typical teaching methods:
• Lack of spontaneous or imaginative play (e.g. may use only parts of toys; line up or stack objects; no imaginative/pretend play).
• An inability to imitate others. (e.g. sounds, gestures, gross or fine motor movements, etc.).
• Inability to focus on the task at hand. Some will have a very short attention span or concentrate only on one thing obsessively.
• Difficulty sharing attention with others.
• Difficulty with abstract ideas (e.g. difficulty using items or toys to represent real objects).
• Difficulty grasping the concept of time and order of events.

Effects on Learning:
Many of the characteristics and aspects of autism discussed above can strongly interfere with the ability to learn through typical teaching methods:

• Lack of spontaneous or imaginative play (e.g. may use only parts of toys; line up or stack objects; no imaginative/pretend play).
• An inability to imitate others. (e.g. sounds, gestures, gross or fine motor movements, etc.).
• Inability to focus on the task at hand. Some will have a very short attention span or concentrate only on one thing obsessively.
• Difficulty sharing attention with others.
• Difficulty with abstract ideas (e.g. difficulty using items or toys to represent real objects).
• Difficulty grasping the concept of time and order of events.

Co-occurring Conditions:

• Many individuals with autism have other health problems:
• Neurological disorders including epilepsy
• Gastro-intestinal problems, sometimes severe
• Compromised immune systems
• Fine and gross motor deficits
• Anxiety and depression

These were adopted from the website of Autism Society Canada. Remember, these are various symptoms, and do not necessarily all occur in each individual suffering from autism.

To read more personal stories and examples, visit the Pumpkin Blog.

It’s really hard to get away from a diagnosis of autism if you have it… All it takes is basically saying “yes” to these three distinctive criteria:

1. Impairment in social interaction
2. Impairment in communication
3. Restricted interest

Sounds familiar? Reminds you of anybody you know? Read on further for more details. The reason I say that is because the earlier the diagnosis (preferably in early childhood), the better the prognosis. Autism may not be cured, but with an early intervention program and a special education plan throughout school, a child who has autism will be able to grow into their full potential and enjoy a full and happy life.

First of all, let me define these three criteria and how they are used in the process of diagnosis. It is obviously more complex than I presented it in the first sentence of this article (I like to exaggerate sometimes…). A person requires a total of six or more characteristics from the above criteria, with at least two from A and B, and at least one from C. There are also additional criteria for diagnosing autism which I will refer to in the end of this article. The following is adapted from the DSM-IV as per this site, with additional notes from my own experience and from other online resources. I am not trying to break any news here, just compile together a list for reference.

A. IMPAIRMENT IN SOCIAL INTERACTION

Qualitative impairment in social interaction. If a person has at least two of the following characteristics that might raise a red flag:

1. Marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction. Examples:
1. Laughing, crying, showing distress for reasons not apparent to others
2. Little or no eye contact
3. Not responsive to verbal cues; acts as if deaf although hearing tests in normal range.

2. Failure to develop peer relationships appropriate to developmental level
   a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people. Examples:
1. lack of showing, bringing, or pointing out objects of interest to other people
2. Autistic children may find it difficult to interact with their own age group and may prefer to interact with adults (or less commonly – with babies).
3. Lack of social or emotional reciprocity. Examples:
1. Not actively participating in simple social play or games
2. Difficulty in mixing with others
3. May not want to cuddle or be cuddled
4. Repetition of own message and responses that are inappropriate to the messages communicated from the people involved in the interaction

4. preferring solitary activities, or involving others in activities only as tools or "mechanical" aids, i.e.:
1. Prefers to be alone; aloof manner
2. Choose solitary activities that do not require interaction with others (i.e.: puzzles, beading)

B. IMPAIRMENT IN COMMUNICATION

Qualitative impairments in communication as manifested by at least one of the following:

1. Delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)
1. Repeating words or phrases in place of normal, responsive language
2. Difficulty in expressing needs; uses gestures or pointing instead of words
3. May also lead the person to what they want instead of using gestures (hold the person’s hand and bring them to where they wan to show them something)
4. Unresponsive to normal teaching methods

2. In individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
3. Stereotyped and repetitive use of language or idiosyncratic language
4. Lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level

C. RESTRICTED INTEREST

Now that’s where the fun begins. While the other behaviours may also be common to other conditions, such as language or developmental delay, this is where all the cliché autisistic beahaviours show off the most. Each individual will of course have their own restricted interest, and these can change throughout the years. But nevetheless, this is what makes autism look so special to the laymen. From the outside, these could even be perceived as charming egocentric personality traits. In reality, they are a method in which the autistic person is trying to make their own life a bit more stable, and put order in an otherwise extremely chaotic world. The restricted interest bring a sense of order and predictability, which is calming and centering.

Restricted repetitive and stereotyped patterns of behavior, interests and activities, as manifested by at least two of the following is a reason to be paying close attention and seeking help or diagnosis for your child:

1. Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus

1. Extreme interest in particular subject busses, trains, birthday cakes, pumpkins, etc.
2. Obsessive counting or spelling
3. Inappropriate attachments to objects

2. Apparently inflexible adherence to specific, nonfunctional routines or rituals

a. Insistence on sameness; resistance to change

b. Repeat the same behaviour over and over again

c. Sustained odd play

3. Stereotyped and repetitive motor mannerisms, i.e.:
1. Spinning
2. Hand or finger flapping or twisting, or complex whole-body movements
3. Slapping or pinching or biting hands or other repetitive self-hurting behaviours
4. Persistent preoccupation with parts of objects, i.e.:

a. Spinning objects

b. Extreme attention to particular details or belongings of a person rather than to the whole person – i.e. a person’s shoes or hair or zippers, etc.

c. Opening and closing doors or containers, flicking lights, etc.

HELPFUL RESOURCES

Autism checklist

Characteristics of Autism

Developmental Chart

Five Early Signs of Autism

First Signs

Autism: Recognizing the Signs in Young Children

Autism Characteristics

Also, visit the Pumpkin Blog for more details about Early Signs of Autism, and more personal stories.

Tamya and I were walking this morning in a garden of forking paths in the rainforest. A beautiful day, sunny but not hot, autumnal just enough to wear a sweater without sweating. The dead conifer leaves piling on the ground warmed up to the sun which in return to its warmth had to give away a distinctively sweet chypre aroma. As we approached the forest, and Tamya decided to go in instead of observing the ducks and Canadian geese in the Lost Lagoon. From than on she was the navigator: in each intersection I asked her to make a choice, by either pointing to where she wanted to go or leading us there. This reminded me of how far we have gone since she was little about communicating to me what she wants, and also made me contemplate once more the challenge of making choices, of screening out information, and of structure and discipline versus choice and leisure.

Our hardest days and most difficult times are not during the week, when the routine is rather structured, but rather – in the weekends, when the boundaries are loose, you can choose whatever you want, and there are so many confusing things to choose from. Quite overwhelming, actually, when you think about it.

Imagine this metaphor: Tamya is in a maze. She is not sure what she is doing there. She only knows that she feels terribly uncomfortable. What she sees as options to choose from is not just the next cross of paths but also the possibilities of climbing over the hedges, digging underneath them, trying to go through them, and perhaps even consuming them until an escape hole is formed. Of course these are all excellent possibilities in theory, but these are probably just 4 ideas out of perhaps a hundred that goes through Tamya’s mind in a few seconds, in a state of panic and extreme discomfort. This is no picnic.

Yet, we expect people like Tamya to make choices every day. And we do so because we care. Making choices, also known as decision making, is one of the most important life skills, and as a parent I want my child to learn that skill and be able to survive and live a happy and healthy life. We need to make choices all the time. Helping a young child with autism or a similar challenge (i.e.: anxiety around changes and transitions) to learn that skill is perhaps more important than any other life skill. Choice is what separates us from other forms of existence, and without making choices, the life of my child will be lead by others!

This can be done everyday, simply by helping the child narrow down the options. Do you want to turn left or right? What is your choice – salad or apple? (This is also a known trick to get your child to acquire healthy nutritional habits). Hopefully, the child will gradually develop the tools to recognize a few options out of myriads of possibilities that exist at any given time, and be able to make a choice within a reasonable time frame.

P.s. Comment on this post or on any of the next few Blogala posts over the weekend and I will make a $1 donation per each reader who commented to the Autism Communication Training of BC