The Symptoms of Autism In Simple Language

Autism is a subject with which I'm intimately familiar. I fell in love with my first autistic child when I was 19 - over 25 years ago. Paul was one of the kids assigned to me in my job at a chronic care facility for children with developmental disabilities. I'd only planned for it to be a summer job - but my love for Paul and other children like him led me into making a career of working with autistic children and adults.

Years later, I watched my fourth child develop distressingly familiar behaviors and patterns, and set out on a frustrating journey to get him appropriate treatment, only to learn that there is so much disagreement on what constitutes a diagnosis of autism or any of the other autism spectrum disorders that it took twelve years to finally get a diagnosis of Asperger's syndrome for him. Along the way, Jared has been misdiagnosed and mis-treated (as opposed to mistreated) as a child with bipolar disorder, childhood schizophrenia, ADHD and chronic depression.
The DSM IV criteria for diagnosing autism can be difficult to understand - and even more difficult to apply. So much of it is dependent on subjective interpretation. What's 'normal social interaction'? What's 'appropriate developmental peer relationships? Even the experts disagree on much of the criteria. Here's a breakdown of the criteria for autism in layman's language to help you understand a little better.

If you see one or two of these symptoms in your child, don't panic and make assumptions. Many children show one or two 'autistic symptoms' as part of their normal development. It's when it becomes a problem and interferes with his daily functioning that you should become concerned.

Social impairment characterized by…
Social impairment is a broad brush. Here are some of the specific things you may notice in your child.
He doesn't spontaneously make eye contact, or actively resists making eye contact with others.
He doesn't use facial expressions the way that other children his age do. He may not respond to a smile with a smile, or react at all to a frown. Many, but not all, autistic children have a 'deadpan' expression.
He doesn't play with other children the same way that others his age do. In fact, he may not seem to notice other children around him at all. By age two, most children are beginning to approach other children. Often, they'll show a fascination with other children. They may imitate their behaviors, or engage in 'parallel play' - playing with the same toys side by side, but not interacting.

Sometime between 24 and 36 months, most children are engaging each other in play. Parallel play gives way to cooperative play - where two 2 year olds may sit side by side and each build their own tower of blocks, at 3 most children will interact in some way with another child in their space. He may hand a block to the other child, or attempt to put his own block on the tower the other is building.

Many autistic children seem to be literally unaware that others are even playing nearby. Others simply choose not to interact with them. Few actually engage in even parallel play.

He doesn't share things with you, especially accomplishments or things that he enjoys. As early as six months, babies are clamoring for attention. The infant who seeks eye contact, shakes a rattle and crows with delight is engaging in 'sharing his enjoyment'. The toddler who delightedly hands you a fistful of crumpled flowers and grass is sharing his enjoyment with you. So is the toddler who plants his spaghetti bowl on his head and grins at you. Most autistic children don't engage with others in this way. They seem to be wrapped up in their own little world.
Children with autism tend to become dependent on routines and rituals. They react violently if those routines are disturbed. They may insist that you close the door twice whenever you go through it, or be unable to go to bed until the corners of their blanket are precisely lined up with the corners of their sheet.
A child with autism may not speak at all, or he may have an odd way of speaking. He may exhibit 'echolalia' - only speaking by repeating what he hears, or he may speak in an expressionless, almost machine-like monotone. He may seem to get 'lost' in a particular phrase or word, repeating it over and over, or become fascinated with 'wordplay', rhyming words nonsensically in the middle of a conversation.
Many children with autism don't engage in imaginative play. They don't play house, or cops and robbers, or engage in the kind of imitative play that most young children do.
Obsessions with one particular subject or interest are common in children with autism.
Children with autism often have gestures or motions that are peculiar. A child may flap his hands for no apparent reason, or cover his eyes and rock back and forth when he's upset or frustrated. These are called 'stereotypical' movements.
Children with autism show a marked delay in speech or communication, or physical milestones or social interactions.