In 1978, the triad of impairments was introduced as a concept and has since formed the backbone of diagnostic criteria for ASD. Whilst Autism Spectrum Disorders can very a great deal between individuals, they all share three common characteristics to a greater or lesser degree.
In recent years, the diagnostic criteria for autism has been reduced to two domains – social communication and restrictive patterns of behaviour, interests and activities.
Social communication, interaction and imagination are key characteristics of ASD
One characteristic of autism is finding it difficult to maintain friendships, to work with others and to manage social situations. You may notice your child does not have the same relationships as their peers – this is not unusual for a child with ASD.
Social interaction is perhaps the most important of all the triad, particularly for those who are receiving a diagnosis later on in childhood or as an adult. Social interaction tends to be pervasive and can have a heavy impact on day to day life for everyone involved.
Social communication – difficulty understanding and translating body language, metaphors, sarcasm and social interactions are all signs of ASD. Your child may have difficulty maintaining eye contact and may also find it hard to retain and process verbal communication.
Social imagination is the term used to describe our ability to manage change and our preferences for routine – often those with ASD will find disturbances to routines deeply challenging and even upsetting.
Common social communication and interaction Autism symptoms include:
Difficulties interpreting body language
Lack of facial expressions
Delay or lack of speech
Difficulties with making eye contact
Abnormal tone of voice when speaking
Being detached in group settings
Lack of empathy for other’s emotions
Difficulty understanding their own emotions
Lack of awareness of personal space
Little interest in playing with other children
Being unable to successfully play with other children (which can cause huge distress)
Studies have shown that the reward system of brains of people with ASD may be overstimulated by repetitive behaviours and understimulated by social stimuli
Repetitive, restricted behaviours, interests and activities
The world can be a terribly uncertain and even scary place for someone with ASD. Engaging in repetitive and restricted behaviours or interests is a key characteristic of Autism Spectrum Disorders.
These behaviours are thought to help in the following ways:
Create order and reliability in a chaotic world
Help the child relax
Increase or decrease amount of sensory input
Help cope with uncertainty
A child might display repetitive movements, difficulty with changes to routine and have very focused interests. These are all key characteristics of ASD.
Repetitive movements can include:
Repetitive movement with objects
Repetitive movement of body parts such as arm or hand flapping
Stimming (repetitive activities involving the senses such as feeling certain textures)
Lining up toys or shoes in certain way
Routine and an ‘insistence on sameness’ are common areas of difficulty with someone with autism. Distress may be experienced if there are changes to:
Appearance of someone (for instance a hair cut or wearing makeup)
Eating certain foods
Wearing certain clothes
Transitions to school holidays
Conversations having to follow a certain pattern
Many people with Autism will develop intense and highly focused interests – often to the exclusion of all else. They may develop a very in depth amount of knowledge, carry objects around related to their interest and find it hard to have a conversation about anything else
Up to 90% children with ASD have sensory sensitivities
The whole service is completely client centred and appointments have been available when we needed them most.
Many people on the autism spectrum will have difficulties processing sensory information – they may be overly or under sensitive to certain textures, smells, sounds or tastes. Being ‘hyper’ or ‘hypo’ sensitive can be really difficult for other people to understand – it is like a complete overload of the system and can be almost physically painful to bear.
Common sensory sensitivities include:
So sensitive to light it’s difficult to get to sleep
Preferring close up views of objects
Poor depth perception (might struggle to throw and catch)
Unable to pick up smells
Overly sensitive to smells – new washing detergent etc
Has a restricted diet because of texture or taste of foods
Tastes and eat inedible food group due to liking texture and taste
A common misconception is that children who have autism don’t want to make friends. Whilst it is true that some children will prefer their own company, other children and young people are desperate to make friends but don’t know how to. This can cause them great distress and be horrible for parents who have to see their child struggling so much.
Dr Geeta Krishnan is a highly competent Consultant Child & Adolescent Psychiatrist with more than 10 years’ experience. Dr Krishnan has a medical degree, and is a Member of the Royal College of Psychiatrists.
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