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Author: Dr Geeta KrishnanConsultant Child & Adolescent Psychiatrist

There are some characteristics of autism that are shared by all children with ASD – however the way that these autism symptoms are presented will vary hugely between children.


Autism Spectrum Disorder Triad of Impairments

In 2978, 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.

autism spectrum


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.

Every child is unique and some may prefer to be solitary, this does not mean your child’s development will be compromised as a result of their independence, as they may thrive in other areas.

  1. 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.
  2. 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.
  3. 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
  • Walking on tiptoes
  • 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:

  1. Create order and reliability in a chaotic world
  2. Help the child relax
  3. Increase or decrease amount of sensory input
  4. 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:

  1. Repetitive movement with objects
  2. Repetitive movement of body parts such as arm or hand flapping
  3. Vocal ‘tics’
  4. Rocking
  5. Spinning
  6. Head banging
  7. Stimming (repetitive activities involving the senses such as feeling certain textures)
  8. 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:

  1. Physical environment
  2. Appearance of someone (for instance a hair cut or wearing makeup)
  3. Eating certain foods
  4. Wearing certain clothes
  5. Transitions to school holidays
  6. Conversations having to follow a certain pattern

Fixated interests

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

90%
Up to 90% children with ASD have sensory sensitivities

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Sensory sensitivities

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
  • Likes chewing objects because of texture
  • Finds certain fabrics physically painful

Download our Autism assessment guide

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.
MBBS, MRCPsych, DPM

Consultant Child & Adolescent Psychiatrist
Manchester

Dr Geeta Krishnan is a highly competent Consultant Child & Adolescent Psychiatrist who works for North West Boroughs Healthcare NHS Foundation Trust, previously Lead Consultant for her Borough in Pennine Care NHS Foundation Trust. Dr Krishnan has...

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