Characteristics of Autism

Children with ASDs may not be eager to communicate. They may not develop skills that other children learn naturally and are not tuned into communication in the same way. They find it very hard to make sense of the things that happen around them. Words may mean very little to them and they may be unable to link what they see with the things being said to them. Children with ASD not only have difficulty making sense of words but also with reading non-verbal messages in facial expressions and gestures. This makes it difficult for them to learn what is expected of them, and to recognise when someone is happy or upset and realise what that means for them.

A Child with ASD may:

• develop speech in a way that is slow (delayed), or disordered (an unusual pattern of speech development)
• not develop speech at all
• often use words out of context and without trying to communicate
• develop the ability to say words before understanding them
• echo (repeat) words other people say - straight away, or later (this is sometimes called echolalia)
• use words and then ‘lose’ them (not use them again) (part of a disordered or unusual pattern of language development)
• not respond when spoken to
• talk at, rather than to other people
• not use eye contact as a natural part of communication, or not use it in the usual way e.g. over intense eye contact, eye contact that isn’t coordinated well with other parts of communication such as facial expression and speech
• not appreciate the need to communicate information to others
• have a poor grasp of abstract concepts and feelings
• rarely understand or use gesture
• not use pointing
• communicates to indicate needs rather than share an experience
• show little desire to communicate socially (just to chat or be friendly, rather than because they want or need something).

Imagination

Imagination helps us understand the world; to predict and see the perspective of other people. Children with ASD are unable to do this in a typical way. When pretend play begins to appear in children who don’t have ASD, it’s a sign that imagination is beginning to develop. In children with ASD this process can occur slowly, in limited or unusual ways, or not at all.

Problems of imagination show themselves in different ways. Some children never seem interested in what a toy is or what it represents. They may focus on the features of the toy such as the wheels of the car or the box the toy came in. Other children may run the toy car in and out of a garage, but don’t act out more complex stories. Some children seem to act out stories or take on particular characters, but the story turns out to be an imitation of a video or book and is always the same. This doesn’t mean that children with autistic spectrum disorders don’t have any imagination; it just means they tend to have less ability in this area and they tend to be less able to share their imaginative ideas than other people. Some children with ASD have a vivid imaginary life but aren’t able to share this with others clearly or communicate that they know what is real and what is imaginary.

Some children with ASD learn to talk easily, but find it hard to understand communication that is not literal. Expressions like ‘I laughed so much I nearly died’, or ‘If you eat any more you’ll burst’, can be very confusing for them. They may have difficulties understanding that a phrase or story is not real.

Routines

Repetitive behaviours and routines are a common feature of ASD. Children with ASD find reassurance in routines and patterns that they can control.

A child with ASD:

• may not easily make sense of sequences and events
• may become distressed if a familiar routine changes
• may impose routines on others
• will often engage in stereotypical body movements (for example, some children will flap their hands, some may rock back and forth, some may tap or flick their fingers)
• will often resist new experiences, for example trying different foods or wearing new clothes, going to new places
• may not be able to deviate from one way of doing things
• may be tolerant of situations and then over-react to something minor
• may only develop symbolic play slowly - if at all (symbolic play is play which involves pretending things are something else using imagination)
• may often pay particular attention to unusual details and struggle to see the bigger picture
• can develop extreme behaviours to avoid some things/experiences
• may not easily move from one activity to another (transitions)

The terms repetitive behaviour and unusual movements (motor mannerisms) are used to describe specific types of unusual or seemingly odd behaviours that are often seen in children with autism. Repetitive behaviours are sometimes referred to as self-stimulating behaviour or ‘stimming’.

Several examples are listed below:

• Hand flapping
• Rocking
• Head Banging
• Spinning
• Pacing
• Tip toe walking
• Other unusual body movements
• Lining up or ordering objects
• Flicking switches repetitively
• Opening and closing doors.

Some repetitive behaviour are very obvious while others are more subtle and hard to detect such as blinking or eye rolling, tapping fingers and mild hair twisting. We all engage in some of these behaviours occasionally, especially when we are stressed. However, your child may engage in these activities excessively to the point that they interfere with learning or daily living activities.

Why Repetitive Behaviour?

It’s not completely clear why repetitive behaviour almost always goes with autism, but it could be that repetitive behaviour is a way of bringing predictability to an otherwise unpredictable world. Some of the reasons children adopt repetitive behaviour are outlined below:

• Self-regulation, which helps the child become calm and overcome situations of stress or upset
• Demonstrates excitement
• Provides the child with an escape route when they are overworked or wound up
• Makes the child happy. Some children find the behaviour pleasurable.
• To get the sensory experience
• Provokes a reaction from others, which reinforces the behaviour
• A way of avoiding a task or activity.

Some children learn to monitor their behaviours so they can engage in them in ‘safe’ environments (at home rather than at school or out in the community).

No matter what repetitive behaviour your child engages in, you need to understand this is something that they often need to do in order to find comfort, or familiarity, or a sense of control, or enjoyment. The repetitive behaviour is extremely unlikely to be harming your child. Rather than trying to stop their repetitive behaviour you could allow it to happen within reasonable limits.

“My son taps repetitively on every surface. On the basis of ‘if you can’t beat them, join them’ we got him a drum kit. If he gets cross, angry or frustrated he goes and plays drums which helps him calm down and he is a grade six drummer now which gives him something to be proud of.” - (Parent)

“It is not uncommon for autistic people to become fixated on past events, animals, places and people! This can be very interesting because they may feel comfortable sharing information and facts with you, which will give you a chance to bond with them in a way that they feel comfortable.” -  [Sibling]

All children have favourite things, games, films, toys but most children can be distracted from these or engaged in another activity without too much fuss. Also most children like interaction with other people in order to get the most enjoyment from their activities.

However, some children with ASD seem to develop interests in a way that makes it seem as though they are obsessed. These interests are usually referred to as ‘special interests’ and to a child with ASD they might be the most important thing in their life. Some children with ASD develop interests that do not involve anyone else, where they can retreat into their own little world for hours and hours, whereas others might want to talk non-stop about their interest, which in turn makes it difficult for them to develop friendships.

These interests are different to repetitive behaviours but some of the reasons for the special interest can overlap, such as:

• Reducing anxiety
• Maintaining a sense of calm
• Making them happy
• A way of avoiding another task or activity.

To others some of the interests of children with ASD may appear utterly pointless or mind numbingly boring but the child will be experiencing something completely unique to them.

“… it is important to use the interest as a means to share interest, open communication…” - [Parent]

Special interests can be anything from common childhood interests to an unusual degree and intensity, to the weird to wonderful. Some of the more common examples of special interests in children might include:

• Computer gaming
• Maps and routes
• Animals
• Counting/Alphabet
• Dinosaurs
• Cartoon characters
• Thomas the tank engine
• Types of cars, vehicles
• Collecting sets of particular toys

As with repetitive behaviours children can become engaged in their special interest if they are feeling anxious or scared, but the reality is that they have an uncontrollable desire to involve themselves in these things because their interest is real and their enjoyment and satisfaction is real.

Children with ASD will normally have one special interest at a time, but they often change as the child develops and experiences more things. Special interests can interfere with learning or daily living activities but they can also be used to motivate and engage with your child.

Some of the most famous autistic people have developed successful careers from their special interest. E.g: Chris Packham (wildlife), Temple Grandin (horses).

“Even though my son had great difficulties working in a group and turn taking, his keen interest in music allowed him to overcome his difficulties. We encouraged him to join in workshops and group music sessions, and this helped him to work on his social skills and team work, with like-minded people. He is now a valid member of a rock group and enjoys performing in gigs throughout the area.” - [Parent]

The seven senses are sight, hearing, touch, smell, taste, balance (vestibular) and body awareness (proprioception). In individuals with autism, the brain sometimes processes sensory information differently to those without ASD. Everybody is different and therefore individuals will experience things differently and respond in different ways.

Sometimes these different sensory perceptions can cause discomfort, distress, anxiety, fear or confusion and result in ‘challenging’ behaviour as the individual tries to block out what is causing the problem.

In some cases one or more of the senses can’t filter out background experiences or interpret information from the environment at a level which is comfortable (hypersensitive). At other times, the registering of information may be poor (hyposensitive) – the brain doesn’t get enough information (hyposensitive).

When the input is ‘too much’, you may find that individuals with ASD rock, flap, spin, hit their ears, etc as a way of trying to block out the overload that they can’t tolerate and to help them to calm down or relieve the discomfort. Or they may hide, or seek a quiet place to reduce the amount of sensory stimuli (sensory avoiding).

In cases where the senses do not register information effectively (hyposensitive), the child may seek out sensations such as noises, touching or movement as a way to feel ‘just right’ and get more sensory information to their brain. Sensory seeking and sensory avoiding behaviours can be seen in the same child in different situations.

Things to look out for:

Hypersensitive

• Dislikes dark and bright lights
• Looks at minute particles, picks up smallest pieces of dust
• Covers ears
• Dislikes having their nails or hair cut
• Resists touch
• Avoids people
• Runs from smells
• Moves away from people
• Craves certain foods
• Uses tip of tongue for tasting
• Places body in strange positions
• Turns whole body to look at something
• Difficulty walking on uneven surfaces
• Becomes anxious or distressed when feet leave the ground

Hyposensitive

• Moves fingers or objects in front of the eyes
• Fascinated with reflections, brightly coloured objects
• Stares at bright lights
• Makes loud rhythmic noises
• Likes vibration
• Likes pressure, tight clothes, tight hugs
• Likes being enclosed in small spaces and e.g. a big duvet
• Enjoys rough and tumble play
• Smells or licks self, people and objects
• Seeks strong odours
• Mouths and licks objects
• Eats anything including strong flavours
• Rocks back and forth
• Lack of awareness of body position in space
• Spins, runs round and round, likes swinging
• Bumps into objects and people

(Adapted from ‘Sensory Issues in Autism’ by the Autism and Practice Group, East Sussex County Council)

The brain may try to process everything at once without filtering out unimportant things like background noise, wallpaper, people moving about, the feel of clothes on their skin, etc resulting in sensory overload.

Sometimes there is an inability to separate foreground and background information so that everything is seen as ‘a whole’. For example, when they look at a room they will see everything at once and so even when something small is changed they will notice. This will make the room look ‘wrong’ and can cause fear, stress and frustration.

When there is too much information to be processed at the same time it may be difficult for children with autism to break a whole picture down into meaningful units. For example, when talking to someone we will see their whole face but some people with autism may see eyes, nose, mouth, etc as individual things which all need to be processed separately. This makes it more complicated to process information and can lead to the child focusing on only one aspect or not being able to process everything.

Sometimes it can take time to process information, particularly if there are distractions (eg background noise, scratchy clothing, etc), if there is a lot of information to process or if the context changes (eg they may learn to make a cup of tea in the kitchen at home but be unable to transfer that skill to a different kitchen).

In some cases senses become distorted which may mean that the autistic child sees, hears, smells, tastes or feels something different to everyone else.

“When my son was older he explained to me ‘When I was a baby I remember having a strange object thrust into my mouth which I found quite annoying. It had a very strange taste and an even stranger texture. Also, when I sucked on it, it made the most awful squeaking noise.’ I now realise the reason why my son got so distressed when a rubber teat on a bottle or dummy was put into his mouth!!” - [Parent]

At times one of the senses may appear ‘shut down’ as a way of the child coping with sensory overload. For example, when noises become too much the child may appear not to hear you because this enables them to cope and to allow their other senses to work better.

Some children will use some senses to compensate for others. For example, they may smell, lick or touch objects, or watch their feet whilst walking, etc.

It is important to remember that when people are tired, unwell or stressed their tolerance levels are affected.  This is also true of a child with ASD.  Their ability to tolerate sensory stimuli can be affected in just the same way. Therefore, try to learn what sensory issues your child may have and the ways in which they cope with these so that you can understand and support them. Below is a list of things that may be helpful and things that may challenge your child. Through observation you may be able to tell if suggestions on the list, or something similar, are relevant to your child.

“My son can only wear certain types of socks, as he gets very agitated by the join line on the toe section. We also had to cut out the labels in clothes as this also caused sensory issues.” - (Parent)

Click the picture below for "Things that may help"

Taken from "Sensory issues in Autism" but the Autism and Practice Group, East Sussex County Council.