Professionals diagnose autism based upon symptoms shown in the categories of social interaction, communication, and behavior. Early diagnosis and intervention — before the age of 3 — are very important, because research shows that many features of autism respond better when you deal with them early. Sadly, some children don’t receive an official diagnosis until years after their parents first suspect that something is wrong, which means they lose valuable time. Even some doctors don’t have the necessary facts to provide an accurate diagnosis. You know your child better than any doctor, so if you disagree with a doctor’s assessment, you should get a second opinion. Trust your instincts if you think your child isn’t developing normally.
Behavior (activities and interests)
Autistic children often have obsessions or preoccupations with objects or with fantasy worlds (they may have trouble distinguishing fantasy from reality) that go beyond the normal interests of a developing child. For example, a child may play exclusively with string or believe she’s an animal. She may have trouble transitioning from one activity to the next and insist on sticking to a ritual or routine — even one that seems to have no meaning. Repeated mannerisms such as hand flapping, rocking, or walking on one’s toes may become habits.
Doctors are certain that autism affects the way the brain functions (and autopsies of autistic brains show abnormalities in different areas), causing a sometimes distinctive set of behavioral symptoms. Each behavioral symptom can range from mild to severe. To complicate things further, not all children diagnosed as autistic display all the behavioral symptoms. The behavioural symptoms govern the diagnosis, making treatment problematic.
People with autism — partly because of the problems they have with communication — have difficulty developing friendships and playing cooperatively with others. Often, kids with autism don’t imitate others’ behaviors, as children usually do, and they don’t share their thoughts and observations. They also don’t spontaneously try to connect with others, as other children will.
Despite the challenges children with autism face regarding social interaction, they still have the desire to interact. Children with autism may just need direct instruction to learn what others pick up by mere observation. Even mildly autistic children who have normal language development find it difficult to form peer relationships because of their problems in understanding social protocols and others’ motivations. This social awkwardness can happen even if a child’s IQ is off the charts. Children on this end of the autism spectrum display little understanding of appropriate behaviors, and they may be criticized for being “brutally honest,” but many people note that they commonly lack pretension, dishonesty, flattery, and guile. However, they can also be quite hurt by their inability to connect socially, although they may not be able to express these emotions. Most people on this part of the spectrum lack the emotional vocabulary.
Autistic individuals have trouble with language development, sometimes losing speech at 18-24 months (known as regressive autism), talking only late in development, or not talking at all. Children may repeat words and phrases like television commercials (a condition known as echolalia), having no apparent understanding of their meaning. The children may hear words but not be able to make sense of what they mean.
Non-verbal communication is also impaired in children with autism. Commonly, autistic individuals may not understand what gestures mean. They won’t point to objects. They may not make eye contact or smile when smiled at. Their responses or lack of responses can be isolating, resulting in communication barriers rising between them and other people.
Other conditions often coexist with autism, further complicating the diagnostic and treatment picture. Some of the more common coexisting conditions include the following:
· Mental retardation
· Obsessive compulsive disorder (OCD)
· Attention Deficit/Hyperactivity Disorder (AD/HD)
Conditions are considered comorbid if they occur at the same time as the autistic symptoms and are deemed to have roughly equal “weight” by the diagnostician. Other associative conditions such as depression are often secondary to the autism — in other words, a person’s difficulties in interacting with the environment and connecting with others result in a depressive disorder.