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What are the signs and symptoms of autistic spectrum disorders (ASDs)?

Autistic spectrum disorders (ASDs) are developmental disorders that can affect both children and adults. ASDs encompass a wide variety of conditions, including autism and high functioning autism (Asperger syndrome), and typically have an impact on an individual’s ability to communicate, interact and build relationships with other people, as well as affecting their imagination, learning and development.

The signs and symptoms of ASDs are usually seen in early childhood, although some people may be diagnosed with the condition as adults. However, both children and adults typically exhibit the same core signs and difficulties that are associated with these disorders. These include difficulties in:

  • Social communication – problems with processing language, understanding verbal intonation and tone, and figures of speech. Individuals with ASDs tend to take things very literally, instead of being able to grasp the underlying meaning of sentences, colloquialisms and sarcasm
  • Social interaction – difficulties understanding non-verbal cues, developing friendships, and appreciating social contexts and rules. People with ASDs may appear to be inappropriate or ‘odd’ to other people
  • Social imagination – individuals who have an ASD may lack empathy, have trouble predicting and understanding the feelings and reactions of others, be unable to see situations from someone else’s perspective, and have difficulties in anticipating the consequences of actions and events

Everyone with an ASD is different and may find difficulties more in some areas than others. In addition, the symptoms of ASD in children usually become more pronounced as the child gradually gets older and is exposed to more situations in which they are expected to interact with other people.

ASD symptoms

Some of the most common signs and symptoms of ASDs are listed below. However, not everyone with an ASD will have all of these.

Speech

  • A delay in speech development i.e. not being able to speak more than 50 words by the age of 2, or not being able to speak at all
  • Constantly repeating certain words or phrases
  • Even if the child can use sentences, they prefer to communicate using single words
  • Avoiding trying to form new sentences, often using repeated or pre-learned phrases instead
  • Struggling to start a conversation and keep it going
  • Appearing to talk ‘at’, rather than ‘with’, other people
  • Speech sounds monotonous and ‘flat’
  • Speaking with a strange rhythm, or in an abnormal tone of voice

Responding to and interacting with other people

  • Not responding to their name, even if their hearing is normal
  • Difficulties with acts of intimacy such as cuddling, particularly when this is initiated by others
  • Responding in an excessively negative way when they are asked to do something, or if a routine/plan changes
  • Finding it difficult to understand the subtleties of language, such as figures of speech, irony, metaphors and sarcasm
  • Difficulty responding to everyday social cues such as greeting people or waving goodbye
  • Little to no interest in interacting with other children their age, instead preferring to play and engage in activities alone
  • Being uninterested in other people’s interests or achievements
  • Rarely uses non-verbal gestures such as facial expressions to communicate with others, or uses inappropriate facial expressions that don’t match what they’re saying
  • Regularly avoids making eye contact
  • Finding it difficult to interact with others and form friendships, even if they want to make friends
  • Finding it difficult to read the context of a social situation, such as speaking formally to teachers and more informally when talking to peers in the playground

Behaviours

  • Experiencing little enjoyment from activities that other people their age usually would
  • Not understanding another child or adult’s need for personal space, and not wanting other people to enter their own personal space
  • Engaging in repetitive movements/actions such as flapping their hands or rocking backwards and forwards
  • Preferring to have a certain routine, and becoming very upset if their routine is changed
  • Playing with toys or objects repetitively and in an unimaginative way e.g. lining them up in a certain order
  • Having an obsessive interest in a particular subject or activity
  • Preferring to play or interact with objects rather than other people

Individuals with an ASD may also struggle with one or more of the following problems:

  • Emotional difficulties – individuals with ASDs can often find it difficult to regulate their emotions. For example, they may:
    • Demonstrate aggressive or disruptive behaviour when they are stressed
    • Cry, shout or laugh for no apparent reason
    • Fail to respond to dangerous objects and situations, but appear to be frightened of harmless objects
  • Sensory difficulties – ASDs can also cause individuals to react unexpectedly to sensory information. For example, they may:
    • Ignore people calling their name
    • React badly to being touched
    • Become upset at sudden noises (often covering their ears to block it out)
  • Varying cognitive abilities – ASDs affect people at all levels of intelligence but can cause differences in the type of intelligence and abilities that an individual has. For example:
    • Non-verbal skills tend to be much stronger than verbal skills
    • Individuals tend to perform better on visual and memory tasks as opposed to abstract thinking or symbolic activities
    • 10% of individuals with an ASD are thought to have what is known as ‘savant’ abilities, which include extraordinary feats such as being able to multiply large numbers in their head, or memorise and play a complex piece of music after hearing it once

In addition, it is not uncommon for ASDs to appear alongside a number of other problems or conditions, which may include:

This page was clinically reviewed by Dr Hayley van Zwanenberg (MBBS, MMedSci, MRCPsych) in October 2018, and is scheduled to be reviewed again in October 2020. To view all Priory ASD specialists, please click here.

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