The definition of Autistic Spectrum Disorder (ASD), includes, ‘autism, Asperger’s disorder, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified’ (APA, 2013, p.809). This diverse definition means that there is a varying spectrum of abilities and characteristics amongst children with ASD. The combination and severity of symptoms will naturally vary from child to child with each behaving very differently and symptoms will range from mild to severe. These will often change over time, according to a variety of factors, including intervention. These are measured on a mild to severe scale from Level 1 to Level 3.
ASD has been defined by the World Health Organisation as:
Persistent deficits in the ability to initiate and to sustain reciprocal social interaction and social communication, and by a range of restricted, repetitive, and inflexible patterns of behaviour and interests…Deficits, ‘are sufficiently severe to cause impairment in personal, family, social, educational, occupational or other important areas of functioning. (WHO, 2018)
Social interaction and communication problems can include:
- Difficulties understanding and responding to social cues, such as eye contact and facial expressions
- An inability to see things from another person’s perspective or share one’s own emotions
- Problems maintaining appropriate back-and-forth conversations
- Subsequent issues making and maintaining friendships
Restricted, repetitive and inflexible patterns of behaviour and interests can include:
- Self-stimulatory behaviour, such as vigorous hand-flapping and walking on one’s toes
- Playing with toys in an unusual way, such as moving a toy car backwards and forwards,whilst visually fixating on only the wheels
- Speaking robotically, using peculiar intonation or pitch, or reciting scripts from films or TV shows
- The need for a highly structured and organised routine, without unplanned interruptions
- Displaying obsessive interest in items or activities that are uncommon for a child of their age, such as dictionaries or waterproof coats
- Unusual sensory interaction with their environment, such as being overcome with loud or persistent noises, a high tolerance to pain or temperature extremes, compulsively smelling or touching items or being enthralled with lights
Indicators that a child may have ASD can include:
- Not making eye contact or preferring to be alone
- Not responding to their own or other close family members’ names by 12 months of age
- Not pointing at or showing any apparent interest in objects by 14 months of age
- Not playing imaginary games by 18 months of age
- Becoming upset by minor changes to their usual routine
- Self-stimulatory behaviour, such as, flapping their hands, rocking backwards and forwards or spinning themselves around
- Reacting intensely to the sound, smell, taste, touch or look of an object or person
Additionally however, with ASD Level 1 (formerly Asperger’s syndrome), intellectual functioning and adaptive behaviour are found to be at least within the average range…and there is only mild or no impairment in the individual’s capacity to use functional language [to]…express personal needs and desires (Page, 2020).