Autism Spectrum Disorders

Autism Spectrum Disorder (ASD) covers a set of developmental disabilities that can cause significant social, communication, and behavioral challenges. People with ASD process information in their brain differently than other people. ASD affects people in different ways and can range from mild to severe.

People with ASD share some symptoms, such as difficulties with social interaction, but there are differences in when the symptoms start, how severe they are, how many symptoms there are, and whether other problems are present. They may have restricted and repetitive patterns of behavior, interests, or activities, such as placing objects in a linear manner, flipping objects, echolalia, or excessive smelling or touching of objects.

Children with ASD may have difficulty developing language skills and understanding what others say to them. They also may have difficulty communicating nonverbally, such as through hand gestures, eye contact, and facial expressions.

Not every child with ASD will have a language problem. A child’s ability to communicate will vary, depending upon his or her intellectual and social development. Some children with ASD may be unable to speak. Others may have rich vocabularies and be able to talk about specific subjects in great detail. Most children with ASD have little or no problem pronouncing words. The majority, however, have difficulty using language effectively, especially when they talk to other people. Many have challenges with the meaning and rhythm of words and sentences. They also may be unable to understand body language and the nuances of vocal tones.

• Repetitive or rigid language. Often, children with ASD who can speak will say things that seem out of context in conversations with others. For example, a child may repeat words he or she has heard over and over, a condition called echolalia. Immediate echolalia occurs when the child repeats words someone has just said. For example, the child may respond to a question by asking the same question. In delayed echolalia, the child will repeat words heard at an earlier time. Some children with ASD speak in a high-pitched or singsong voice or use robot-like speech. Other children may use scripted phrases to start a conversation. Still others may repeat what they hear on television programs or commercials.

• Narrow interests and exceptional abilities. Some children may be able to deliver an in-depth monologue about a topic that holds their interest, even though they may not be able to carry on a two-way conversation about the same topic. Others have musical talents or an advanced ability to count and do math calculations.

• Uneven language development. Many children with ASD develop some speech and language skills, but not to a normal level of ability, and their progress is usually uneven. For example, they may develop a strong vocabulary in a particular area of interest very quickly. Many children have good memories for information just heard or seen. Some children may be able to read words before 5 years of age, but they may not comprehend what they have read. They often do not respond to the speech of others and may not respond to their own names.

• Poor nonverbal conversation skills. Children with ASD often are unable to use gestures—such as pointing to an object—to give meaning to their speech. They often avoid eye contact, which can make them seem rude, uninterested, or inattentive. Without meaningful gestures or the language to communicate, many children with ASD become frustrated in their attempts to make their feelings and needs known. They may act out their frustrations through vocal outbursts or other inappropriate behaviors.