Know The Signs

This picture shows Ben racing to the eggs at an Easter Egg hunt, something that would have been too overwhelming for him a year ago.  This picture is my reminder to never underestimate the potential of any child.

Are you wondering if your child or someone you know may be autistic?  If so, you’ve probably already started doing your homework.  You’ve done some online research.  Maybe you’ve even read a book by Temple Grandin.  If you need some good sites to check, you can start here: 

http://www.helpguide.org/mental/autism_signs_symptoms.htm

Maybe you’ve talked about it with your husband or a trusted friend.  You might have even discussed your observations with your pediatrician.  

I first noticed differences in Ben’s development not long after Ben turned two. I wasn’t thinking about autism at that point, at least not on a conscious level.  I mainly noticed delays in his speech and language.  I had him evaluated by an early intervention program, and, though he showed a gap in his language, he did not qualify for services.  And, since the evaluators didn’t mention autism, I didn't think any more about it for awhile.  Finally, when Ben turned four, I made up my mind to pursue formal evaluations.

So what is autism really?  How do autistic individuals act?  What are the signs to look for?  

It’s important to understand that autism is a spectrum.  This means that no two individuals will have exactly the same characteristics.  There is an old saying that if you’ve met one person with autism, then you’ve met one person with autism.  The autism spectrum ranges from individuals who are nonverbal to highly verbal.  It includes individuals who need lots of support with daily living to individuals who can live and function independently.  Also, remember that those nonverbal individuals who require full-time care can be just as brilliant, if not more so, then those highly verbal individuals on the spectrum.  Each person is unique, with his or her own gifts to bring.  However, there are some common characteristics to look for that most autistic individuals will display. 

     1)   Difficulty understanding and engaging in social interactions        

This was a big one for Ben.  I noticed on the playground that he would run in circles around the equipment rather than playing with the other children.  If we were at a public place like the library, and he was playing at a train table, he would become very agitated when another child would want to come and play with the trains.  Other times, such as at school, he would seem completely unaware of the other children.  I’d have to remind him to say hello and goodbye to his teachers and friends.  Hugs were awkward too.  Sometimes children on the spectrum don’t like hugs or any sort of physical contact.  Ben doesn’t mind hugs but often gives them very stiffly.  Lack of eye contact is also very common because eye contact can be physically painful and overstimulating for those on the spectrum.  Even though Ben does not look at others while they are talking, he is still listening and understanding what others are saying. 

Another common sign is that children on the spectrum often prefer to play alone.  I remember feeling a bit proud that I had such a self-reliant little boy.  Ben could play literally for hours by himself at a very young age.  I have found that my son enjoys social outings but often needs a lot of "down time" afterwords to decompress.  If social gatherings become overstimulating, we find a quiet place or sometimes we say our goodbyes and leave.  It's important understand that social interactions can be quite draining for those on the spectrum, even though they enjoy the company of others.

           

2)  Difficulty with language, especially communication

 Children with autism often have difficulty engaging with their peers or adults in "typical" ways.  They don’t understand the “give and take” of a conversation.   In Ben’s case, he is very verbal, but he wants to talk about topics of his interest.  He’s only recently, through lots of language therapy, become interested in having a conversation where he initiates by asking questions to another person and listens to their response.  This branch of language is known as pragmatic language.  Some autistic children don’t talk at all, instead leading their parents or caregivers to the object that they desire, such as to the refrigerator for food.  Others can become very frustrated when they cannot communicate their needs or when they are misunderstood, which can lead to meltdown behaviors.

Ben also has a very unusual way of talking.  He often talks in the third person, as in  “Ben wants a drink.”  He also has many conversations by using lines from his favorite TV shows and books.  Often, adults in his life don't even realize that he's scripting during the conversation.  Ben also has difficulty understanding questions, especially “how” and “why” questions.  Language is often delayed with children on the spectrum.  

Some autistic individuals never communicate with words, and this is okay.  They learn to communicate through other methods.  Technology has opened the door for a wide range of communication devices in recent years.  It is important to remember that just because a person cannot speak does not mean that they have nothing to say.    

Some signs of language delays include young children who don’t point, don’t wave “bye-bye”, or who have language skills and suddenly lose them.  If any of these things are the case for your child, talk to the pediatrician about your observations.

3)  Rigid and repetitive behaviors          

Autistic individuals crave structure in their lives.  They crave rituals and routines.  There was time when Ben would become highly agitated if we drove a different way home from school.   They often become upset in crowds or in unpredictable situations, such as going to eat at a new restaurant, participating in large family events, or situations such as fire drills at school.   We still have to warn Ben of any changes to his school schedule well in advance, or he can become anxious.   Autistic individuals like to know the rules, and they can become upset when others break the rules or seem to “get away” with behaviors that they know to be unacceptable.  They often have a strong sense of justice and will perseverate or dwell on an issue until it is resolved.  I have seen older autistic children at my school who become upset with something that happened on the playground, and, if the issue is not addressed, the child will continue to be bothered by the situation days later.

“Stimming”, or self-stimulatory behavior, is common among those on the spectrum.  Ben flaps his hands when he’s excited and rocks back and forth rhythmically, pushing his head in the pillow, until he falls asleep at night.  Other children might spin or twirl objects, shake objects such as sticks or leaves in front of their face, or repeat the same line over and over from a TV show or movie (also called echoalia).  Ben often incorporates lines from his favorite books into his pretend play.   These stimming behaviors are calming and soothing.  We all have stims, whether it is twirling our hair, biting our nails, or doodling during a lecture.  As long as the stims aren't hurting the person or others, then they should not be discouraged.

Another common trait is that autistic children will become fascinated with parts of objects.  In my son’s case, it was wheels on cars.  Even from a very young age, he loved to watch them spin.  I remember once at nine months old he turned over his stroller just so he could spin the wheels.  It is also common for them to line up toys or play with their toys in ways that are different than you would typically expect.  Little girls might line up their dollies rather than pretending to feed them or put them in bed.  They may also carry around unusual objects, like coat hangers, keys, or wooden spoons.  Ben has always been a collector.  He likes to get every kind of toy that he can find (Thomas trains, Angry Birds, etc) and once he has a complete set, he moves on to his next object of interest.  And, he becomes very passionate about his topics of interest. (Right now it’s United States geography.)  He will watch movies over and over until they are memorized and he can recite them from memory.

Often, children with autism also have difficulties with attention, sensory issues, gastro-intestinal issues, and trouble sleeping at night.  They may have anxiety or obsessive/compulsive behaviors.  
Many autistic children are picky eaters.  They may also eat items that are not food.  Some even have seizures.  These issues are common among autistic individuals, but they are not inherently part of the autism.

So, if you’ve read this and you notice many commonalities in your child or loved one, my advice to you is to seek out a specialist in your area.  This person can help you to determine if the differences you are noticing are in fact autistic traits.

And, finally, here’s one more thing to consider.  So many people use the word “tragedy” and “devastating” when they refer to autism.  And, I will admit that when you first hear the word “autism” and it’s referring to your loved one, it will throw you back.  However, autism is NOT a tragedy nor the end of the world for your family.  I believe in looking at the strengths in every person, and the mind of an autistic person is uniquely wired to think and work in ways that our neurtypical (i.e. non-autistic) minds can’t.  My son has an amazing memory, a voracious vocabulary, and visual-spatial skills that are already outstripping my own.   He challenges me intellectually every day.  His autism will not limit his potential.  Instead, I believe that his autism will open doors of opportunity for him and help him to go places that I can’t even dream about yet.  

Autism is not something that has happened to your child or loved one.  It is interwoven into the very fabric of the person.  The most disabling feature of autism is the very society in which we live.  Autistic people are like diesels who are fueled by gasoline engine.  They don't work properly because society isn't designed for their unique brains.  The good news is that the more we learn, the more we can create an inclusive world where everyone can shine.

You are not alone in this.  Reach out to others to help you on this journey.  Find your community.  Listen and learn from autistic adults.  They are the true experts.

            
As we always say to our students before the big test, you got this!                    

*For the sake of this article, I used the masculine pronoun “he”.  Of course, these signs of autism also hold true for little girls.