By Lisa Jo Rudy 

 Medically reviewed by Diana Apetauerova, MD

No single autism trait defines the diagnosis, and each autistic child is different. There are no medical tests that can tell you whether a child has autism, and there are no hard and fast rules to diagnose it.

In some cases, it can be tough for even a professional to diagnose an autism spectrum disorde (ASD). But if your child has several of the following autism traits—and they can't be linked to any other disorder—it might be a good idea to consider an autism screening or evaluation.

This article will discuss how autism traits are expressed and what you should look for if you suspect your child may have autism. It also offers some tips on seeking an evaluation.

IMG_256

Possible Red Flags

When you have an autistic child, there's a good chance you will notice some possible red flags. Your child may have:

  • Limitations when communicating

  • Difficulties in playing with other children

  • Sensory differences

  • Certain other medical conditions

Difficulties With Communicating

Autistic children often have difficulties with speech and language. If they are obvious difficulties, such as a 5-year-old having no spoken language development, they are easy to spot. But autistic children don't fit neatly into categories. For example, an autistic 5-year-old may use plenty of words and even use more words than other children their age.

When doctors determine if a child has autism, they look at a child's communication skills. They carefully consider prosody and pragmatic language. Prosody is the tone, volume, and speed of speech.

Pragmatic language is the way a person participates in conversation. This includes taking turns while speaking, staying on topic, or showing interest in what someone else says.

Autistic children often have challenges with language, but it's not just whether or not they know words. The tenor of speech and the way it flows during communication is important.

Here are some traits that suggest a child has communication skill challenges:1

  • They use few or no spoken words by age 2.

  • They don't use gestures, gibberish, or other ways to communicate their needs or thoughts.

  • They only use words they repeat from TV, movies, or other people.

  • Their words aren't used to communicate their thoughts or needs. (For example, they repeat a random phrase from a favorite TV show.)

  • They are not hard of hearing, but they don't respond when someone calls their name.

  • They don't look into someone's eyes when they speak, even when asked to do so.

  • They never initiate interactions or conversations with others.

  • They learn to speak when most other children learn, but they use words in a non-traditional way, have an unusually flat voice, or misunderstand the intended meaning of words.

Difficulties in Playing With Other Children

Autistic children interact in unusual ways with objects, toys, and potential playmates.2 They are most likely to prefer playing alone rather than with other children. They may even demand that playmates interact with them in certain predictable ways.

Play is a fun, flexible activity that people do because they want to do it. Autistic children often engage in inflexible, repetitive play. When they play, it usually does not involve playing pretend.

Autistic children often view the world as something concrete and literal. They may struggle with abstract concepts and using their imagination. Here are just a few examples of the way autistic kids like to play:3

  • Lining up objects or toys instead of using them in pretend or interactive play

  • Playing the same way with the same objects (toys, doors, containers, etc.) over and over again

  • Acting out the same scenes (often from TV) over and over again in exactly the same way

  • Participating in "parallel play" (two children playing near one another but not interacting) even after the age of 2 or 3, when most kids begin to interact with each other as they play

  • Ignoring or responding angrily to other kids when asked to join them in their play or change what they are playing

  • Having difficulty with age-appropriate forms of play such as rule-based games, pretend play, organized sports, or other activities that require social communication.

Sensory Differences

Autistic people have a difficult time processing information they receive from their senses (sight, smell, touch, movement, hearing, and vision). This is called a sensory processing disorder.

A sensory processing disorder causes a mismatched reaction to what they experience through their senses. For example, autistic kids may be highly sensitive to taste and sounds.

Bright lights may be overwhelming and certain kinds of touch may feel extremely uncomfortable to an autistic child.4

Co-Existing Medical Conditions

Autistic kids are more likely to have certain specific medical conditions.5 These co-existing medical conditions include the following:

  • Autistic people typically have sleep problems. Many autistic kids have trouble falling or staying asleep. Autistic adults often have similar issues.

  • Autistic kids experience differences with gross and fine motor skills; for example, they may have problems using silverware or scissors. They may have trouble climbing, jumping, or performing other basic physical activities.

  • Autistic children are more likely to be diagnosed with seizure disorders.

  • Many autistic children experience gastrointestinal (GI) problems like constipation, diarrhea, and/or vomiting.

  • Autistic people, no matter what age, are more likely to experience mental health or developmental issues such as social anxiety, generalized anxiety, attention deficit hyperactivity disorder (ADHD), depression, or obsessive-compulsive disorder (OCD).

Co-existing medical and mental health issues are often missed in children because people assume the issues are related to autism. These include epilepsy, injuries, gastrointestinal problems, mood disorders, allergies, and numerous other medical conditions.

 

Less Common Signs

Some autistic people may show less common traits, but these traits provide a hint that there may be a developmental issue.6

These issues may include:

  • Hyperlexia: Autistic children may be able to read written language at a very young age, although they may not understand what they're reading.

  • Synesthesia: They may have unique responses to sound, color, letters, or numbers. For example, some people with synesthesia "see" sounds or "hear" colors.

  • Savant syndrome: Autistic savants have amazing abilities to memorize information, do complex math problems, play piano, and so forth. This is much like the character of Raymond in the movie "Rain Man."

Some researchers have suggested slightly more than one-third of autistic people meet the definition of savant.7

Seeking an Evaluation

If you've read through this checklist and find that your child seems to show some of these traits, now is the right time to seek an autism evaluation.

Contact your pediatrician and ask for a referral to a clinic, developmental pediatrician, or another specialist. If your pediatrician can't help, consider contacting your school district for suggestions.

You can also seek an evaluation before your pediatrician suggests it. Parents are often the first to notice their child's differences and delays. That's because pediatricians only see children once a year or when the children are sick. They may not have a chance to see what you notice every day.

Consider an autism evaluation if your child displays related traits. While you may discover that your child is not autistic, chances are you've discovered some issues that should be addressed while your child is young.

Summary

Autism traits vary in both children and adults. But if your child displays communication difficulties, difficulties in playing with other children, sensory differences, or certain other medical conditions, you should get your child evaluated.

Contact your child's pediatrician to discuss your concerns. If your child is diagnosed with ASD, your pediatrician can connect you with the resources you need to help your child lead a happy, healthy life.

Sources

U.S Department of Health and Human Services. National Institute on Deafness and Other Communication Disorders. Autism spectrum disorder: Communication problems in children.

Bentenuto A, De Falco S, Venuti P. Mother-child play: A comparison of autism spectrum disorder, Down syndrome, and typical development. Front Psychol. 2016;7:1829. doi:10.3389/fpsyg.2016.01829

Centers for Disease Control and Prevention. Autism spectrum disorder signs and symptoms.

Crasta JE, Salzinger E, Lin MH, Gavin WJ, Davies PL. Sensory processing and attention profiles among children with sensory processing disorders and autism spectrum disorders. Front Integr Neurosci. 2020;14:22. doi:10.3389/fnint.2020.00022

Tye C, Runicles AK, Whitehouse AJO, Alvares GA. Characterizing the interplay between autism spectrum disorder and comorbid medical conditions: An integrative review. Front Psychiatry. 2019;9:751. doi:10.3389/fpsyt.2018.00751

Bouvet L, Donnadieu S, Valdois S, Caron C, Dawson M, Mottron L. Veridical mapping in savant abilities, absolute pitch, and synesthesia: An autism case study. Front Psychol. 2014;5:106. doi:10.3389/fpsyg.2014.00106

Hughes JEA, Ward J, Gruffydd E, et al. Savant syndrome has a distinct psychological profile in autism. Mol Autism. 2018;9:53. doi:10.1186/s13229-018-0237-1

Additional Reading

Meier SM, Petersen L, Schendel DE, Mattheisen M, Mortensen PB, Mors O. Obsessive-compulsive disorder and autism spectrum eisorders: Longitudinal and offspring risk. Hashimoto K, ed. PLoS ONE. 2015;10(11):e0141703. doi:10.1371/journal.pone.0141703

Neil L, Olsson NC, Pellicano E. The relationship between intolerance of uncertainty, sensory sensitivities, and anxiety in autistic and typically developing children. Journal of Autism and Developmental Disorders. 2016;46:1962-1973. doi:10.1007/s10803-016-2721-9

Towle PO, Patrick PA. Autism spectrum disorder screening instruments for very young children: A systematic review. Autism Research and Treatment. 2016;2016:4624829. doi:10.1155/2016/4624829

IMG_256

By Lisa Jo Rudy
Lisa Jo Rudy, MDiv, is a writer, advocate, author, and consultant specializing in the field of autism.