By Lisa Jo Rudy 

 Medically reviewed by Huma Sheikh, MD

The traits associated with autism are usually seen before age 3. They include difficulties in communication, social interactions, and responsiveness, as well as possible obsessive or repetitive behaviors.1

It's said that "if you've met one person with autism, you've met one person with autism." That's because the appearance of autism can vary from person to person in the types of traits and their intensity. One autistic person may be very verbal, bright, and engaged, while another is non-verbal, intellectually challenged, and almost entirely self-absorbed.

This article details common traits associated with autism, as well as traits that occur less often. It provides information about when to see a healthcare provider for a diagnosis.

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 Pollyana Ventura / Getty Images.

Common Traits in Autism

The National Institutes of Mental Health has created a list of traits that are often seen in autism. It's important to bear in mind that none of these traits on their own is likely to indicate autism. Autism is a pervasive developmental disorder, which means that a child must have many of these traits in order to qualify for a diagnosis.

By the same token, however, many children reach early milestones on time (or even early) and still qualify for an autism spectrum disorder (ASD) diagnosis. While some children may seem neurotypical in their development for a while but then develop autism traits, others may have obvious traits from infancy.

Early traits of autism include:

  • No babbling or pointing by age 1

  • No single words by 16 months or two-word phrases by age 2

  • No response to their name

  • Loss of language or social skills

  • Poor eye contact

  • Excessive lining up of toys or objects

  • No smiling or social responsiveness

  • Unusual over-or-under responsiveness to sensory input such as touch, smell, taste, noise

Autism traits are often present before the age of 3. Some children, however, have milder traits that may not be obvious at a very young age and such children may, as a result, be diagnosed after age 3.

When a later diagnosis occurs, it's usually because they have several indicators, such as:1

  • Limited ability to make friends with peers

  • Absence of imaginative and social play

  • Stereotyped, repetitive, or unusual use of language

  • Patterns of interest that are unusual in intensity or focus

  • Preoccupation with certain objects or subjects

  • Inflexible adherence to specific routines or rituals

If traits such as these suddenly appear in a child older than 3, and those traits were definitely not present from an earlier age, the child would not qualify for an autism diagnosis. The child would, however, almost certainly receive a different developmental or psychiatric diagnosis.

Rare Traits in Autism

Autistic people are more likely to experience:

  • Seizures2

  • Intellectual disability

  • Savant syndrome (extraordinary abilities in one very specific area, such as mathematics)3

  • Hyperlexia (early ability to decode words without understanding them)

  • Synesthesia (association of words or ideas with sounds, colors, tastes, etc.)4

  • Low muscle tone and/or difficulties with fine and gross motor skills

Complications and Sub-Group Indications

Autism has many proposed sub-groups, which often align with the presence of other conditions.

Autism Traits in Boys vs. Girls

The vast majority of people diagnosed with autism are people assigned male at birth. This may be, in part, because autism tends to look very different in females and, as a result, it may not be recognized as often.5

In general, autistic males show overt traits such as stimming (pacing, flicking fingers, rocking). They may be quite loud, get upset easily, or become angry when required to take part in activities that are outside their comfort zone. These behaviors naturally draw the attention of parents, teachers, and doctors.

Autistic females, on the other hand, tend to be very quiet and withdrawn.6 They are often loners who choose not to participate in group activities. Because many accept the cultural notion that girls are often quiet and unengaged, these behaviors are much easier to mistake for shyness or normal social reticence.

Of course, there can be wide variations depending on the individual.

Association With Other Conditions

Most autism traits also occur with other developmental and mental health disorders. As a result, it is not unusual for autistic children to have multiple diagnoses.

In addition, autistic people seem to be more prone to other problems not listed in the diagnostic criteria.7These problems include sleep disorders, gastrointestinal disorders, self-abusive behavior, and more.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes specifiers for these co-existing conditions:8

  • Intellectual impairment

  • Language impairment

  • Attention deficit hyperactivity disorder (ADHD)

  • Developmental coordination disorder

  • Disruptive behavior disorder

  • Impulse control disorder

  • Conduct disorder

  • Depressive disorder

  • Bipolar disorder

  • Tics

  • Tourette's disorder

  • Self-injury

  • Feeding disorder

  • Elimination disorder

  • Sleep disorder

  • Catatonia

When to See a Healthcare Provider

It can be very tough for a parent to determine whether behaviors are traits of autism or just ordinary variations in development. How much lining up of toys is excessive? How much desire for repetition is normal?

There is also the possibility that some developmental differences are caused by non-autism-related issues. For example, not responding to a name could very well be a symptom of hearing impairment. Late talking could be due to aphasia or apraxia of speech.

To properly diagnose autism, professionals use a set of specific tests that actually measure a child's presentation. They may also decide that your child should undergo testing for hearing impairment or speech issues that are unrelated to autism.

For that reason, if you're concerned about your child, take your concerns to your pediatrician. If the pediatrician is not able to help, and you still have worries, it may be time to make an appointment with a developmental pediatrician or another diagnostician.

 Sources

Centers for Disease Control and Prevention. Signs and Symptoms of Autism Spectrum Disorders.

Besag FM. Epilepsy in patients with autism: links, risks and treatment challenges. Neuropsychiatr Dis Treat. 2018;14:1-10. doi:10.2147/NDT.S120509

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

Ward J, Hoadley C, Hughes JE, et al. Atypical sensory sensitivity as a shared feature between synaesthesia and autism. Sci Rep. 2017;7:41155. doi:10.1038/srep41155

Giarelli E, Wiggins LD, Rice CE, et al. Sex differences in the evaluation and diagnosis of autism spectrum disorders among children. Disabil Health J. 2010;3(2):107-16. doi:10.1016/j.dhjo.2009.07.001

Mandy W, Chilvers R, Chowdhury U, Salter G, Seigal A, Skuse D. Sex differences in autism spectrum disorder: evidence from a large sample of children and adolescents. J Autism Dev Disord. 2012;42(7):1304-13. doi:10.1007/s10803-011-1356-0

Doshi-Velez F, Ge Y, Kohane I. Comorbidity clusters in autism spectrum disorders: an electronic health record time-series analysis. Pediatrics. 2014;133(1):e54-e63. doi:10.1542/peds.2013-0819

Lai MC, Lombardo MV, Chakrabarti B, Baron-Cohen S. Subgrouping the autism "spectrum": reflections on DSM-5. PLoS Biol. 2013;11(4):e1001544. doi: 10.1371/journal.pbio.1001544. Epub 2013 Apr 23.

National Institute on Deafness and Other Communication Disorders. Autism Spectrum Disorder: Communication Problems in Children.

Additional Reading

Ousley O, Cermak T. Autism Spectrum Disorder: Defining Dimensions and Subgroups. Curr Dev Disord Rep. 2013;1(1):20–28. doi:10.1007/s40474-013-0003-1

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