| Impairments in social communication and interaction |
| Impaired verbal and nonverbal communication |
- Abnormal language development, including muteness.
- Spoken language, if present, may be atypical. For example:
- Unusual prosody of speech (rate, rhythm, tone, volume).
- Persistent echolalia.
- Referring to self by name or as "you," "he," or "she."
- Non-speech-like vocalizations.
- Tendency to speak freely only about specific topics of interest.
- Talking at others rather than having a back-and-forth conversation.
- Unusual vocabulary for age or social group.
- Responses to others may seem rude or inappropriate.
- Difficulty understanding others' intentions (eg, takes things literally, misunderstands metaphors or sarcasm).
- Unable to adapt style of communication to social situations (eg, overly formal or inappropriately familiar).
- Limited use of language for communication.
- Poor response to name (despite normal hearing).
- Reduced, absent, or atypical nonverbal communication (eg, eye contact, gestures, facial expression, body orientation).
|
| Impaired social-emotional reciprocity and inability to establish peer friendships |
- Little or no response to others' gestures or facial expressions.
- Reduced or absent response to others' feelings.
- Poor understanding or following of social conventions (eg, greetings, farewell behaviors, taking turns, classroom behavior, awareness of personal space).
- Reduced interest in people, including children their own age.
- Apparent preference for aloneness.
- Difficulty making and maintaining peer friendships (may find it to be easier with younger children or adults).
- Reduced or lack of enjoyment of situations that most other children enjoy (eg, birthday parties).
- Difficulty joining in play of other children (eg, makes no effort to join in or uses wrong approach [eg, aggressive, disruptive]).
- Difficulty interacting in unstructured social situations (eg, school recess).
- Easily overwhelmed by social or other types of stimulation, for example:
- Extreme reactions to invasion of personal space.
- Resistance to being hurried.
- Abnormal interactions with adults (no interaction or too intense).
|
| Repetitive behaviors/restricted interests and atypical sensory responses |
- Repetitive/stereotyped motor and vocal mannerisms (eg, hand flapping, rocking behaviors, echolalia)
- Lack of flexible, cooperative, imaginative play or creativity. For example:
- Rigid expectation that other children adhere to rules of play.
- Strong adherence to rules of fairness (may lead to arguments).
- Repeatedly re-enacting scenes from videos or cartoons.
- Preference for highly specific, narrow interests or hobbies (eg, collecting, listing, numbering).
- Difficulty with imagination (eg, in writing, for future planning).
- Preoccupation with restricted patterns of interest that are abnormal in intensity or focus and interfere with activities of daily life.
- Strong preference for familiar routines.
- Inability to cope with change or situations that lack structure (may lead to distress [eg, anxiety, aggression]).
- Extremes of emotional reactivity that are excessive for circumstances.
- Aberrant response to sensory stimuli (over- or under-sensitive). For example:
- Excessively touching people or objects.
- Preferring to be in the dark.
- Deliberately smelling objects.
|
