Autism: Symptoms and Diagnosis

An Official Diagnosis

The World Health Organization gives these criteria for the diagnosis of autism:

Qualitative impairments in reciprocal social interaction
Qualitative impairments in communication
Restricted, repetitive and stereotyped patterns of behavior, interests and activities
Developmental abnormalities must have been present in the first three years for the diagnosis to be made

Concerned parents should always seek the advice of a specialist. Any analysis of symptoms must be performed by a sensitive, experienced professional.

Impaired Social Interaction

The most obvious and important symptom of autism is impaired social interaction. Known as ‘autistic aloneness’, this is the appearance of an autistic individual being all alone in their own world, not seeming to want or need other people. Low-functioning sufferers will have very faulty use of eye contact, expressions and gestures. Unlike sufferers of most other mental disorders, they appear not to understand empathy. Perhaps due to a lack of a proper theory of mind, they will neither seek comfort nor attempt to comfort others, and will not delight in the enjoyment of others.

Even high-functioning autistic individuals are unable to reciprocate appropriately and naturally, and report that they have to ‘learn’ to use their eyes, expressions and gestures appropriately. Even then, they risk coming across as unnatural and stilted.

Impaired Communication

Many autistic sufferers have little facility for language. Even when present, speech tends to be flat and unmodulated. Understanding is painstakingly literal. (For example, an autistic child, upon hearing “lend me your ears”, may become frightened because they believe that they must remove their ears.) Conversation is usually a one-sided affair at best, with the sufferer simply answering questions and nothing more.

Another missing facet of communication is the facility for imaginative play and activity. Imagine two girls, one autistic, playing with dolls. The non-autistic girl will tend to dress up her dolls, have them act out scenes and live imaginative little lives. The autistic girl, on the other hand, will be more likely to place the dolls in long rows, or to wave them in front of a light and watch the play of shadows on the carpet.

Restricted Activities and Interests

Autistic individuals are usually much beloved of routine and regularity. Pioneering autism researcher Leo Kanner spoke of an “obsessive desire for sameness”. Indeed, many sufferers become highly distressed at trivial changes in their environment, such as a cup on the wrong hanger, or a bus not going past at the normal time.

Sufferers often have elaborate routines and stereotyped behaviors, and can become very distressed if interrupted. Furthermore, interests are often narrow and unusual. The play of light, seen through moving fingers, is a common fascination. High-functioning individuals may develop a fixation with, for example, train timetables, multiplication tables, jigsaws, obscure laws, historical dates or birthdays. What makes these interests so unusual is that they are isolated and not connected to other interests; a sufferer may be fascinated by the flights of a certain airline, but report being bored with those of another.

Early Onset

Autism is unusual in its timing. Mental disorders are often diagnosed soon after birth (in the case of a developmental abnormality), or in the teenage years (in the case of a psychosis). Not so with autism. It is most often diagnosed at around one or two years of age. Furthermore, if problems occur only after the third birthday, then autism is unlikely to be the culprit.