Core Differences In Autism

1. Social Communication

Examples of difficulties and differences in social communication may include:

  • Delayed or absent expressive communication i.e. non-verbal or pre-verbal
  • Echolalia i.e. repeats learnt sounds or phrases
  • Extensive vocabulary but only on specific topics of high preference interests
  • Speaks in monologues, often on restricted topic of interest
  • Unusual pitch or tone when communicating
  • Difficulties in interacting with others e.g. initiating conversation, turn taking in conversation
  • Limited receptive language skills i.e. limited understanding of verbal language
  • Delay in processing language
  • Avoidance of social demands
  • Limited understanding of social rules
  • Preference for solitude
  • Difficulty in understanding non-verbal language e.g. body language, facial expression
  • Limited use of non-verbal language
  • Difficulties in joint attention
  • Literal interpretation of language

Point to remember

  • When speaking to a child/young person with autism, it is often useful to reduce the amount of language you use, speak more slowly and allow additional time for processing. The use of visual supports will also facilitate understanding.

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2. Restricted, repetitive patterns of behaviour, interests or activities

Many repetitive behaviours are an indicator of anxiety, and the child/young person finds comfort in the repetitive, familiar pattern. Restricted interests also offer familiarity and routine, which is in turn calming.

Examples of repetitive behaviours and restricted interests and activities may include:

  • Repetitive motor behaviours e.g. rocking in chair, flapping hands in front of eyes, pacing up and down a room
  • Repetitive noises e.g. humming, repeating a favourite line from a film
  • Sorting objects, categorising objects, lining up toys
  • Unusual attachment to favourite object
  • Very fixed interest on specific topics e.g. favourite TV programme, book, topic of interest
  • Preference for predictable routines and rituals
  • Preference for sameness

Point to remember

  • Restricted interests can become skills and talents.

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3. Sensory Processing Differences

In DSM 5, sensory processing differences are listed as diagnostic criteria within the heading ‘Restricted, repetitive patterns of behaviour, interests or activities’. DSM 5 states that an individual with autism may be hyper-reactive or hypo-reactive to sensory input, or may have unusual fascination with certain types of sensory input (e.g. spinning objects, flashing lights).

Examples of sensory processing differences may include:

  • Hyper-reactivity to sensory input e.g. sensitive to certain noises, smells, movement, touch, lighting
  • Overwhelmed in sensory rich environments e.g. a busy classroom, the playground, dining hall
  • Distress in response to specific sensory input e.g. fire alarm, touching food items, smell of paint
  • Avoidance of unwanted sensory input e.g. refusing to participate in an art activity, running from room during music
  • Anxious response to unpredictable input e.g. someone brushing past, sudden noises
  • Hypo-reactivity to sensory input e.g. unaware when name is called, high pain threshold
  • Requires increased sensory input to engage attention
  • Craves certain types of sensory input e.g. movement, smells, deep pressure input

Point to remember

  • Children and young people with autism can fluctuate in their responses to sensory input, with some stimulation not upsetting them one day but then becoming distressing on another day.

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4. Anxiety

Many of the core features of autism can lead to increased anxiety.

Examples of the causes of anxiety may include:

  • Anxiety in response to social demands
  • Increased anxiety in social situations
  • Anxiety as a result of sensory overload i.e. overwhelmed by sensory stimulation
  • Anxiety in response to transitions e.g. moving to a new classroom
  • Anxiety in response to unexpected changes e.g. a substitute teacher, change in the timetable
  • Anxiety due to a lack of understanding of instructions or what is expected
  • Anxiety and depression due to social withdrawal/isolation

Examples of indicators of anxiety may include:

  • Withdrawing from interactions
  • Appearing to ‘zone out’ from classroom activities and withdrawing into own world
  • Emotional outbursts e.g. sudden crying
  • Increase in repetitive behaviours e.g. flapping hands in front of eyes, repeating familiar phrases, rocking in chair
  • Seeking deep pressure input e.g. jumping, tight hugs, chewing on sleeve, clenching fists
  • Reduced ability to process language and respond appropriately
  • Refusal to engage in activities
  • Complaining of feeling unwell
  • Increased absences from school or leaving early/coming in late
  • Increased drive for familiar routines and rituals
  • Increase in behaviours considered challenging e.g. swearing, shouting, pushing or hitting others, rough with objects or furniture
  • Self injury e.g. biting hand, banging head
  • Physiological changes e.g. very pale or flushed complexion, sweating, dilated pupils

Point to remember

  • Some children and young people may mask their anxiety in school but have a challenging outburst at home. It is therefore important to reduce sources of anxiety throughout the school day.

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5. Cognitive Inflexibility

Examples of cognitive inflexibility may include:

  • Preference for routine and sameness
  • Difficulty coping with transitions and changes
  • Difficulty in understanding how others feel, often called ‘theory of mind’ e.g. knowing that saying “I don’t like your dress” can hurt someone’s feelings
  • Difficulty in understanding that others can have a different viewpoint and opinion
  • Difficulty in problem solving and in finding alternatives when things go wrong e.g. what to do if you miss the school bus
  • Compulsive behaviours
  • Unable to see the ‘whole picture’, often referred to as weak central coherence e.g. walking into Assembly Hall and starting to play the piano, not realising that he/she is actually there for P.E.

Difficulties in generalising learnt skills to other settings

Point to remember

  • Many people with autism will cope with change if they are prepared for it and if it is presented to them visually.

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6. Learning Difficulties

Examples of learning difficulties may include:

  • Below average IQ scores as assessed by educational psychologist
  • Above average IQ but may not score well in tests and exams due to factors such as difficulty understanding instructions, distractibility, working under time pressure
  • Many children and young people with autism will have a higher Performance IQ than Verbal IQ in educational psychology assessments
  • Uneven profile e.g. high scores in reading but significant difficulties in writing
  • Splinter skills e.g. excels in Science but below average in History
  • Working memory difficulties
  • Unable to understand concepts when presented verbally, but understanding improves when concepts are presented visually
  • Prefers to work alone; difficulty in group discussions and projects
  • Excels in topics of preferred interest but has difficulty transitioning to new curriculum topics and subjects
  • Hand writing difficulties

Difficulty in presenting work verbally e.g. oral exams, presentations

Point to remember

  • Children and young people with autism may have difficulty learning through traditional methods but will excel with other approaches e.g. visual, kinaesthetic

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7. Organisational difficulties

Examples of organisational difficulties may include:

  • Arriving to classes late
  • Bringing the incorrect books and homework to classes
  • Difficulty in following the timetable and finding the correct classrooms
  • Difficulty in completing work to deadlines
  • Tidying away materials incorrectly
  • Unable to independently pack PE bag
  • Unable or slow when dressing independently
  • Difficulties in making plans e.g. planning how to do a Science experiment, planning a project

Point to remember

  • Everyone benefits from visual supports to help in organisation. Maps and diaries are examples of supports we all use.

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8. Attention difficulties

Examples of attention difficulties may include:

  • Difficulties in joint attention i.e. child or young person sharing attention with another person on an object or activity
  • Monotropism i.e. many children and young people with autism can only focus attention on one thing at a time, and will have difficulty dividing or shifting attention
  • Focusing attention on high preference object or activity and ignoring relevant stimulus e.g. focusing on a moving screensaver on the computer, and so missing what the teacher is saying
  • Distractibility e.g. easily distracted by new of preferred input
  • Difficulties in filtering out irrelevant input e.g. window blinds moving in the wind, sound of a lawnmower outside
  • Over-focus on details, and so miss the whole picture

Point to remember

  • Most children and young people with autism are strongly drawn to visual input so limiting visual distractions may improve attention.

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