Brain & Nervous System Guide to Autism Symptoms Could Your Child Have Autism? By Lisa Jo Rudy facebook twitter linkedin Lisa Jo Rudy, MDiv, is a writer, advocate, author, and consultant specializing in the field of autism. Learn about our editorial process Lisa Jo Rudy Medically reviewed by Medically reviewed by Steven Gans, MD on September 28, 2019 Steven Gans, MD, is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on October 04, 2019 Print Table of Contents View All Communication Deficits Play Skills Unusual Physical Behaviors Co-Existing Medical Conditions Less Common Signs When to Seek an Evaluation No individual symptom is a sign of autism, and no two children with autism have identical symptoms. There are no medical tests that can determine whether a child is autistic, and there are no hard and fast rules for how autism should be diagnosed. In fact, in some cases, it can be tough for even a professional to diagnose an autism spectrum disorder. But if your child has several of the following symptoms—and they can't be attributed to any other disorder—it might be a good idea to consider an autism screening or evaluation. Verywell / Brianna Gilmartin Communication Deficits Children with autism spectrum disorders almost always have challenges with speech and language, but unless the challenges are obvious (such as a five-year-old with no spoken language), they can be hard to spot. That's because children with autism may use plenty of words and may even use more words than their peers. When assessing autism spectrum, doctors will assess communications skills in terms of prosody and pragmatic language. Prosody refers to the tone, volume, and speed of speech. Pragmatic language refers to conversational practices, including taking turns while speaking, staying on topic, or showing interest in someone else's comments. Here are some tips for determining if your child is having difficulties with verbal communication: They use few or no spoken words by age two, nor do they use gestures, gibberish, or other means to communicate their needs or thoughts.They use only words they are repeating from television, movies, or other people, especially if they are not using the words to communicate meaning (for example, repeating a random phrase from a favorite TV show).They are not hard of hearing but don't respond when their name is called.They have lack of eye contact, even when eye contact is requested.They never initiate interactions or conversations with others.They do not go through the usual babbling or gibberish stages of speech.They develop spoken language at the usual time, but use words oddly, have an unusually flat voice, or misunderstand the intended meaning of words. Play Skills Children with autism interact in unusual ways with objects, toys, and potential playmates. They are most likely to prefer their own company than the company of other children or to demand that playmates interact with them in certain predictable ways. In clinical terms, play is defined as an activity that is pleasurable, voluntary, motivated, flexible, and non-literal. Children with autism often engage in inflexible, repetitive play patterns without any symbolic or pretend behavior. Children with autism tend to view the world as concrete and literal and, as such, have difficulty with abstract concepts and imaginative behavior. Here are just some of the forms of play that are common among children with autism: Lining up objects or toys rather than using them in pretend or interactive playInteracting in the same way with the same objects (toys, doors, containers, etc.) over and over againEnacting the same scenes (often from TV) over and over again in exactly the same wayEngaging in "parallel play" (two children playing near one another but not interacting) long past the point when such play is developmentally typicalIgnoring or responding angrily to attempts to join them in their play or make changes to their play schemesHaving difficulty with age-appropriate forms of play such as rule-based games, pretend play, organized sports, or other activities that require social communication Unusual Physical Behaviors People with autism often have unusual physical behaviors that set them apart from their peers. While none of these behaviors is, in itself, a sign of autism, all of them can be part of the autism "package." For example, autistic children may: Rock, flap, or otherwise "stim," often as a way to calm themselvesOver- or under-respond to sensory input, including painAre unusually picky eaters and may refuse foods with particular textures or strong flavorsHave an unusual gait that may include toe walking or awkward movementsRespond in age-inappropriate ways to unexpected changes in routine (angry melt-downs or extreme anxiety as a result of apparently minor changes)Exhibit age-inappropriate behaviors or interests or have difficulty with developing age-appropriate abilities in toileting, dressing, etc. Co-Existing Medical Conditions While the criteria for autism spectrum disorder do not include physical or mental symptoms or illness, such issues are unusually common among children with autism. Sleep problems are common among people with autism. Many autistic children have trouble falling or staying asleep, and adults on the spectrum often have similar issues.Many children with autism have mild or more significant delays in gross and fine motor skills; for example, they may have difficulty with manipulating silverware, using scissors, climbing, jumping, etc.Seizure disorders are more common among children with autism.Gastrointestinal (GI) problems such as constipation, diarrhea, and/or vomiting are more common among children with autism.Autistic people of all ages are more prone than their typical peers to social anxiety, generalized anxiety, attention deficit hyperactivity disorder (ADHD), depression, obsessive-compulsive disorder (OCD), and other developmental disorders and mental illness. Co-existing medical and psychiatric problems are frequently missed in children because they are presumed to be autism-related. These include epilepsy, injuries, gastrointestinal problems, mood disorders, allergies, and numerous other medical conditions. Less Common Signs Quite a few people with autism have unusual symptoms that may not cause problems in themselves but which do suggest a different developmental path. A few such symptoms include: Hyperlexia: A very precocious ability to decode written language without the accompanying ability to understand the meaning of the textSynesthesia: Unique responses to sound, color, letters, or numbers (for example, some people with synesthesia "see" sounds, "hear" colors, or otherwise experience unique responses to sensory input)Savant syndrome: Autistic savants, who represent a small percentage of the autistic population, may have amazing abilities to memorize information, do complex calculations, play piano, and so forth—much like the character of Raymond in the movie "Rain Man." Hyperlexia, synesthesia, and savant syndrome are not as uncommon as you may think. A 2009 study from the University of Wisconsin suggests that as many as one in 10 people with autism have remarkable abilities to varying degrees. When to Seek an Evaluation If you've read through this checklist and find that your child seems to exhibit some of these symptoms, now is the right time to seek an autism evaluation. Start by contacting your pediatrician and asking 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 may choose to seek an evaluation before your pediatrician suggests it, and that choice is perfectly appropriate. The reality is that parents are often the first to notice their child's differences and delays. After all, your pediatrician only sees your child once a year, or when he's sick, so she may not have a chance to see what you notice every day. There really is no downside to seeking an evaluation. While you may discover that your child is not autistic, chances are you've discovered some issues that can and should be addressed while your child is young. If your child is autistic, now is a great time to start providing therapies that can give your child the tools she needs to be successful. How High Functioning Autism Is Diagnosed in Adults Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. U.S Department of Health and Human Services. 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Philos Trans R Soc Lond B Biol Sci. 2009;364(1522):1351-57. doi:10.1098/rstb.2008.0326 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