3 Ways Autism Presents in Children

Autism spectrum disorder (ASD) doesn’t look the same in every child. That could account for why 25% of kids with autism remain undiagnosed. 

Autism is a neurodevelopmental condition that can affect how children communicate, interact with others, process sensory information, and experience the world around them. Some signs appear early in childhood, while others become more noticeable when social and academic demands increase.

At Infinite Life & Wellness in White Plains, New York, Dr. Evelyn Ha looks beyond the autism stereotypes and takes a whole-child approach to wellness. Read on as she shares three ways autism may present in children.

1. Differences in communication and social interaction

Communication is about much more than whether your child can talk. Some autistic children have delayed speech or use few spoken words, while others develop large vocabularies and speak extensively. 

The differences may instead appear in how they use language and interact socially. For example, your child might:

• Have difficulty starting or maintaining back-and-forth conversations
• Have difficulty interpreting facial expressions 
• Prefer playing alone or have difficulty joining other children
• Repeat words or phrases
• Talk extensively about a favorite subject without recognizing when someone else wants to speak

Eye contact can also differ. It’s well known that some autistic children make less eye contact, but some do make eye contact. That said, they may still struggle to interpret the unwritten social rules that come naturally to their peers.

These differences can also become easier to spot as your child gets older. A child who seemed socially comfortable during preschool may struggle more when friendships become increasingly complex.

2. Repetitive behaviors and a strong preference for predictability

Autistic children may find comfort in routine and predictability. 

Stimming and repetitive behaviors

Repetitive movements, sometimes called stimming or self-stimulation, can include hand flapping, rocking, spinning, pacing, or other repeated actions. Your child might twirl their hair, rub their skin, fidget, snap their fingers, repeat certain words, or pick/bite their nails.

Children can stim in many different ways, and it can look different from child to child. Regardless of the specific behavior, stimming may help a child regulate emotions, express excitement, or cope with an overwhelming environment.

Predictable routines

A strong interest isn’t automatically a sign of autism, either. Plenty of children become temporarily obsessed with trains, princesses, animals, or a favorite game. With autism, interests may be unusually intense or focused and occur alongside other developmental or behavioral differences.

The same is true of routines. What matters is the overall pattern, including how strongly your child reacts when that routine is disrupted.

3. Unusual responses to sensory experiences

A scratchy shirt tag might be mildly annoying to you. To your child, it may feel unbearable.

Autism can affect the way children process sounds, sights, textures, tastes, smells, movement, and other sensory information. Children can be unusually sensitive to certain sensations or seek additional sensory input.

For example, your child might:

• Cover their ears around everyday sounds
• Refuse certain clothing because of its texture
• Have a very limited selection of foods based on texture or smell
• Become overwhelmed in crowded or brightly lit places
• Dislike being touched or hugged
• Seek movement by jumping, spinning, or rocking
• Seem unusually interested in lights, textures, or moving objects

Sensory differences can sometimes be mistaken for misbehavior. A child having a meltdown in a crowded grocery store, for example, may not simply be refusing to cooperate. The combination of fluorescent lights, music, conversations, carts, smells, and people moving around them may have become overwhelming.

Autism can look different in girls

Autism can sometimes be less obvious in girls (and therefore underdiagnosed), particularly when they learn to imitate the social behaviors of their peers. 

A girl may watch how other children interact and consciously copy their expressions, conversation styles, or behaviors to fit in. This is sometimes called masking.

This is one reason it’s important to consider your child’s complete developmental and behavioral picture rather than looking for one stereotypical presentation of autism.

A few signs don't automatically mean your child has autism

Recognizing one or two of these behaviors doesn’t mean your child is autistic.

Children develop at different rates, and speech delays, attention-deficit/hyperactivity disorder (ADHD), anxiety, hearing problems, sensory processing differences, and other developmental or medical conditions can produce overlapping behaviors.

Understanding your child is the first step

An autism evaluation isn't about putting your child into a box. Rather, a diagnosis can provide valuable information about how your child communicates, learns, processes their environment, and where they may need additional support.

When families understand what's behind a child's challenges, they can make more informed decisions about therapies, school accommodations, communication strategies, and other resources that may help them thrive.

To schedule an appointment with Dr. Ha, call 914-332-1124 or request an appointment online.