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The Detection of Autism

Detection of autism in any of its forms is not always as easy as one might think. Many people, particularly high-functioning autistics or those with Asperger Syndrome remain undetected into their 30’s, 40’s and even 50’s. One such noteworthy case is Susan Boyle, who wasn’t diagnosed until she was in her 40’s.

Susan, if you don’t recall, is the Scottish woman who appeared on Britain’s Got Talent, looking rather frumpy and matronly. People scoffed as if talent were limited to only those with good looks. As soon as Susan began to sing, however, attitudes changed, for her voice was angelic and talent heaven-sent. Susan revealed only months after her stunning appearance on television that she was recently diagnosed with Asperger’s.

Some autism spectrum disorders, such as Asperger’s may not have been diagnosed or detected. It’s important to remember that diagnosis is of this particular spectrum disorder is relatively new.

Doctors often have difficulty detecting autism, as it’s a spectrum disorder. Each autistic person’s condition varies from others based on where how the condition specifically affects them.

The chart below will help parents, teachers, and caregivers detect early signs of autism.

Childhood Autism Indicators
Difficulty making friendsUncontrollable laughter or cryingNo eye contactInsensitivity to painPrefers to be alone
The child has difficulty making friendsLaughter or giggling at the wrong timesLittle to no eye contact even with parentsInsensitivity to pain and lack of fearPrefers to be alone, aloof manners
Attachment to objectsExtreme activity or inactivityTrouble learningResistant to changeChild sees no dangers
Extreme attachment to objectsExcessive activity or inactivityDifficulty learning with normal methodsResists change in routineNo fear of obvious dangers
EcholaliaChild rejects parents affectionWon't listen to parentsPoints without speakingMeltdown
Child repeating words heardRejects cuddling or affectionNot responsive to verbal cues, acts deafCannot verbalize needs, points or gestures insteadExperiences meltdowns not tantrums
Child spinning topsSustained odd playUneven motor skills
Spins objects of all kindsSustained odd play or activitiesUneven motor skills; prefers stacking things


While some of the behavioral conditions described above may be caused by other conditions than autism, if two or more are evident, it is best to have a child checked by a specialist.  Detection techniques today are vastly improved and may help parents and children alike gain a fuller understanding of the condition and where a child or adult places on the spectrum.  From there, care may begin.

It is important to note here that a primary care physician, even those specializing in childhood medicine may not be able to make an accurate diagnosis simply because there are so many other conditions that autism’s symptoms may match.  Even within autism, it is sometimes difficult to distinguish between Asperger’s Disorder and High Functioning Autism.

Detection in adults may be easier as there’s often patterns of behavior that are more noticeable and routine, and often the adult is able to articulate their concerns. Frequently adults with Asperger’s Syndrome live their lives without detection or diagnosis.  Nonetheless, finding diagnosticians for adults with autism is rare.  Presumptions in the medical community are that autism is a childhood condition – a mistake made very commonly.

It is rare for someone with autism to self-detect and seek diagnosis and care. In almost every case, detection is made by others, including parents, grandparents, teachers, school psychologists and others.

Here are some of the core signals that apply to both adults and children.

Social interactions and relationships. Symptoms may include:

  • Significant problems developing nonverbal communication skills, such as eye-to-eye gazing, facial expressions, and body posture.
  • Failure to establish friendships with children of the same age.
  • Lack of interest in sharing enjoyment, interests, or achievements with other people. Many autistic people may be reluctant to share their interests because they’ve learned early that when they do share them, other people don’t like the WAY they share them. For example, many autistic individuals tend to share their interests in a way that, to other people, feels like a monologue.
  • Deficits in cognitive empathy. People with autism may have difficulty perceiving or understanding another person’s feelings, such as pain or sorrow. That said, those on the spectrum usually do FEEL empathy and care about other people’s feelings, once they do understand. The idea that autistic people “lack empathy” is incorrect, outdated, and stigmatizing. Autistic individuals do have emotions and can empathize with other people’s feelings once they know what those feelings are. They may have difficulty in understanding how to express their empathy, which can sometimes be awkward even among neurotypical individuals.

Verbal and nonverbal communication. Symptoms may include:

  • Delay in, or lack of, learning to talk. As many as 40% of people with autism never speak.
  • Problems taking steps to start a conversation. Also, people with autism have difficulties continuing a conversation after it has begun.
  • Stereotyped and repetitive use of language. People with autism often repeat, over-and-over, a phrase they have heard previously (echolalia).
  • Difficulty understanding their listener’s perspective. For example, a person with autism may not understand that someone is using humor. They may interpret the communication word for word and fail to catch the implied meaning.
  • Some children and adults, particularly those higher on the autism spectrum, may become nonverbal from time to time. This is an uncommon condition called Selective Mutism that can last between one and six months. While selectively nonverbal, the person may speak to some individuals based on comfort and a lack of stress.

Limited interests in activities or play. Symptoms may include:

  • An unusual focus on pieces. Younger children with autism often focus on parts of toys, such as the wheels on a car, rather than playing with the entire toy.
  • Preoccupation with certain topics. For example, older children and adults may be fascinated by video games, trading cards, or license plates.
  • A need for sameness and routines. For example, a child with autism may always need to eat bread before salad and insist on driving the same route every day to school.
  • Stereotyped behaviors. These may include body rocking and hand flapping.

Parents should look for behavioral issues developing as early as the first year, such as the child turning his or her head away to avoid eye contact with parents, siblings or grandparents. Disinterest in playing some games like peekaboo, disdain for being held and cuddled (often from hypersensitivity to touch or extreme ticklishness), and failure to begin to talk when expected. Parents should monitor a child’s speech development. Even if the child begins to speak with proper timing, they may lose speech skills. Parents may also believe the child to be deaf when he or she fails to respond to sounds but may react to shrill sounds such as train whistles.

Teens face grave difficulties with autism. Social interactions are difficult, and they often feel isolated and alone, despite increased skills with interaction. Puberty causes a range of unique frustrations often leading to depression, anxiety and unfortunately, suicidal behavior. Epilepsy has been known to emerge during an autistic’s teen years.

Many people with autism have unusual sensory perceptions. For example, they may describe a light touch as painful and deep pressure as providing a calming feeling. Others may not feel pain at all. Some people with autism have strong food likes and dislikes and unusual preoccupations.

Parents, caregivers, and family should consider these facts with the children, teens, and adults in their care, and seek proper medical diagnosis quickly. Equally, the awareness of brilliance should also be considered. A child prodigy, for example, should also be evaluated. If, for example, a child can compose music at 4 or 5, or can perform intense mathematical calculations in Kindergarten, it’s very likely he or she is an Aspergian and may be a genius.

WebMD has courteously contributed to this article.