Autism Spectrum Disorder (ASD) Assessments

Disruptiveness, acting up, zoning out when the child is required to listen for longer periods of time (e.g., instructions for a game, teacher speaking, a friend sharing their experience of an event). This will differ with each age group, so using same age peers as a frame of reference could be helpful.

Not-quite-relevant responses – some children learn to mask their communication difficulties very well by picking out the few words that they do understand and giving their best shot at responding to those. If a child’s responses often seem to only somewhat relate to the question, probing deeper (“describe in your own words what I asked you/what was the story about” etc.) will give a clearer picture of their level of comprehension.

Over or under-developed speech – late speech development and/or selective mutism, “staccato” speech, idiosyncratic language (describing trousers as “leg sleeves”). Again, using the child’s peers (ideally, from outside the immediate family environment) as a baseline is a good way to determine where they fit in. Either extreme – late to develop speech, very simple, short utterances or “little professor”, overly-formal speech are all potential indicators.

Flat affect – limited range of emotional expression or presenting older/with adult mannerisms;
poor or limited eye contact, preference for side-by side interactions and activities instead of face-to-face.

Being consistently overfamiliar or overly shy with new people regardless of circumstances.
A clear preference for spending time on their own and lack of awareness of other people.

Being very extroverted and enjoying being with people but experiencing difficulties because they don’t have ability to “read the room” or lack flexibility. A child may appear bossy because they don’t understand unwritten rules of socialisation, like turn-taking, waiting etc.

Habitually becoming ‘fixated’ with a certain topic or activity and will spend much time on this favourite task.

Difficulty adapting to changes in routine or not knowing what is happening next, which can sometimes trigger verbal or physical aggression.

Interactions that appear unkind or rude to others, due to difficulties with expressive communication and body language. Individuals with ASD can sometimes appear “blunt” when they are simply trying to share their views honestly without intent to cause harm.

Incongruent emotional responses, e.g., laughing when someone is crying, or becoming overwhelmed and upset by positive attention, e.g., classmates singing “happy birthday”.

People with ASD tend to experience variations of over or under sensory stimulation (touch, smell, sight, taste and hearing). For example, they may hear a sound much louder (or much softer) than it is in reality. Anxiety is frequently seen as a co-morbid condition in up to 84 percent of people with ASD, and repetitive behaviours (“stimming” – short for self-stimulatory) are often used to mediate both anxiety and sensory challenges.

High dependence on routines and doing things in the same order, becoming upset when the order is disrupted, e.g.,having to deviate from the familiar route on the way to the shops; might present well at school due to highly structured activities, but have a meltdown at home due to “holding it in” for the whole day. School holidays might be a particularly challenging time.

Sensory avoidance (covering ears at loud noises, strong dislike for labels or stitching on clothing, certain fabrics, hair brushing, showering, certain food textures and flavours, disliking different foods touching on the plate); sensory seeking (seeking movement, often in spite of the risk of social ostracism, e.g., stretching, rolling, crashing on the floor at inappropriate times/places, seeking out textures, like smooth fabrics/fur to pat/stroke, crunching ice, mouthing objects past toddlerhood).

Lack of imaginative/pretend play, e.g., lining up toys instead of playing with them.
Intense preoccupation with an activity, which takes place at the expense of everything else.

In girls the signs can be more subtle, as they are typically better at masking (hiding intense interests and sensory behaviours when in public) and camouflaging (taking on the interests of their peers that will gain them social acceptance).

If you or someone you know resonates with these signs, it could be beneficial to pursue an ASD assessment.