Autism and Communication (cont.)
Roxanne Dryden-Edwards, MD
Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Autism facts
- What is autism?
- How does autism impact the family?
- What are the different types of autism?
- What are the symptoms and signs of autism in children and adults?
- Impairment of social interaction and communication
- What causes autism?
- Is autism genetic?
- Do vaccines play a role in autism?
- How is autism diagnosed in children and adults?
- How is autism treated in children and adults?
- What common sociobehavioral interventions are used to treat autism?
- What are the common medications used to treat the symptoms of autism?
- Can diet and supplements play a role in the treatment of autism?
- What is the prognosis for children and adults with autism?
- For more information about autism in children and adults
- Take the Autism Quiz
- Autism Spectrum Disorder FAQs
- Find a local Developmental-Behavioral Pediatrician in your town
What are the symptoms and signs of autism in children and adults?
The current Diagnosis and Statistical Manual of Mental Disorders, fifth edition (DSM-V) identifies two features that are associated with autism:
- impairment in social interaction and communication, and
Impairment of social interaction and communication
Individuals with autism fail to develop normal personal interactions in virtually every setting. This means that affected persons fail to form the normal social contacts that are such an important part of human development. This impairment may be so severe that it even affects the bonding between a mother and an infant. It is important to note that, contrary to popular belief, many, if not most, persons with this disorder are capable of showing affection, demonstrating affection bonding with their mothers or other caregivers. However, the ways in which individuals with autism demonstrate affection and bonding may differ greatly from the ways in which others do so. Their limited socialization may erroneously lead family members and health professionals away from considering the diagnosis of autism.
As the child develops, interaction with others continues to be abnormal. Affected behaviors can include eye contact, facial expressions, and body postures. There is usually an inability to develop normal peer and sibling relationships and the child often seems isolated. There may be little or no joy or interest in normal age-appropriate activities. Affected children or adults do not seek out peers for play or other social interactions. In severe cases, they may not even be aware of the presence of other individuals.
Communication is usually severely impaired in persons with autism. What the individual understands (receptive language) as well as what is actually spoken by the individual (expressive language) are significantly delayed or nonexistent. Deficits in language comprehension include the inability to understand simple directions, questions, or commands. Persons with a high-functioning autism spectrum disorder might understand simple speech but still have difficulty interpreting the more subtle meaning in conversation. There may be an absence of dramatic or pretend play and these children may not be able to engage in simple age-appropriate childhood games such as Simon Says or Hide-and-Go-Seek. Teens and adults with autism may continue to engage in playing with games that are for young children and may seek to establish friendships with people much younger than them.
Individuals with autism who do speak may be unable to initiate or participate in a two-way conversation (reciprocal). Frequently the way in which a person with this disorder speaks is perceived as unusual. Their speech may seem to lack the normal emotion and sound flat or monotonous. The sentences are often very immature: "want water" instead of "I want some water, please." Those with autism often repeat words or phrases that are spoken to them. For example, you might say, "Look at the airplane!" and the child or adult may respond "at airplane," without any knowledge of what was said. This repetition is known as echolalia. Memorization and recitation of songs, stories, commercials, or even entire scripts is not uncommon. While many feel this is a sign of intelligence, the autistic person usually does not appear to understand any of the content in his or her speech.
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