Autism is a neurodevelopmental disorder. Clinically, it has two core symptoms, one is social communication disorder, and the other is narrow interests and stereotyped repetitive behavior patterns.
Autism usually starts before the age of 3. The incidence rate in the United States is reported to be 1/68. The incidence rate in boys is much higher than that in girls, about 4-6 times that of girls. The clinical manifestations of autism vary greatly.
Some clinical manifestations of autistic children
First, let's talk about social communication disorder. What are the clinical manifestations of children with autism?
01. Not sociable
The most obvious thing is that this type of child is not sociable: they don't like to play with other children, and often hide in a corner to play with toys that interest them; they don't listen to the instructions of parents or teachers, have no interest in joining group activities, or can't follow the rules of the game well when joining group activities; they can't share well with other children, don't understand the rules of queuing, waiting, and taking turns, and can't participate in some cooperative games.
If there are any requirements, they like to hold the hands of adults, can't use the index finger to indicate, and use specific language is also very backward, and can't share attention with parents. For example, "Mom, what is that?" They usually don't respond.
02. Narrow interests, stereotyped repetitive behavior patterns
Another symptom is narrow interests and stereotyped repetitive behavior patterns. Children with autism will have some strange movements in body or language. For example, they like to turn around repeatedly, smell the smell of objects repeatedly, like to pay attention to some round objects, such as wheels, electric fans, air conditioner external units, and rotating lights at the door of barber shops, like to run back and forth, and like to classify objects according to shape, size, and color.
There are some imitative or repetitive language, like a parrot. For example, if you ask him "How old are you?" he will not say "I am three years old" or "how old" but will repeat your question: "How old are you?" What do you want to eat? He will say "What do you want to eat?" Repeat your sentence, or the last few words of your sentence. The child will say some words over and over again.
Some autistic children have no communication meaning in their language. For example, if he wants to drink water, he will repeat some language from cartoons, such as "The crow wants to drink water"; for example, if we want to watch TV, he will repeat the language in the cartoon Dora: "Come on, come on, let's watch TV together." It is not like the language expression of normal children.
In addition to some stereotyped movements, some repetitive language and behavior, these children will also show great stubbornness and insist on a rule and refuse to change. For example, they have to take a fixed route to go somewhere and have some routine movements before going to bed every day. For example, where to put slippers, where to put towels at the head of the bed, which song should the mother sing, some children are even so stereotyped that the way the mother enters the room must have a fixed way or a fixed procedure. Once these procedures are changed, the child will feel very uncomfortable, that is, he cannot accept the slightest change.
There are also some children, for example, there is an extracurricular activity at 9 or 10 o'clock every day in the kindergarten. If it rains, this outdoor activity will be cancelled, and these children will find it very difficult to adapt. Even if it rains or the weather is very bad, he will run to the playground to carry out this activity.
Some children will perform a ritualized greeting and use some very formal language in some daily communication.
Some children are so stereotyped and repetitive that they are reflected in their choice of food. He eats the same food every day, or the child's diet is very single and picky, only eating white rice or drinking milk, that is, it is difficult to add some unfamiliar flavors to him, even if there is a little change, he can perceive it and spit it out.
There are also some children who, for example, go to visit a venue. When they enter, it is daytime, but when they come back, it is dark. At this time, they will also show discomfort. They will say that it must be bright and daytime, which is very stereotyped.
Then there are some children who have an abnormal perception. For example, they particularly like certain specific sounds, or are particularly afraid of hearing certain sounds, repeatedly smell or touch some objects, repeatedly put their hands in front of their eyes to look at their hands, or look at some objects with squinting eyes, or show excessive attention to some round objects or some rotating objects we mentioned earlier.
03. Delayed language development
In addition to the social communication and interaction disorders, narrow interests, and stereotyped repetitive behavior patterns we mentioned earlier, most autistic children also show a delay in language development, that is, they have no meaningful language at the age of 2 or 3.
Some autistic children will have normal language development at a certain age, but at the age of two or three, they will have a regression in language, that is, they can no longer say what they could say before. Some children have some meaningless language, repeat language, talk to themselves, that is, you hear him mumbling all day long, but you can't understand what he is saying.
Some children have certain language skills, they can speak but it is a one-way communication, this language lacks the nature of communication. Some children have a lot of language, they seem to be very good at speaking, but it is also a one-way communication, no communication, no interaction.
For example, some children with autism like to talk about a certain topic, such as military, the universe or dinosaurs, they will chatter with you about these issues, even repeating them 20 or even 30 times a day. Then when he talks, he doesn't care about other people's feedback or feelings. For example, when others are impatient or even when they are about to leave, he still wants to grab others to continue talking.
Some children with autism will show a relatively strong ability in mechanical memory or music and art. For example, these children will remember everything they see, and they can recite the Three Character Classic, or recite hundreds of Tang poems, or a song at a very young age. After listening to it several times, he can sing it all out, even if he has no language ability. Some autistic children pay special attention to numbers, letters, Chinese characters, and license plates, and remember them deeply.
Some symptoms of early identification of autism
So what are the early symptoms that can help us identify autism earlier?
Including less language. Children with autism still do not babble at 12 months old, do not have a meaningful language at 18 months old, and do not say more than 2 words at 2 years old. These are some high-risk signals in language. In addition, at a young age, for example, in the recognition of some expressions, they cannot smile to the caregiver at 6 months old, and cannot make some behavioral adjustments based on the caregiver's expression at 9 months old.
Cliff experiment
When the child is 9 months old, you can do a cliff experiment. This cliff experiment is to spread a layer of checkered cloth on the table. The front half is a flat ground, and the back half is a cliff from a visual point of view. Put the child on this flat slope, and then his caregiver stands opposite the child.
Normal child's performance: When the child is climbing at the junction of the flat slope and the cliff, the normal child will stop and observe the caregiver's expression. If the caregiver makes an encouraging expression at this time, "It's okay, keep climbing." Then the normal child will continue to climb, even if it is a cliff from his visual point of view, but he gets an encouraging signal from the other party's information, and he will bravely climb down and climb towards his caregiver. If the caregiver makes a very dangerous and terrifying expression at this junction, conveying danger and not to climb forward, the child will sit at this junction and will not continue to climb forward.
Performance of autistic children: For a child who may be autistic in the future, he does not have this ability at 9 months old. He also does not have the ability to pay attention to the caregiver's expression, nor does he have the ability to get clues from the caregiver's expression and adjust his behavior. He may just climb without purpose, climb down in one breath, or sit there without climbing to the dividing point.
Most children of 15 months old can point to their facial features. If you ask him where his nose is or where his ears are, he may point to them.
Children aged 18 months will have a process of pointing with their index finger. This is actually a process of sharing what I see and what I want. If the child still does not have the index finger at 18 months, and he still pulls the parent's hand to pull you over when he wants something, it means that the child may have some problems in communication and sharing, which needs to be taken seriously by parents.
The child's language has regressed, which is a high-risk signal. That is, he used to say a lot of words, but suddenly at a certain age, his language gradually degraded. This is also a high-risk signal.
The child has no interest in peers and is unwilling to play chasing, cooperative, or interactive games with peers. This is also a high-risk signal.
Children aged 2 or older still do not have some imaginary games, such as holding a toy to pretend to make a phone call, pretend to feed a doll, or take care of the doll to take a bath. These imaginary games. If the child still lacks these imaginary games after the age of two, this is also a high-risk signal.
At this time, parents should take their children to the hospital as soon as possible and find a specialist doctor to conduct a developmental assessment of the child and carry out further intervention.
