The majority of Lucas's speech in this clip is repeated or echolalic. Though this repetition may resemble a dialogue in that Lucas does respond when spoken to, these echoed responses are neither meaningful nor communicative. Immediate echolalia can also be confusing since typically developing children will mimic others as they are learning to speak. Commentary by Dr. Christopher Smith.
Ryan, who is four and a half years old, has autism. Here, he insists on playing with a balloon only with his mother and has a tantrum when the evaluator, Connor Puleo, attempts to play with him. There are many warning signs shown here for autism. In particular are the many examples of echolalia where Ryan repeats his mother's questions rather than answering them. Other warning signs include Ryan's clear delays in language, lack of eye contact, lack of gestures or pointing to communicate his wants and possibly insistence on sameness.
Though Lucas seems more interested in this picture book, he does not look back at his therapist Georgia as many typically developing children might. He does not seem to be interested in her reactions to the book or in sharing his enjoyment. Further, Lucas shows great difficulty in imitating and understanding the emotions Georgia demonstrates for him. He repeats "I'm angry." and smiles.
Social Communication and Social Interaction
Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history
Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.
Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication.
Deficits in developing, maintaining, and understanding relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.
Restricted and Repetitive Patterns of Behavior
Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history
Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypies, lining up toys or flipping objects, echolalia, idiosyncratic phrases).
Insistence on sameness, inflexible adherence to routines, or ritualized patterns or verbal nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat food every day).
Highly restricted, fixated interests that are abnormal in intensity or focus (e.g, strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interest).
Hyper- or hyporeactivity to sensory input or unusual interests in sensory aspects of the environment (e.g., apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).