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Lack of Social Interaction No Engagement
The following clip shows Christian in his classroom at school. Though he is at the train table with his teacher, Christian is only minimally engaged in the actiivity and quickly loses interest, removing himself from the group. Throughout the interaction, Christian rarely vocalizes or looks at others and his facial expression is flat, making it unclear if he enjoys playing with the trains. Further, he makes no effort to keep the interaction going. He plays next to others, rather than with them and then walks away from the social scene entirely. In contrast, Christian's classmate frequently looks back and forth to her teacher's face, watches and imitates her teacher's actions, and smiles and shares her enjoyment by asking the teacher to play ...
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Teaching Lucas Eye Contact 2
While playing games with his therapist Georgia, Lucas cannot maintain eye contact during the social interaction and often avoids Georgia's attempts to make eye contact by looking or turning away. This is an excellent example of the fleeting or unusual eye contact that may be an early indicator of autism.
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Twins Playing with Mom
Dr. Smith narrates a video comparison of twins during a routine play session with mom. One twin, Nathan, is on the autism spectrum, while the other, Benjamin, is typically developing. Compared to Benjamin's enjoyment and easy engagement in the session, Nathan's enjoyment in the interaction is dubious, characterized by minimal sustained eye contact, smiling or social reciprocity.
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A Simple Request
Dr. Smith descirbes the many components that must be coordinate to carry out a simple request, including eye contact, communicative speech and gesture. Given that eeach of these skills may be challenging for a child with autism, many children with autism may chose to act for themselves, before they think or attempt to request help from others.
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Working with Therapist on Eye Contact and Speech
The following clip shows a behavioral therapist encouraging Leighdionne, a young girl with ASD, to make eye contact and imitate. The therapist employs multiple methods including voice, touch and the use of food to direct Leighdionne's attention to her face, praising her immediately when she makes even brief eye contact. Like many children with autism, Leighdionne appears highly distressed by this exercise and avoids the eye contact of her therapist, prefering instead to turn and squint at objects in her peripheral vision.
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Touching Head and Lack of Eye Contact
In this clip a therapist works on building Sajid's ability to follow a simple command, 'touch your head.' The skill is taught by repeated practice of the command with some support from the therapist (e.g. pushing Sajod's arms upwards), followed by a small reward. Notably, Sajid makes almost no eye contact with his therapist throughout their work together, another warning sign of autism.
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Touching Head and Lack of Eye Contact
In the following clip, a therapist teaches Sajid a simple command, "touch head." The lesson demostrates not only Sajid's receptive language delays, but also his poor eye contact and lack of facial expressions, all symptoms of ASD.
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Response to Name /Eye Contact Therapy
Children with ASD often do not respond to their name consistently. In this clip, the therapist evaluates Quincy's response to his name in an unstructured, stimulating environment, the play room. Once preoccupied by the toys, Quincy rarely reponds to his name though his therapist attempts to encourage this skill by instructing him to look at her and praising him for orienting to her voice.
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Lack of Eye Contact
Lack of eye contact is one of the possible warning signs for autism. Chistian K. avoids making eye contact with his mother even when he is very close to her, sitting in her lap. Rather, Christian appears more inclined to peer at his candy from different angles than to look at his mother, a sensory seeking behavior often seen in autism.
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Playing with a Balloon
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.
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Avoiding Eye Contact
Poor eye contact can be an early warning sign of autism, Watch how this child with autism consistently avoids the eye contact of the therapist despite her numerous and varied attempts to catch the child's eye.
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Teaching Lucas Eye Contact 1
Lucas, a young boy on the autism spectrum, does not consistently make eye contact with others, an early warning sign. Therapist Georgia tries repeatedly to gain and maintain Lucas' eye contact during a therapy session. Despite her numerous physical and verbal attempts to catch his eye, Lucas spends most of the session turned away from her.
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Nathan Does Not Look Mom in the Eye
Nathan does not consistently respond to his name, a key risk alert for ASD. Though he eventually walks in her direction after numerous calls, Nathan never orients to the sound of his own name. That is, he does not turn his head and look his mother in the eye when she calls him.
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Christian Communicates
Some chidlren with autism have significant language delays, such that they may use no or only a few words meaningfully and spontaneously. At 5 years old, Christian speaks only a few words, which include "mama," "Keekin" (Christian),"Titi"(his brother) and "mu" (music).
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Lack of Eye Contact (Smiles Briefly)
A lack of eye contact can be a warning sign for autism. Although both Evan's mother, Raquel, and the evaluator, Connor, persistently try to elicit eye contact and a smile from Evan, he avoids direct eye contact throughout the interaction. Though Evan eventually offers a brief smile after several attempts, he does not look at his mother who is directly in front of him.
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Risk Alert Eye Contact
Dr Deborah Fein describes ways to look for appropriate eye contact in a child it can be hard to tell if a child is looking at your forehead, or your hairline, or your glasses and you think they are making eye contact with you.
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.
Non-verbal Communicative Behaviors
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.
- Flattened affect (lack of facial expressions)10
- Inability to follow a point1
- Lack of attention to voice4
- Lack of expressive language17
- Lack of eye contact16
- Lack of gesturing1
- Lack of pointing to request2
- Lack of pointing to show1
- Lack of receptive language2
- Lack of response to name11
- Unusual Point1
Understanding & Maintaining Relationships
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 Motor Movements and Speech
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).
Preoccupations -Interests or Objects
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).