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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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Pointing
The mother of 2 boys with ASD and a third with developmental delays describes how none of her boys learned how to point on their own or point, gesture in a social, spontaneous way. Gabriel, who is 3 years old, has been taught through therapy to point when when he wants something. His younger brothers, Benjamin and Nathan, are still being taught hand over hand that they must point to request. Such deficits in nonverbal communication are risk alerts for ASD.
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).