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Love of NYC Subway
Dr. Smith explains that children on the spectrum have narrowly focused interests and spend a great deal of time reviewing materials related to these interests. Social interaction may also be limited as typical children often become bored with this specific topic and the child's one sided rehearsal of related facts. These preoccupations can sometimes be confused with savantism.
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Examples of Sensory Stimulation
Dr. Smith explains that not all children with autism (but many) engage in an array of unsual behaviors related to sensory interests, including oral, auditory, visual and tactile fixations. Making repetitive finger movements in front of the eyes is a classic symptom of autism that also likely has a sensory component.
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Unusual Mouthing
One of the possible warning signs of autism are unusual, repetitive behaviors. Stephen K., who is 4 years 8 months, is shown mouthing his fingers in a very unusual way. This repetitive licking of his fingers may be related to sensory interest in the taste or feel of certain textures.
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Lining Up Objects
Lining up objects is a repetitive behavior that can be a warning sign for autism. In this video, Riley displays her interest in lining up a variety of objects in multiple locations, including her home and the doctor's office. It is evident that Riley's interest in lining up objects interferes with her other activities. She ignores her mother's attempts to introduce toys and becomes irritated when objects are removed from her constructed rows.
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Response to Toys
Children with autism may play with their toys in an atypical, inappropriate or repetitive manner. We see Evan, a boy on the autism spectrum, repeatedly throwing his blocks over a gate rather than stacking them as many typcially developing children might.
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Sal's Rocking, Evan Starts Rocking, Ethan Sits Quietly
Excessive rocking combined with odd finger and hand mannerisms can be a warning sign for autism. Sal, the oldest of the three children on the spectrum, exhibits these behaviors while watching a cartoon with his brothers. Although all of the boys seem interested in the cartoon, none of them share their enjoyment with one another, another warning sign.
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Restrictive Behavior (Sal Wants Rocky)
Children with autism may become fixated on specific desires, so much so that it will restrict their ability to do anything else. Sal's desire to "see rocky" is so intense that it distracts him from doing anything else, such as completing a puzzle with his father.
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Nathan Gets Upset When Picture Cards Won't Line Up
Some chidlren with autism may become preoccupied with lining things up or putting things in a certain place or exact orientation. Nathan becomes upset when he cannot align his cards in a specific way. His communications and social deficits are also clear when he repeatedly fails to ask his mother for help, despite being clearly distressed. Rather, his mother must offer to help and repeatedly guess what he wants because Nathan is not effectively communicating with her through language or nonverbal cues (e.g. pointing, gesturing, showing).
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Risk Alerts Restricted and Sensory Interests
Dr. Deborah Fein discusses and explains restricted and repetitive behaviors and interests (RRBIs), one of the three domains that comprises an autism diagnosis. RRBIs encompass the risk alerts which are classified by the unusual behaviors performed repetitively or for sensory stimulation, including: Restricted and Sensory Interests and Motor Stereotypies.
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).