Behaviors of Children with Autistic Spectrum Disorders David L. Rickman, Ph.D. School Psychologist

1. Behaviors of Children withAutistic Spectrum DisordersDavid L. Rickman, Ph.D.School Psychologist

2. Autistic Spectrum Disorders (ASD) (Pervasive Developmental Disorders) Classic Autism (Autistic Disorder) Asperger Syndrome (milder form of ASD) Rett Syndrome (rare; almost exclusively in females) Childhood Disintegrative Disorder (rare; average onset between three and four years; strong male preponderance) PDD Not Otherwise Specified (diagnosis made when behaviors do not fit into a single category)

3. Children with Autistic Spectrum Disorder (ASD) exhibit a wide range of challenging behaviors. These behaviors are not necessarily limited to the symptoms of ASD. Conduct problems, obsessive-compulsive traits, anxiety, and depression are not uncommon among autistic individuals, especially adults with autism. The misdiagnosis of ASD occurs frequently in the case of milder forms of the disorder (e.g., Asperger Syndrome). This is due in large part to the similarity of symptoms found in other psychiatric groups. The hallmark symptoms – and most recognizable behaviors – exhibited by children with ASD include stereotyped behaviors and severe difficulties in the areas of communication and social interaction. The behaviors of children with Asperger Syndrome differ qualitatively from those of children with Classic Autism (Autistic Disorder). Systematic observation of the child’s behaviors in the educational setting continues to be the most valid and reliable method of identifying ASD, in addition to providing valuable information to assist in Response to Intervention practices.

4. Stereotyped Behaviors: Avoiding eye contact; averting gaze Staring at objects excessively Flicking fingers rapidly Unusual eating habits (e.g., eating only one type of food) Licking, tasting, and/or attempting to eat inedible objects Excessive smelling or sniffing of objects Spinning objects Rocking back and forth; making rapid darting movements Prancing (walking on tiptoes) Flapping hands or fingers in front of face or at sides Making self-stimulatory high-pitched sounds or other vocalizations Self-injurious behaviors such as biting, slapping, hitting self; banging head. May seem oblivious to pain

5. Communicative Domain: Looks away from speaker Repeats words out of context Echolalia Speaks with flat tone, affect, or dysrhythmic patterns Repeats unintelligible sounds Does not initiate conversation Use of gestures instead of speech Use of pronouns inappropriately (e.g., refers to self as “he”) Lack of understanding of subtle cues (verbal and/or nonverbal)

6. Social Interactive Domain: Avoids eye contact Resists physical contact; may be hypersensitive to touch Lack of imitative behavior and/or cooperative play Does not acknowledge others (e.g., “looks through people”) Laughing, giggling, crying inappropriately Becomes very upset when routines are changed Difficulty understanding the feelings of others Difficulty understanding facial expressions Problems with regulating social interactions (reciprocity)

7. Asperger Syndrome: Avoids or limits eye contact May not understand sarcasm or innuendo; very literal interpretation of language Little or no ability to make and keep friends Limited interest in what other people say Lack of empathy Extreme or obsessive interest in a favorite, narrow subject Speaks like an adult or in a “bookish”, flat manner May appear depressed May engage in repeated, obsessive, and/or ritualistic behaviors Appears clumsy or uncoordinated Usually average to above-average intelligence; likely to demonstrate well-developed verbal as compared to nonverbal skills In most cases, aware that he or she is “different”

8. Classroom Implications: Inattention (e.g., withdrawal; engaging in other activities) Defiance Physical and/or verbal aggression (e.g., hitting; threats) Organizational difficulties (e.g., no concept of time) Difficulties with making transitions (e.g., changing routine) Hypersensitivity to sound, touch, etc. (e.g., bell, clothes) Receptive and/or expressive language problems (e.g., may require visual information) Academic problems Sensorimotor difficulties “Savantism” or advanced skills Varying cognitive abilities depending upon ASD severity Inability to understand or predict other people’s actions Seizures (approximately 25 percent incidence in ASD spectrum)

9. Web Resources http://www.health.nih.gov/ http://www.autism-society.org http://www.autism.org/ http://www.autismtoday.com/ http://www.autismeducation.net/interventions.htm

10. References American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-IV-TR (fourth edition, text revision). Washington DC: American Psychiatric Association, 2000. Department of Health and Human Services. Autism Spectrum Disorders: Pervasive Developmental Disorders. Rockville, MD: National Institute of Mental Health, 2007.