ASD Symptoms 

The abilities and challenges of people with ASD vary significantly. While one person might be nonverbal, another may have no issues at all communicating. Some can live independent lives, while others need more support and live with their families or in assisted housing. Besides, symptoms may change during adolescence. However, about 84% of people with ASD experience at least some impairment in everyday functioning. 

ASD symptoms can be grouped into 2 big categories: social communication and interaction symptoms, and restricted interests and repetitive behaviors. 

Social Communication and Interaction Symptoms

• Trouble using and understanding nonverbal communication:
  • Inconsistent or limited eye contact; not looking at or listening to people when they are talking.
  • Difficulty interpreting gestures or facial expressions.
  • Facial expressions, movements, or gestures don’t match what is being said.
  • Struggles to understand tone of voice, behavior, or body language of others.
• Difficulty adjusting behaviors to social situations.
• Resisting physical affection like cuddling or holding and preferring playing alone.
• Reduced or infrequent sharing of interests or emotions about objects or activities.
• Verbal communication challenges:
  • Delayed or absent language development. 
  • Difficulty with back-and-forth conversations.
  • Talking at length about a favorite subject.
  • Slow or non-responsive to one’s name or other attempts to gain attention.
  • Unusual tone of voice (singsong or flat, robot-like) and stilted or scripted speech.
  • Trouble understanding another person’s point of view.
  • Difficulty understanding humor or sarcasm or taking phrases literally. 
• Difficulty following instructions with more than 1 or 2 steps. 
• Difficulties in making and keeping friends or relationships:
  • Difficulty taking turns, keeping conversations running, and understanding the social rules of friendship.

Restricted Interests and Repetitive Behaviors 

• Coordination issues or unusual movement patterns:
  • Walking stiffly 
  • Walking on toes
• Repetitive or unusual behaviors:
  • Hand flapping or rocking
  • Arranging things or toys in a very particular manner 
  • Self-injurious behavior (like hitting head somewhere, biting or scratching themselves)
• Intense focus on specific interests:
  • Deep and lasting interest in particular topics or niche subjects, expecting others to share this interest
• Rigid routines or rituals and inflexible of behavior:
  • Upset by minor changes in routine 
  • Difficulty transitioning and handling changes of routine
• Sensitivity to sensory input: 
  • Light
  • Sound
  • Clothing
  • Temperature
  • Food preferences 
  • Symptoms due to accompanying mental health disorders:
    • Attention-Deficit/Hyperactivity Disorder
    • Anxiety
    • Depression
    • Obsessive Compulsive Disorder (OCD)

Other Symptoms

• Gastrointestinal problems
  • Abdominal pain
  • Constipation
• Chronic overeating
• Pica (eating non-food items)
• Sleep problems: 
  • Excessive sleepiness
  • Disrupted sleep
• Symptoms due to accompanying genetic conditions
  • Down Syndrome
  • Fragile X Syndrome
  • Tuberous Sclerosis
• Symptoms due to accompanying mental health disorders:
  • Attention-Deficit/Hyperactivity Disorder (ADHD)
  • Depression
  • Obsessive Compulsive Disorder (OCD)

When to Seek Help 

There is no such thing as too early when it comes to seeking help for suspected ASD symptoms. It is important to reach out for diagnosis, and if confirmed, to start treatment and support as soon as possible. Early treatment is essential to ensure the individual can reach their full potential.

Early support will also help reduce challenges and build on strengths, allowing to learn new skills to manage everyday challenges. 

How to Seek Help

The first step when experiencing or observing symptoms that could be related to ASD is to consult a pediatrician or general practitioner. 

Another option is to contact the state’s public early childhood system to request a free evaluation:

• For small children age 3 or younger, evaluations will be conduction by the local intervention system or call 919-962-2001.
• For children over 3 years and adolescents, evaluations can also be scheduled through preschool, school, and local school district.

If it remains unclear who to contact for an evaluation, call Early Childhood Technical Assistance Center (ECTA) at 919-962-2001 or visit the ECTA website.

Symptom Changes During Adolescence

Adolescence brings significant physical and psychological changes, making it a challenging period for everyone, but especially for individuals with autism spectrum disorder (ASD). This time of life presents unique vulnerabilities for those with ASD.

While research on behavior changes in adolescents with ASD is inconclusive, some studies suggest a decrease in disruptive behaviors. However, it is widely recognized that adolescents with ASD are more likely to develop anxieties, particularly social anxieties, as their social challenges become more apparent and peer relationships grow in importance. 

Depression rates are also higher among adolescents with ASD compared to their neurotypical peers. The increasing academic expectations and challenges during this period can exacerbate difficulties with executive functions like time management, task completion, remembering tasks, and multitasking. These challenges may lead to social isolation, refusal to attend school, or exposure to bullying. 

Given these challenges, it is crucial to work closed with the individual’s Individualized Education Program (IEP) case manager and health care providers to anticipate and facilitate transitions. An IEP outlines specific goals and needs to ensure that children and adolescents with special needs receive the support and services needed to follow the same curriculum if possible and to thrive in school.

Per federal law, IEP participants are further entitled to a transition plan from middle to high school and beyond, which must begin no later than age of 16. However, many schools and case manager start discussions around the age of 13 or 14. The transition plan helps address academic and employment-relation options, provides resources, and assists with applications for public programs like Supplemental Security Income (SSI), State Supplementary Program, food assistance programs such as CalFresh in California…

Adolescents with ASD may also consider moving out need to move out when pursuing further studies. Since housing placement programs can have long waitlists, early planning is essential. Two valuable websites for housing options and programs are the website of the American Autism Association and the Interagency Autism Coordinating Committee which is a federal advisory committee.