Social Development

Social impairments can be observed even in infants, as they smile less and pay less attention to what goes on around them, socially. As toddlers, autistic children continue to have less eye contact. Due to their limited verbal skills, they are more likely to physically grab someone’s hand to get their attention. As the preschool years approach, autistic children are less likely to communicate verbally, and lack social understanding. They may also have difficulty taking turns with others. The lack of social skill can at times make it difficult for autistic children to form friendships.

Autistic children also show empathy deficits. They often do not recognize or respond to faces, so they do not connect that each face they encounter belongs to a different person. They may feel that their own feelings are the only ones that matter. If people are showing emotion, such as crying, an autistic child may not react. They are not cold or heartless, they simply lack awareness of their surroundings without focused training.

Because of the lack of communication and these empathy deficits, autistic children have difficulty embracing social situations. They may not return eye contact and will instead fixate their eyes on inanimate objects. Instead of seeking out and accepting relationships, they may avoid them. They will take comfort in their inner world.

The fear of relationships can manifest as aggressive behavior. The aggression is not always directed at those around them. Instead, the aggression can be directed inward and may result in self-injurious behaviors. If autistic children cannot calm their fears, they may also resort to compulsive behaviors to distract or calm themselves. Routines are important with autistic children and may help smooth over any social anxiety they may experience.

Early Indicators 

There is no single personality trait that can be applied to all autistic children. Some parents classify their autistic child as a screamer, while others may explain their child as cooperative and low maintenance. There are some early indicators that parents can watch out for that could be a signal that their child is not developing normally:

• does not respond to his or her name
• does not babble, point, or make meaningful gestures by the first birthday
• does not speak one word by sixteen months: as many as 50% of those with autism never speak
• avoids eye contact
• after gaining language or social skills, the child loses them or digresses
• does not know how to play with toys: may play with the wheels on the truck, rather than the entire toy
• is attached to one particular object
• excessively lines up toys or objects
• does not smile
• body rocking, hand/arm flapping, or other repetitive behaviors

As some of the above signs may be “normal” to some extent, pediatricians may initially dismiss the signs and advise parents to wait it out. It is advised that if you see any of these signs in your child and you feel that there is something wrong with your child’s development, you should address your concerns with your child’s doctor and ask for an autism evaluation. The quicker you achieve a diagnosis, the sooner your child can benefit from early intervention. Most of the signs are recognized within a child’s first three years.

Play Time

Play is a behavior that is essential to the normal development of children. Most children progress through five developmental stages of play:

• sensory motor play
• manipulative play
• physical play
• social play
• make-believe play

A child diagnosed with autism will exhibit signs of impaired play throughout this development. An autistic child often does not move beyond the sensory motor play stage, and therefore misses out on the stage involving manipulative play. You will observe that children with autism do not always know how to play with a particular toy. They will spin the wheels on a car instead of pushing it along the floor to pretend they are driving it. The play involves manipulating the toy instead of playing with it. 

The reason playtime is so challenging for autistic children is because they often may not pass through the introductory stages of simple manipulation (waving toys) and relational play (stacking toys). Due to repeated failures at play, these children often participate less in unprompted play.

Deficits in Gross Motor Skills

Gross motor skills are those involving large-muscle activities such as walking or throwing a ball. An autistic child may have difficulty walking normally and may instead toe-walk (walking only on their toes). Toe-walking can lead to abnormal development in the calf muscles, so it is a habit that you should try and change.

Without a normal sense for their surroundings, autistic children can become accident prone when participating in gross motor activities. They bump into objects because they lack awareness of their environment. This may take reminders or guidance so that injuries do not occur.

Deficits in Fine Motor Skills

Autistic children will often show delays in the development of fine motor skills. Fine motor skills involve use of small-muscle activities such as drawing or picking up small objects. Due to an autistic child’s need to engage in self-stimulatory or repetitive behaviors, fine motor skills can cause difficulty. Hyposensitive children may engage in behaviors such as hand-flapping or rocking to stay stimulated, making it difficult to focus on tasks such as manipulating small objects. A hypersensitive child may also use self-stimulation to prevent sensory overload. In these situations, these children cannot focus on tasks that require the application of fine motor skills.

Sensory Issues

Children with autism can have severe reactions to sensory stimulation. Their senses can be either hypersensitive or hyposensitive. If a child is hypersensitive to stimulation, they become overwhelmed with even moderate levels of light, sound, or touch. The hypersensitive child may have a tantrum when receiving the lightest touch. A child who is hyposensitive may seek out physical contact, asking for tight hugs. Also, the hyposensitive child may have a high tolerance for pain and may not react even with a significant injury.

Communication Deficits

There are two communication terms that you may hear about when learning about your child’s autism:

• Receptive language: The ability to understand communication that is directed at you.
• Expressive language: The ability to make others understand what you are communicating.

Autistic children do no easily initiate conversations, but they can respond when others attempt to communicate. When speaking, they often engage in an action called echolalia, which is the practice of repeating back words that they hear. After participating in behavioral programs or therapy, autistic children can learn to use language to express themselves.

Autistic children also can have difficulty reading the faces of those around them. If these children can practice reading faces and focusing on the eyes of the individual speaking with them, they can often improve their communication skills. There are programs available, such as FaceSay, which helps autistic children engage and focus on the eyes of those they are trying to communicate with.

Supporting a Non-Verbal Child

Children whom have limited communication skills often do not know how to develop and maintain friendships, but they still have a desire to experience relationships. There are things that adults can do to help a autistic children adjust to feel included in social situations:

• Help your child forge friendships. Get to know other families in your school and set up play dates. Stay during the visit to help your child practice his or her social skills. Even though your child may not look interested in other children, they can learn from being in play environments with their peers.
• Encourage your child to play with others. When you are on play dates or at the park, encourage your child to play with others. It may require that you take the lead by showing your child how to approach other children. Capitalize on an activity that your child seems to like. If your child likes to swim, visit the local pool with a small group of families.
• Ask your child’s teacher to support your efforts. If your child has an opportunity to work in a small group or with a partner while in school, it will provide chances for communication to develop.
• Give your child time to adjust. When you take your child out with other children or are in an environment where there are children around, give your child time to observe new behaviors before asking them to participate. Even if a new activity is attempted and abandoned, don’t give up. Allow some time for adjustment and try again.
• Limit the amount of information you give your child. Always speak slowly and clearly. Give your child a chance to assimilate the information and formulate a response before repeating yourself.