An Overview of Autism in Children

By Lisa Jo Rudy| Reviewed by Joel Forman, MD

Autism, by definition, can only be diagnosed if symptoms appear before age three. As a result, autism is usually diagnosed in children—often in children as young as three years old or even younger. Yes, there are circumstances in which autism is diagnosed in teens or adults, but the average age of diagnosis is between ages three and six.

Because autism is usually diagnosed in youngsters, many people think of it as a childhood disorder. In fact, most programs, therapies, and supports are available only to children with autism and their parents. But, it is incredibly rare for a child who is accurately diagnosed with autism to lose that diagnosis as an adult. The vast majority of children with autism grow up to be adults with autism. 


What Does Autism in Children Look Like?

They say if you've met one child with've met one child with autism. That saying, for better or worse, is absolutely accurate.


You can't recognize an autistic child by his/her looks. Autistic children look no different from anyone else. Children with autism can be silent or chatty, bright or intellectually challenged. Their behaviors can range from quirky to aggressive. They may do well academically or face serious learning disabilities.


All that said, though, children with autism do have certain qualities in common. It's important to remember, however, that autism is a pervasive developmental disorder, which means that no single symptom or behavior, on its own, is likely to suggest autism.


It's also important to note that these differences must be significant to qualify for an autism diagnosis. They must interfere with the child's ability to do ordinary things, make friends, or succeed at school. So, for example, a typical child may be quiet and shy—and that might worry his/her parents. But if the child is capable of appropriately responding when addressed, answer questions when asked, and manage day to day life without much effort, his/her quiet shyness is more likely to be a character trait than a sign of autism.

So what does autism look like?

  • Children with autism almost always have some kind of speech difference. They may not speak at all, have speech delays, speak with an unusual prosody (sounding flat, for example), or they may literally memorize and repeat speeches from television. They may also speak very quickly, say the same thing over and over again, or use incorrect grammar when they should be old enough to speak correctly.
  • Children with autism always have social communication difficulties. Again, these may show up in many different ways. They may never want to interact with anyone at all, preferring to spin, line up objects, or continually flush the toilet. Or they may want to interact all the time and have no idea when enough is enough. They may insist on getting their own way and pursuing their own interests all the time or they may be very passive. Autistic children usually take longer than their typical peers to learn to play with—rather than near—other children.
  • Most children with autism have some kind of sensory dysfunction. They may crave or avoid loud noise, hugs, strong flavors, or strong smells. They may be ultra-sensitive to light or easily distracted by small sounds and movements. Some children with autism are very distressed by sensory input that others may not even notice—or by certain sounds (squeaks, animal noises, babies crying).
  • Children with autism often (though not always) move differently from other children. "Stims" (short for self-stimulation) are common and may look idiosyncratic. For example, while typical children may suck their thumbs, bite their nails, or twirl their hair, autistic children are more likely to flap their hands, run on their toes, or rock back and forth. Autistic children are also more likely to walk stiffly with their hands held still at their sides or run with an awkward gait. They may be clumsy and have a tough time throwing, catching, writing, or drawing.
  • Autistic kids behave differently from their typical peers. While typical children may tantrum to get their own way (or because they are tired or hungry), autistic children are more likely to tantrum because they are overwhelmed, frustrated, or unable to communicate their needs. They are also likely to be "young for their age," sticking with "babyish" interests until much later than their peers.
  • Behaviors are also different. Autistic kids often "perseverate,"meaning that they say or do the same things over and over in exactly the same way or get "stuck" on a thought, idea, interaction, or desire. They may become rule-bound and get very upset when rules are bent or broken. They are more likely to become emotional over apparently small things. Even a high functioning tween with autism may suddenly burst out crying over a change in plans or a forgotten water bottle. In some cases, autistic children can be aggressive or self-abusive or they may run away (called "eloping") for no obvious reason.
  • Children with autism play differently from other children. They may play all alone and find it difficult or even impossible to engage with other children. They may "play" by organizing or lining up objects, stuffing them into containers, or wandering around the yard or playground tossing dirt into the air. They are unlikely to play social "pretend" games like "house" and may find it difficult to follow the rules of sports like soccer or baseball.

Why Is It Important to Recognize Autism in Children?

There are several reasons why it's important to recognize, diagnose, and treat autism in children. Here are just a few:

  • Early and intensive treatment is shown to be effective in significantly reducing symptoms. The fewer and milder your child's symptoms are, the better they will be able to engage in inclusive school programs and community experiences.
  • Understanding the reasons behind your child's behaviors and challenges can help you better understand what your child needs to succeed. 
  • Schools and health insurance companies provide a wide range of free services to children with autism which would not be available to a child with "delays."
  • Social security and other agencies may be able to help you meet your child's particular needs.
  • Autism is now so widely known that many non-profits and corporations specifically cater to the needs of families with autistic children. Once you understand your child's diagnosis, you will quickly discover autism-friendly programs ranging from sports teams to movie nights to special days at the zoo.
  • When you know your child's diagnosis, you can find support programs and groups and meet parents with similar challenges. Not only will you discover resources you never knew about, but you may also find new friends—both for yourself and for your child.

If You Think Your Child May Be Autistic

Based on the description above, you may feel that your child should be evaluated for autism. If that's the case:

  • Read a little more about the symptoms of autism to be sure that you're accurately understanding how autism differs from other developmental challenges.
  • Talk with your pediatrician to find out whether he or she agrees with your assessment—and ask for recommendations for practitioners or clinics that can conduct an evaluation. If your pediatrician disagrees with you, be sure you understand why and be sure you agree. If you don't agree, move on to the next step.
  • Talk with your school district to determine whether they have facilities to evaluate your child free of charge. If not, they may be able to recommend a clinic or practitioner that they work with.
  • Choose a practitioner or clinic and make an appointment.

Don't be shy about asking for an evaluation. If your child is autistic, you've certainly done the right thing. If your child has delays or challenges that don't qualify him/her for an autism diagnosis, you've discovered those issues and can have them treated. If your child is simply developing differently, you can set your mind at ease.


In short, an evaluation can only help. And, since it's usually possible to have your child evaluated for free, what do you have to lose?

See More:

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