By: Sabiha Toni

The bell rings,
signaling the end of a long, drawling computer science class.

“Wait! I just
have one more question!”

We groan. This
was Adam, the technological enthusiast, the introductory programming genius.
His hand was always in the air. His inquisitiveness was a nuisance, unless of
course the knowledge he absorbed came into use at the end of the semester, when
we all lined up for his help for our final projects. We greeted him in between
classes, stopped for a small chat at times.

At the end of the
semester as valedictorian of the Class of 2011, Adam described—to many of our
surprises—his struggle with Asperger’s.

Reserved.

Socially inept.

Good with
numbers.

There is a
particular combination of characteristics that are expected of an autistic
individual—a certain demeanor about them, a certain personality, and certain
similarities to a certain famed autistic pop-culture character. What happens
with situations such as Adam’s in which the signs don’t appear as blatant? The
problem with such a rigid set of expectations is the fact that autism is not
simply an assemblage of “red flags” but a variation of multiple signs and
symptoms with different degrees of effect, which contributes to the difficulty
in pinpointing the causes of the disorder.

To cover such a
variety of combinations, the term ASDs,
or “Autism Spectrum Disorders” was
established (Johnson 2007). Because ASDs are neurodevelopmental
disorders—meaning that they impair the development of the brain—it is common to
find symptoms in three broad areas:

1. Social Interaction: People with autistic disorders tend to
   avoid social contact with others, or lack interest in interacting with the
   people around them. These signs can be picked up from a very early age, even in
   the first year of life. Many infants may not be responsive to others or avoid
   eye contact. As they grow, toddlers can show disinterest in intermingling with
   peers, taking turns with them, and playing with them (Volkmar, 2005). These
   social impairments often make it difficult for those with ASDs to create and
   maintain meaningful relationships.
2. Communication: Communicative limitations in
   individuals with autism are prominent and also tie-in to their social skills.
   For example, autistic people often do not have a desire to communicate. They
   are often quiet and do not attempt to compensate through gestures, signifying
   that there is no intent to communicate. About one fourth of autistic children
   begin to learn and say words but eventually stop speaking them (Johnson, 2007).
   Conversational language may be slow to develop in certain types of ASD and
   autistic individuals often babble incoherently or parrot words, sentences,
   jingles, etc. (Johnson, 2007).  
3. Behavior: Stereotyped behavior, which is characterized
   by repetitive or rhythmic actions with no purpose or function, are common among
   people with autism. For example, many will flap their hands, pace, or rock from
   side to side continuously (Rapin, 2008). Habits and compulsions are also key
   characteristics of most people with autistic disorders. They are often very
   averse to interruptions in an activity or changes in routine (Johnson, 2007).

Many of these signs can be seen in those
with autistic disorders, but not all need to be present to diagnose an
individual with an ASD. Because there is such a range in the combination of
signs and symptoms, and because many of these tendencies are not unique to ASDs
(for example, normally developing toddlers may also flap their hands), it is
not appropriate to class every patient under one disorder. Different signs vary
in the degree of severity in different types of ASDs. Thus, it is important to
take into consideration impairments in the three general areas above, but not
implement them universally as signs of all individuals with autism.

References:

Johnson, CP. Early
clinical characteristics of children with autism. In: Gupta, V.B. ed: Autistic
Spectrum Disorders in Children. New York: Marcel Dekker, Inc., 2004:85-123.

Rapin I, Tuchman RF. Autism:
definition, neurobiology, screening, diagnosis. Pediatr Clin North Am. 2008;55(5):1129–46.

Volkmar F, Chawarska K, Klin A.
Autism in infancy and early childhood, Annu Rev Psychol. 2005;56:315—36.