PROBLEMS WITH SOCIAL INTERACTION

• Social isolation, withdrawal
• Limited eye contact, reciprocal interaction, social smile, sharing, showing
• Self-absorption, oblivious to others, in own world
• Socially indiscriminate behavior (e.g. going with strangers or invading  personal space such as touching or climbing on people), lack of stranger and  separation anxiety
• Social skills deficit

PRESERVATION

• Narrow or unusual range or interests and play behaviors, obsessive preoccupations     (e.g., videos, toys with wheels such as trains, or symbols such as letters or shapes), attachment to and holding particular objects
• Stereotyped and repetitive play (e.g., spinning, flicking, throwing, lining up, sorting, opening and closing)
• Upset with change, difficulty with transition, idiosyncratic, or ritualized patterns or routine, desired to maintain sameness and order, things must be a certain way or done a particular way
• Stereotypes (e.g., repetitive or self-stimulating movements or vocalizations such as rocking, head shaking, body tensing, toe walking, teeth grinding or clenching, hand or finger movements, facial grimacing, repetitive running, twirling, hand flapping, or jumping when excited, pacing, playing with saliva, picking at skin, hyperventilating)

SOMATOSENSORY DISTURBANCE

• Love of movement, frolic play, tickling, climbing, rocking, swinging
• Unresponsive at times to verbal input (e.g., not reacting when name called, hearing may be questioned, even though normal)
• Hypersensitivity to some sounds (e.g., distress or covering ears in response to loud noise, sounds made by appliances or motors, or certain songs, commercials, or voices)
• Distress with commotion, crowds
• Fascination with specific visual stimuli such as spinning or rhythmic movements, details, fingers, lights, shiny surfaces, linear patterns (e.g., credits on TV, fans, Wheel of Fortune)
• Abnormal sensory inspection (e.g., mouthing, smelling, scratching, rubbing, visually scrutinizing objects or fingers close to eyes, placing ears against things that vibrate or hum, pressing objects against face)
• Tactile defensiveness (e.g. dislike being touched, touching certain things, wearing clothes, having face washed, teeth brushed, hair combed)
• High tolerance for pain (e.g., not crying when hurt)
• Sleep disturbance (e.g., difficulty falling asleep, awaking early or during the night)
• Feeding disorder (e.g., limited food preferences, hypersensitivity to textures, retaining food in the mouth, inconsistency in eating over time, pica)

ATYPICAL DEVELOPMENTAL PATTERN

• Possible developmental regression or slowing at approximately 1-2 years of age (e.g., loss of words)
• Visual and motor skills higher than expressive and receptive language especially for children with delayed development
• Expressive language disorder: (1) no speech or absence of communicative speech with nonverbal communication at a higher level than verbal (e.g., pulling others by the hand and leading to what wants) (2) limited reciprocal conversational speech (versus communication in stress-and need-related situations, self directed verbalizations, or speaking on topics of interest to self)
• Atypical vocalizations such as unusual voice quality or modulation, screeching, odd noises, repetitivevocalizations, echolalia, idiosyncratic jargon or speech, preservative speech, sporadic speech (e.g., uttering a word or phrase once and rarely or never saying it again), rote phrases out of context (from the past or videos), nonsensical speech, pronoun substitutions
• Splinter skills: specific abilities significantly above the child’s mental age that often involve (1) rote memory (e.g., identification of numbers, letters, shapes, logos, and colors; singing or humming tunes; memorizing car routes; counting; saying the alphabet; reading; spelling; reciting segments from videos or books). (2) visual, manipulative, or mechanical skills (e.g., completing puzzles, matching shapes, using a computer or VCR), or (3) gross motor skills

MOOD DISTURBANCE

• Overreactivity, irritability, agitation, tantrums, aggression, self-injurious behavior (distressed by input or occurrences most children can tolerate such as intrusions, activity interruptions, proximity, confinement, performance demands)
• Emotional liability with mood changes sometimes internally triggered (e.g., laughing, or becoming upset for no apparent reason)
• Flat affect, unresponsive in some situations
• Unusual fears (e.g., elevators, steps, toilets)

PROBLEMS WITH ATTENTION AND SAFETY

• Selective attention, situational overactivity (e.g. hyperfocused on activities, objects, or topics of interest to self and inattentive at other times)
• Recklessness, limited safety awareness, obliviousto danger (e.g., climbing on things that are unstable or unsafe, wandering about house at night, running off  by self, going into traffic or water, pulling objects over on self such as lamp, TV, or kettle)