| Impairments in social communication and interaction |
| Impaired verbal and nonverbal communication |
- Lack of, delay, or regression in spoken language.
|
- Spoken language, if present, may be atypical. For example:
- Unusual intonations (monotone, sing-song).
- Echolalia.
- Incorrect pronoun use (referring to self by name or as "you," "he," or "she" after age 3 years).
- Non-speech-like vocalizations (eg, grunting, squealing).
- Limited to specific topics of interest.
|
- Limited use of language for communication (eg, using only single words even though capable of speaking in sentences).
|
- Lack of response or slow to respond when called by name (despite normal hearing).
|
- Reduced or absent nonverbal communication (eg, gestures, facial expression).
|
| Impaired social-emotional reciprocity and inability to establish peer friendships |
- Little or no response to others' gestures or facial expressions.
|
- Reduced or absent interest in or attempts to share interest with another person (eg, by pointing or monitoring the other's gaze). For example:
- Lack of social smile or eye contact.
- Lack of imitation (eg, clapping).
- Limited or absent social bids.
- Lack of ability or interest in sustaining a social interaction.
- Resistance to being cuddled.
|
- Lack of awareness of other people; appearing to focus inward or "be in their own world."
|
- Preference for solitary play (lack of initiation or participation in social play with others).
|
- Lack of interest in other children or odd social approaches to other children (eg, disruptive, aggressive).
|
- Lack of awareness of common social conventions (eg, taking turns in a conversation, awareness of personal space).
|
- Lack of or minimal recognition or responsiveness to another's feelings (eg, happiness, distress).
|
- Other atypical interactions with peers or adults. For example:
- Normal or even exaggerated level of motivation to socialize, with limited ability to infer the intentions or behaviors of others.
- Unable to sustain mutually enjoyable social interactions due to an inability to respect social conventions (eg, personal boundaries) or to anticipate the knowledge and interests of others (eg, may talk only about preferred interests and not engage in the social partner's interests).
|
| Repetitive behaviors/restricted interests and atypical sensory reactions* |
- Repetitive/stereotyped motor and vocal mannerisms (eg, hand flapping, rocking behaviors, echolalia).
|
- Resistance to change, insistence on following the same routines.
|
- Re-enacting or repeating scenes or scripts that have been heard (eg, from videos or cartoons).
|
- Atypical play:
- Repetitive (eg, lines up objects, opens and closes doors, turns lights on and off).
- Lacking imaginative/creative play.
- No pretend play (eg, feeding doll).
- Over-attention to parts of objects (eg, spinning wheels).
|
- Lack of or unusual reaction to sensory stimuli (eg, noise, texture, smells).
|
