![]() Similarly, restricted and repetitive behaviors (RRBs) are diagnostic features of ASD ( American Psychiatric Association, 2013), but are also seen in children who do not have ASD. Impairments in social engagement, including delayed abilities to direct and follow the gaze or point of others, and impaired response to name, are present not only in children with ASD but also in some children with significant cognitive delays who do not have ASD ( Mundy, Sigman, & Kasari, 1994 Trillingsgaard, Sørensen, Němec, & Jørgensen, 2005). ![]() For example, language delays are the most common reason for referral of young children with ASD, but are also a common concern in children with other developmental disorders ( Coonrod & Stone, 2004 Richards, Mossey, & Robins, 2016)Īlthough social communication symptoms are often considered to be “hallmarks” of ASD, and these behaviors appear to differentiate diagnostic groups at a group level, they may also be seen in children who are not later diagnosed with ASD, and must be considered carefully when diagnosing individual children. In fact, many of the early atypical behaviors that have been identified in very young children with ASD are also present to some degree in other, non-ASD developmental disorders. Group differences in ASD symptoms are usually determined by comparing mean differences, which limits their relevance for clinicians evaluating individual children, who must judge degree of symptoms and delays as well as differential diagnosis of ASD vs. Similarly, RRBs are a clear feature of ASD that emerge early ( Wolff et al., 2014) with frequency and severity changing with age ( Esbensen, Seltzer, Lam, & Bodfish, 2009).Īlthough these early symptoms of autism spectrum disorder (ASD) have been well characterized ( Ozonoff et al., 2010 Zwaigenbaum, Bryson, & Garon, 2013), the extent to which they are present in young children with other developmental disorders - or those with typical development - is unclear. Many social communication symptoms - including limited social smiling and gaze to faces, directed vocalizations and facial expressions, sharing interests, response to name, and use of nonverbal communication - have been shown to differentiate ASD from typically developing children and from those with developmental delays by 20 months ( Dow, Guthrie, Stronach, & Wetherby, 2017), with some differences emerging as early as 12 months ( Ozonoff et al., 2010). ![]() The diagnosis of autism spectrum disorder (ASD) is based on the presence of behavioral symptoms in two areas: social engagement and communication, and restricted and repetitive behaviors (RRBs). ![]()
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