Today it was revealed that children across the UK are waiting up to four years to be diagnosed with autism.
Ministers slammed the ‘harmful’ delays because they can stop children ‘getting the help they need in other aspects of their lives’.
So what does autism look like in children?
Some infants show hints in their first months. In others, behaviours don’t become obvious until they’re toddlers. Some don’t show any signs at all.
Here, Dr Punit Shah, a professor in psychology and expert in neurodiversity from the University of Bath, breaks down some of the potential giveaway signs…
For many children with autism avoiding eye contact during a conversation helps to reduce anxiety, experts say
Avoiding eye contact
Not giving eye contact during a conversion is one sign your child may have autism.
That’s because for many children with autism avoiding eye contact helps to reduce anxiety, explains Dr Shah, who appeared on the first episode of the 2023 BBC docuseries ‘Inside Our Autistic Minds’ presented by Springwatch host Chris Packham.
‘The reasons for why some autistic people avoid eye contact vary and not all autistic people do avoid it,’ he added. ‘For some that do, it is to reduce anxiety, which helps them to manage better in social situations.’
It can also help children with autism better understand a social situation by reading the person’s facial expressions.
Dr Shah said: ‘For others, it can help them process other stimuli better, without the complexity of the social information from the eyes and face.’
Sensory sensitivity
Becoming distressed at loud noises is one sensory difference often noticeable in children with autism.
These sensory sensitivities can make it hard to filter out irrelevant noises making it hard not to become uncomfortable or distracted leading to an overwhelming feeling.
‘Generally speaking, autistic children have sensory sensitivities to different things,’ Dr Shah said.
‘This can often be to predictable things, like bright lights and loud sounds, but also unusual colours and patterns.
‘It really depends on the person.’
Speech difficulty
Echoing words and phrases, not talking as much as other children and talking ‘at’ others are all signs of autism.
Dr Shah said: ‘Speech is generally a bit delayed in autistic children, but not always.
‘Another sign can be repetitive sounds or speech – sometimes known as echolalia – which can be a feature of autism.’
Taking language very literally is also a communication difficulty that autistic children often struggle with, according to the NHS.
For example, they may not understand phrases like ‘break a leg’ and instead take it too literally.
Communicating what they want can also prove to be a challenge for some autistic children.
Charity Child Autism UK gives the example of taking an adult to the biscuit tin rather than asking or pointing.
Children with autism who like routine and show signs of repetitive behaviour may play with the a toy in the same way each time or line items up
It can be harder for children with autism to make friends and they often chose to play alone, according to Child Autism UK
Repetitive behaviour
Preferring a very strict daily routine and getting upset if it changes is a sign of autism in children, the NHS says.
Dr Shah explains this need for routine can present itself in different ways and can be idiosyncratic, meaning children will have unusual habits or ways of behaving.
However, this does depend on the individuals interests and needs.
‘Typically, this can take the form of needing the daily routine to be predictable based on timing of daily activities,’ he said.
Children with autism who like routine and show signs of repetitive behaviour may play with the a toy in the same way each time or line items up, according to Child Autism UK.
The charity highlights that signs can also include ‘being restrictive around certain activities such as eating only yellow food, watching the same programme over and over or only wearing a favourite jumper’.
Repetitive movements
It’s not just a repetitive routine, children with autism can also do the same movements on repeat.
In young children this could present itself as flapping their hands, flicking their fingers or rocking their body, the NHS says.
However, children may also want to seek out specific visual or auditory experiences, Child Autism UK says.
The charity suggests this could be relative actions such as spinning wheels on a toy train, looking at the bars of a fence, or listening to the themes tunes of favourite programmes.
Misunderstanding emotion
It can be harder for children with autism to make friends and they often chose to play alone, according to Child Autism UK.
Some children may also struggle to say how they feel and sometimes do not understand what others are feeling, the NHS says.
However, misunderstanding emotion and not seeming to understand what others are thinking or feeling can be a sign of several conditions.
Dr Shah said: ‘This really depends on the person and can often be related to conditions that overlap with autism, such as alexithymia (or emotional blindness) rather than autism itself.’
This can also present itself differently in young girls with autism as they may hide some signs of autism by copying how other children behave and play, the NHS says.
Many girls with autism also appear to cope better with social situations, but this could be because they are copying other children.
‘Although we know there are sex differences in autism, these are not well understood,’ Professor Shah said.
‘Because the very diagnostic criteria of autism have been shaped mostly by clinical observation of boys, we are still very much learning what autism “looks like” in girls. This will take time.
