Behaviors and the 12-symptom checklist for Autism

True or False? All people who have behaviors of stimming (i.e. hand flapping), echoing, spinning and perseveration (i.e. lining up objects, subject fascination) are in the autism spectrum. The answer is false. These characteristics are byproducts of autism. In fact, a child or adult displaying one or more of these issues may indicate that the individual has sensory processing challenges or gross motor issues, not autism.
According to the American Psychiatric Association, a diagnosis of autistic disorder is made when an individual displays 6 or more of 12 symptoms in three major areas of social interaction, communication and behavior. The checklist is from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSMIV). If a child displays some but not all of the criteria, he may receive a PDD-NOS diagnosis which is a diagnosis within the autism spectrum, too. Delays or abnormal functioning in social interaction, language as used in social communication and symbolic or imaginative play should occur in at least one of these areas prior to age 3. The autism definition in the upcoming Fifth Edition of the DSM is being revised and will be changing. In the meantime, the current 12-symptom checklist is as follows:
1. Social Interaction: (at least two from this area):
a) marked impairment in the use of nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction b) failure to develop peer relations appropriate to developmental level c) lack of spontaneous seeking to share enjoyment, interests, or achievements with other people d) lack of social or emotional reciprocity (example: not actively participating in simple social play or games, preferring solitary activities or involving others in activities only as tools)
2. Communication: (at least one from this area)
a) lack of or delay in the development of spoken language b) individuals with adequate speech show a marked impairment in ability to initiate or sustain conversation with others c) stereotyped and repetitive use of language or idiosyncratic language d) lack of varied, spontaneous make-believe play or social imitative play at appropriate developmental level
3. Restricted repetitive behavior and stereotyped behavior patterns: (at least one from this area)
a) all encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal in either intensity or focus b) inflexible adherence to specific, nonfunctional routines or rituals
c) stereotyped and repetitive motor mannerisms (such as hand flapping, finger flapping etc.) d) persistent preoccupation with parts of objects
Typically, children with ASD will display some stimming, echoing, perseveration and in certain cases spinning characteristics, too. Echo laic behavior may disappear within time for children with ASD as they develop more speech abilities. Stimming, however, may not necessarily disappear with time. Stimming, such as flapping of hands, helps a child with ASD deal with high anxiety situations. Lucas was one child who frequently stimmed. He was a bright child with high functioning autism. The boy had extreme stimming issues from a very early age. As he grew older, his stimming would sometimes increase in the classroom, depending on the day. General education classes were very challenging for the boy because of so many unexpected events each day. For example, if a child finished an activity before he did, Lucas would get up out of his desk and begin flapping. When children were absent in the classroom, it made Lucas nervous because a desk was suddenly empty. Lucas would even get anxious if books were moved out of order in the classroom library, which happened almost every day. Going to school became exhausting for the boy because of all the unpredictability that occurs during a normal classroom day.
There are instances when stimming can be harmful. When stimming is causing harm to an individual or extremely distracting, occupational therapy and Applied Behavior Analysis (ABA) can be applied to lessen its impact. Stimming itself is a part of the sensory processing dysfunction usually associated with autism. Medications can help lessen some of the stimming that results from high anxiety that may occur in certain social situations. Stimming, echo laic behavior, preservation on certain areas of interest and even spinning, when understood, can all be modified and lessened to help an individual to function better in his daily environment. In fact, an ASD child’s perseveration and love for certain subject areas can be applied to better our quality of life because of the individual’s persistence to obtain exact information.
Pamela Gross Downing, a special education teacher, can be reached at .