Autism: Symptoms, Complaints, Signs

The following symptoms and complaints may indicate autism:

Autism spectrum disorders (ASD)

Age-independent deficits

  • Social interaction and communication:
    • Interaction disorders refer to the initiation, maintenance and formation of interpersonal relationships in the context of family, friendship, partnership, as well as peers in kindergarten, school and work.
    • Disorders of communication relate on the one hand to language development, on the other hand in particular to non-verbal communication including gestures, facial expressions or gaze behavior. In cognitively well gifted affected also paraverbal performance such as understanding transferred meaning in proverbs and humor or irony.
  • Restricted, repetitive patterns of behavior, interests, or activities include special interests, ritualized daily routines, and a strong aversion to change in one’s circumstances.
  • These phenomena must exist from early childhood and remain present throughout life.

Asperger’s syndrome

Patients with Asperger syndrome (AS) display three core autistic symptoms:

  • “Social interaction disorder”
    • Z. E.g., lack of or limited socioemotional reciprocity; difficulty in informal conversational situations (small talk).
  • “Disruption of communication”
    • Z. E.g., nonverbal signals are understood only to a limited extent or not at all; eye contact, facial expressions, and gestures for communication are used only to a limited extent; transferring meanings of verbal communication (e.g., metaphors, irony) are understood only to a limited extent or not at all
  • “Restricted interests and repetitive behavior patterns”
    • Striking interest in special interests; useless-seeming orderliness preferences; ritualized daily routines and a strong aversion to changes in one’s circumstances.

Every second affected person with AS suffers from comorbid anxiety disorders or depression. The following symptoms and complaints may indicate Asperger syndrome:

  • Delayed motor development
  • Coordination disorders
  • Aloofness
  • Impairment of verbal and nonverbal communication (conspicuous use of language).
  • Contact deficits, both social and emotional (conspicuous eye contact; socially awkward, maladaptive, or odd behavior)
  • Irritability
  • Ritualized routines (as well as time-consuming special interests).
  • Relatively normal mental development
  • Relatively normal intelligence

Other clues

  • Asperger syndrome (AS) can be distinguished from early childhood autism (FA) by the lack of linguistic-cognitive development in the first years of life.
  • In a “mild” autistic symptom expression, social-communicative and interactional deficits can be compensated by high social-cognitive compensatory performance of the affected person.
  • In threshold situations (e.g., moving out of the parental home, career change, partnership desire), the non-intuitive compensation mechanisms are often too rigid.

Diagnostic criteria of Asperger syndrome in adults (according to the ADULT Asperger Assessment (AAA).

Domains Subtopics
A: Qualitative impairment of social interaction (≥ 3 of 5 domains).
  • Significant impairments in the area of nonverbal behavior.
  • Does not want to please others or share his/her experiences
  • Unsuccessful in building relationships with peers
  • Lack of social or emotional reciprocity
  • Problems interpreting social situations or other people’s feelings or thoughts.
B: Restricted, repetitive, and stereotyped patterns of behavior and interests (≥ 3 of 5 domains).
  • Extensive engagement with stereotyped and restricted patterns of behavior.
  • Apparently inflexible pursuit of specific non-functional activities or rituals
  • Stereotypical and repetitive mannerisms.
  • Persistent preoccupation with certain parts of objects/systems.
  • Tendency to “black and white thinking” without being able to flexibly consider various other possibilities
C: Qualitative impairment in verbal and nonverbal communication (≥ 3 of 5 areas.
  • Tendency to talk about oneself or content of interest in every conversation
  • Significant impairment in initiating and maintaining a conversation.
  • Pedantic narrative style or get lost in details
  • Inability to detect interest or boredom in the listener
D: Impairment of imagination (≥ 1 of 3 domains).
  • Lack of spontaneous, varied role-playing (e.g., playing “so-so” games with children)
  • Inability to tell, write or invent stories.
  • Lack of interest in novels or dramas or limited to, for example, science, technology, history
E: Necessary conditions (all ranges):
  • During childhood, there are already abnormalities in each of the areas A to D.
  • Resulting impairments in social, occupational or other important areas of life.
  • In the field of language development, there are no significant delays.
  • Another profound developmental disorder or schizophrenia must be excluded.

Kanner syndrome

Early childhood autism/profound developmental disorder with:

  • Contact disorder
  • Encapsulation
  • Fear of change
  • Monotonous crying of the infant
  • Severely delayed speech development to mutism (speech inhibition).
  • Ability of abstract thinking is significantly limited
  • Motor stereotypies such as repetitive movements.
  • Sensory disturbances such as decreased sensitivity to pain.

Mahler syndrome

  • Symbiotic psychosis: very strong fixation of the affected person to the mother.

Psychogenic autism

  • Reactive autism following severe psychological trauma.

Somatogenic autism

  • Autistic symptomatology that is organically caused by the brain.