Autism Toolbox a resource for Scottish Schools

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Indicators of autism as provided in guidelines by Scottish Intercollegiate Guidelines Network (SIGN):

THESE INDICATORS WILL BE REVIEWED IN 2107 TO REFLECT NEW SIGN GUIDELINE 145

Warnings of possible ASD in school-age children

Warning signs

Communication impairments

  • abnormalities in language development including muteness
  • odd or inappropriate prosody
  • persistent echolalia
  • reference to self as ‘you’, ‘she’ or ‘he’ beyond three years
  • unusual vocabulary for child’s age/social group
  • limited use of language for communication and/or tendency to talk freely only about specific topics

Social impairments

  • inability to join in play of other children or inappropriate attempts at joint play (may manifest as aggressive or disruptive behaviour)
  • lack of awareness of classroom ‘norms’ (criticising teachers, overt unwillingness to co-operate in classroom activities, inability to appreciate or follow current trends)
  • easily overwhelmed by social and other stimulation
  • failure to relate normally to adults (too intense/no relationship)
  • showing extreme reactions to invasion of personal space and resistance to being hurried

Impairments of interests, activities and/or behaviours

  • lack of flexible cooperative imaginative play/creativity
  • difficulty in organising self in relation to unstructured space (eg hugging the perimeter of playgrounds, halls)
  • inability to cope with change or unstructured situations, even ones that other children enjoy (school trips, teachers being away etc)

Other factors

  • unusual profile of skills/deficits
  • any other evidence of odd behaviours including unusual responses to sensory stimuli

ADDITIONAL WARNINGS OF POSSIBLE ASD IN ADOLESCENTS* 
NB difficulties are likely to be more subtle in older individuals or those without learning disability.

Warning signs

General picture

  • long standing difficulties in social behaviours, communication and coping with change, which are more obvious at times of transition (eg change of school, leaving school)
  • significant discrepancy between academic ability and ‘social’ intelligence , most difficulties in unstructured social situations, eg in school or work breaks
  • socially ‘naïve’, lack common sense, not as independent as peers

Language, non-verbal skills and social communication

  • problems with communication, even if wide vocabulary and normal use of grammar. May be unduly quiet, may talk at others rather than hold a to and fro conversation, or may provide excessive information on topics of own interest
  • unable to adapt style of communication to social situations eg may sound like ‘a little professor’ (overly formal), or be inappropriately familiar
  • may have speech peculiarities including ‘flat’, unmodulated speech, repetitiveness, use of stereotyped phrases
  • may take things literally and fail to understand sarcasm or metaphor
  • unusual use and timing of non-verbal interaction (eg eye contact, gesture and facial expression)

Social problems

  • difficulty making and maintaining peer friendships, though may find it easier with adults or younger children
  • can appear unaware or uninterested in peer group ‘norms’, may alienate by behaviours which transgress ‘unwritten rules’
  • may lack awareness of personal space, or be intolerant of intrusions on own space

Rigidity in thinking and behaviour

  • preference for highly specific, narrow interests or hobbies, or may enjoy collecting, numbering or listing
  • strong preferences for familiar routines, may have repetitive behaviours or intrusive rituals
  • problems using imagination eg in writing, future planning
  • may have unusual reactions to sensory stimuli eg sounds, tastes, smell, touch, hot or cold.

* developed by the guideline group based on their knowledge of the evidence base and their clinical experience

 

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