Sign guidelines
| Additional warnings of possible ASD in adolescents*: warning signs |
| General picture |
| Difficulties in social behaviours, communication and coping with change, long standing and 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) |
NB: difficulties are likely to be more subtle in older individuals or those without learning disability. Reproduced with permission from Scottish Intercollegiate Guidelines Network (SIGN).7
*Developed by the guideline group based on their knowledge of the evidence base and their clinical experience.