Autism usually appears during the first three years of life. It is characterized by impairment in three areas: social interaction, verbal and nonverbal communication, and range of activities and interests.

Difficulty with social interaction may be shown, for example, by failure to cuddle, indifference or resistance to affection or physical contact, and/or lack of eye contact. Sometimes parents mistakenly suspect that the infant or young child is deaf.

Impairment in communication may include absent or delayed language, echolaic language in which the person is only able to repeat what is said to him or her, little or delayed use of gestures or facial expressions to communicate, and/or unusual speech inflection such as a monotone.

In the younger child, a restricted range of interests and activities may show itself in an attachment to just a few objects such as a string or rubber band. The child may have repetitive bodily actions such as incessant hand movements, rocking back and forth, or repeated words. There may be strong reactions to small changes in the environment. The older child may insist on following routines in a precise way and have a low tolerance for frustration.

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