Are These Autism Symptoms or Poor Social Skills?

Are These Autism Symptoms or Poor Social Skills
Dr. Roseann Capanna-Hodge

Dr. Roseann Capanna-Hodge

It can be challenging to determine whether certain behaviors are symptoms of autism or simply poor social skills for both parents and professionals. As a neurodevelopmental disorder, Autism Spectrum Disorder or ASD affects communication, social interaction, and behavior. 

Because it is a spectrum disorder, it also affects individuals differently. In addition, its symptoms can range from mild to severe, but all autistics struggle with social skills in some way, shape, or form. 

Poor social skills refer to difficulties in social interactions and social communication. These difficulties may include an inability to understand social cues and body language. Picking up subtle cues like a tone in a person's voice or sarcasm may be missed. 

Autistics also experience difficulty making and maintaining friendships and have trouble expressing themselves effectively in social situations. Good social skills require having back-and-forth conversations, which is a much harder skill to develop for those on the spectrum.

While poor social skills can be a symptom of autism, they can also be present in other conditions. Social anxiety disorder and shyness are good examples. In addition, individuals with autism may also have other symptoms unrelated to social skills, such as repetitive behaviors or sensory sensitivities. Children with ADHD often have social skill deficits as well. 

Poor social skills can be a symptom of autism. However, not everyone with poor social skills has autism. Moreover, those with autism have poor social skills and other symptoms, including restricted interests. 

Here are some factors that can help distinguish between autism and poor social skills:

 

Here are some factors that can help distinguish between autism and poor social skills

1. Frequency and Severity of the Behavior

 

If the behavior is a consistent pattern that occurs in multiple situations and is causing significant impairment, it is likely to be a symptom of autism. Poor social skills, on the other hand, may manifest more inconsistently or only in specific contexts or be related to impulsivity.

2. Age of Onset

 

Autism symptoms typically present in early childhood. It is currently believed that autism is a condition that exists from birth. This disorder is generally not diagnosed until a child reaches 24 months.

However, parents frequently report disturbances or abnormalities before that time (Baghdadli et al., 2003). On the other hand, poor social skills may be more of a developmental delay that can improve more quickly with practice.

3. Other Associated Behaviors Observed by Professionals

 

Other behaviors, such as repetitive movements or obsessive interests unrelated to poor social skills, often accompany autism. While parents can often see these behaviors, sometimes they are more subtle.  A trained professional, such as a psychologist or psychiatrist, can provide a more accurate diagnosis based on observation and assessment.

Autism vs. Poor Social Skills 

 

When autism is compared to difficulty with social skills, what confuses parents and practitioners alike is that, on the surface, they believe that children who struggle with social skills don't have any interest in play or being with other kids. That just isn't the case. A person can lack skills and still be interested in peers. What they lack are well-developed social skills.

People with good social skills excel in reciprocal back-and-forth conversations. That means they understand the nuances of showing interest in others (even when you can't stand the topic) and being able to interpret body language and tone.

For younger children, reciprocal communication is shown in back-and-forth play with other kids. It means that they're able to take turns, and they're able to let another child determine what they're going to play.

When it comes to conversations, their conversations are not one-sided. Kids with good social skills can talk about what others want to talk about, aside from their interests.

Furthermore, somebody who's autistic has restricted interests. That means they may only be interested in talking about what they like. They are inflexible and don't have more profound pragmatic language skills. Furthermore, they don't have the skills to go back and forth in conversations.

For example, a kid was obsessed with trains or baseball statistics. Every conversation they engage in will bring back the topic of trains or baseball. These kids might seem to have the skills to contribute to other topics but can't. That means other kids don't get their needs met, and they often move on to other flexible kids. 

I once worked with a child who was misdiagnosed with ADHD when she had autism. When the school personnel and I observed her, she tried to initiate play 14 times during a 30-minute observation. She tried to play but couldn't stick with playing with others when others were in charge.

The school personnel said, “Look at how engaged she was.” But I said, “She's old enough to join and play, but she couldn't because it wasn't her preferred area.” Her parents had been trying for years to get her the right help, and this observation helped uncover what was happening.

When it comes to kids who have ADHD or are impulsive, they understand the more profound components of social components, but their lack of self-regulation gets in the way. So, they're able to have back-and-forth conversations when they are regulated. What gets in the way is their impulsivity and slowing down enough to be present. 

So when you dig deeper, they can respond and be appropriate. For that reason, many kids get misdiagnosed because, on the surface, many autistic children look like they know what they are doing because they show interest. However, they lack the excellent reciprocal communication skills essential for successful peer socializing.

General Signs of Autism
 

The signs of autism can vary widely from person to person, depending on their assets and deficits. Some common signs of autism include:

1. Delayed or Lack of Speech 

 

Kids with autism may start talking later than other children or struggle with language development and communication.  Poor pragmatic language is a part of autism. 

2. Poor Eye Contact

 

Children with autism may avoid eye contact, have difficulty maintaining eye contact, or not understand its importance in social interaction. It is important to note that many individuals without autism with sensory processing difficulties often have poor eye contact.

3. Difficulty with Social Interaction

 

Kids with autism may struggle to understand social cues and don't engage in typical social behaviors like smiling, sharing, or taking turns. They may be impatient or overly frank in their interactions. 

4. Repetitive Behaviors

 

Kids with autism may engage in repetitive behaviors like hand-flapping or rocking. In addition, they may have obsessive interests in specific topics or objects.

5. Sensory Issues

 

Kids with autism may be overly sensitive or under-sensitive to sensory stimuli, such as sounds, touch, or smells.

6. Difficulty with Changes in Routine

 

Children with autism may have difficulty adapting to changes in routine or unexpected events. Anxiety, rigidity, and sensory issues are factors in their inflexibility. 

Signs of Autism in Boys

Autism Spectrum Disorder affects both boys and girls, but studies have shown that it is more common in boys than in girls. As per the Centers for Disease Control and Prevention (CDC), the prevalence of ASD in boys is about four times higher than in girls. 

However, recent research suggests that autism may be underdiagnosed in girls, as they may present differently than boys and exhibit symptoms less recognized as indicative of ASD (Lai et al., 2015).  

Boys display more coordination issues, which is associated with more significant impairment. And with more significant impairment, boys tend to get identified earlier. 

Girls with ASD may have better social communication skills than boys with ASD but struggle with social interactions. They also have more internalizing symptoms, such as anxiety and depression.

Signs of Autism in Girls

 

Autism in girls differ from boys in a way theirs may be more subtle or masked. Girls with autism also struggle with making and maintaining friendships. But, like boys, they may also engage in repetitive behaviors and exhibit sensory issues. They will also show a strong interest in specific topics and become resistant to change.

Girls with autism may develop strategies to mask or camouflage their symptoms in social situations. They tend to imitate other people's social behaviors or avoid eye contact. It is also more socially acceptable to be “shy” as a female, so the symptoms can be more masked, Especially when they are a good student. For these reasons, autism becomes harder to diagnose in girls. 

What is Stimming?

 

Stimming is short for self-stimulatory behavior and refers to repetitive movements or sounds that individuals with autism engage in. These behaviors are often used to help regulate their emotions or sensory input. 

While stimming behaviors may appear unusual to neurotypical individuals, they can be an important coping mechanism for people with autism. For example, stimming can help autistic children reduce stress and anxiety. It also allows them to self-regulate and assume control of their environment. 

Stimming behaviors can also serve as a way for autistic kids to express themselves non-verbally and release physical energy. It's essential to recognize that stimming is a normal part of these kids and can be an important coping mechanism. It's not necessarily something that needs to be removed or suppressed. 

In some cases, stimming behaviors affect a child negatively, and they may need behavioral support to reduce these behaviors.  Parents may seek ABA therapy to help a child unlearn stimming behaviors and learn replacement behaviors.

It's also vital to provide support and guidance in finding appropriate ways for autistic kids to engage in stimming behaviors. Particularly if these behaviors may harm themselves or others.

Some examples of stimming behaviors that individuals with autism may engage in include:

Some examples of stimming behaviors that individuals with autism may engage

  • Hand flapping
  • Rocking back and forth
  • Spinning in circles
  • Flicking or tapping fingers
  • Repeating words or phrases
  • Clenching and unclenching fists
  • Pacing back and forth
  • Rubbing or scratching the skin
  • Bouncing or jumping up and down
  • Chewing on objects or clothing
  • Humming or making vocalizations
  • Staring at lights or other visual stimuli
  • Snapping fingers or clapping hands
  • Twirling or playing with objects
  • Scratching or rubbing textured surfaces

It's important to note that stimming behaviors can vary widely from person to person with autism. Some kids may also engage in multiple types of stimming.  Stimming behaviors can serve as a way for a child to self-regulate and manage sensory inputs.

Signs of Autism in Babies

 

The signs of autism in babies or children up to 12 months may not be noticeable until later in development. But some early symptoms to watch for may include:

1. Lack of Eye Contact

 

Babies with autism may avoid eye contact or have difficulty maintaining eye contact during social interaction.

2. Delayed or Lack of Babbling or Cooing

 

Babies with autism may not start making typical baby sounds or engage in back-and-forth babbling with caregivers.

3. Lack of Social Smiling

 

Babies with autism may not smile in response to social interactions, such as being smiled at or talked to.

4. Delayed Motor Development

 

Babies with autism may be slower to reach developmental milestones, like walking, sitting up, or crawling.

5. Repetitive Behaviors

 

Babies with autism may engage in repetitive movements or behaviors, such as hand-flapping or rocking.

6. Sensory Issues

 

Babies with autism may be overly sensitive or under-sensitive to sensory stimuli like sounds, touch, or smells.

Early Signs of Autism in Toddlers

 

The signs of autism in toddlers aged between 16 and 18 months may become more noticeable as they develop social and communication skills. For example, toddlers with autism may be slow to start talking or may not start using words at all. They may also be “echoing” words and phrases as a primary means of communication. 

They may also fail to engage in typical social behaviors, such as making eye contact, sharing, or taking turns during play. Toddlers also do repetitive movements or behaviors, such as hand-flapping, rocking, or spinning objects. 

Some toddlers with autism may not seem interested in playing with toys. They may also play with their toys in unusual or repetitive ways. They may also struggle with imaginative play, such as pretending to be a character or engaging in make-believe scenarios.

Toddlers with autism also experience greater sleep difficulties, gastrointestinal difficulties, and sensory food aversions. These sensory issues can lead to “picky eating” or ARFID. 

Furthermore, toddlers with autism may be overly sensitive or under-sensitive to sensory stimuli, such as sounds, touch, or smells. They also need help adapting to changes in routine or unexpected events. These kids also need help transitioning, so they exert too much effort to move from one activity or task to another.

Examples and Signs of Autism in a 2-year-old Child 

 

If you observe an autistic child 24 months of age, you'll likely notice his disinterest in certain toys. Moreover, they might be playing with them repeatedly or unusually. They might also have little to no speech, leading to difficulty in understanding what they need or want. 

Autistic kids rarely respond when called by their names. They are not interested in playing with other children or making eye contact. These kids would rather keep to themselves and flap their hands, spin their toys, or line up things.  

The child may also be sensitive to sensory stimuli like sounds, touch, or smells. They may also have difficulty transitioning from one activity to another and become upset when routines change.

How Do You Know if Someone is Autistic or Just Lacking Social Skills?

 

It can be challenging to distinguish between autism and poor social skills, as some symptoms may overlap. For starters, autism symptoms typically appear in early childhood, while poor social skills may develop later in life.

Children with autism may have difficulty recognizing and interpreting social cues like tone of voice, facial expressions, and body language. As a result, they need help understanding other people's emotions and intentions.

Kids with autism also have difficulty communicating their thoughts, feelings, and needs to others. They may need help starting conversations, staying on topic, and responding properly to questions or comments.

These kids may also have sensory sensitivities or difficulties with sensory processing. For example, they may be over or under-sensitive to touch, sound, or light. It can make social situations overwhelming and uncomfortable for them.

Furthermore, autistic children have limited interests and engage in repetitive behaviors. As a result, they need help to connect with others who do not share their interests. These challenges can make it harder for these children to form and maintain relationships.

They also don't participate in group activities or navigate social situations. However, with support and understanding, autistic children can learn and develop social skills to improve their social interactions.

Children with poor social skills without autism typically may show delays but respond to support. They also understand the nuances of the social world and can be appropriate when they slow down. Poor impulse control or emotional regulation often is at the nexus of the difficulty. 

Whereas with autism, they lack understanding and are slow to learn or even unable to learn the skills.

Why is Social Interaction so Hard for Those with Autism?

 

Social interaction can be challenging for autistic kids because their disorder affects how their brain processes information, including social information. Since they also have difficulty recognizing and interpreting body language, tone of voice, or facial expressions, it isn't easy to understand other people's emotions and intentions.

Additionally, autistic kids struggle to communicate their thoughts, feelings, and need to others. As a result, they need help starting conversations, staying on topic, and responding correctly to questions or comments. 

Their sensory sensitivities or difficulties also come in the way. For example, because they are over or under-sensitive to touch, sound, or light social situations can be overwhelming and uncomfortable. 

Their restricted or limited interests also make it difficult for them to connect with others who do not share their interests. But with support and understanding, individuals with autism can learn and develop social skills to improve their social interactions.

Can Someone with ASD Have Good Social Skills?

 

Individuals with ASD can have good social skills when given extra effort and support. It is all about making the implicit explicit. Social skills need direct instruction, and autistics need a lot of practice. 

Autism is a spectrum disorder, meaning children with ASD can vary widely in their abilities and strengths. While some kids with ASD may struggle with social interaction and communication, others may have strong social interests. However, they may also experience difficulties in other areas, such as anxiety or group sports. 

Some individuals with ASD may have learned social skills through therapy or other interventions. They can use these skills effectively in social situations. 

Others may have a natural talent for social interaction, despite experiencing some of the other symptoms of ASD. It is also essential to recognize that social skills can vary depending on the situation and an autistic's comfort level. Individuals with ASD may have different comfort and skill levels in different social contexts.

How can Autistic Kids Learn Better People Skills?

 

Kids with ASD can learn better people skills through therapies, interventions, and practice. Here are some strategies that may help:

1. Social Skills Training

 

Social skills training involves teaching kids with ASD specific skills related to social interaction. They learn to initiate and maintain conversations, read social cues, and adequately express emotions. This training can be done personally or in group settings, and this should be a long-term strategy because of the amount of practice one needs.

2. Role Playing

 

Role-playing involves practicing social skills in a safe and controlled environment. It can help individuals with ASD learn to handle different social situations and develop confidence in their abilities.

3. Video Modeling

 

Video modeling involves watching videos of people engaging in social interactions and imitating their behavior. It can help kids with ASD learn appropriate social behavior and communication.

4. Cognitive-Behavioral Therapy (CBT)

 

CBT can help individuals with ASD learn to identify and manage their thoughts, feelings, and behaviors in social situations. As a result, it can improve their social skills and reduce anxiety and stress.

5. Social groups

 

Social groups provide a supportive environment for parents with autistic kids to help them practice their child's social skills. It also encourages interaction with others with similar experiences. It can help build social confidence and develop friendships in a safe space.

6. Neurofeedback

 

Neurofeedback is a type of therapy that uses real-time monitoring of brain activity to help individuals with autism regulate their brain waves and improve their ability to self-regulate their emotions, behavior, and attention.

Neurofeedback may help improve communication between different parts of the brain and promote more excellent synchronization of brain waves. It may also help reduce hyperactivity and improve attention and focus. One study found that children with autism who received neurofeedback therapy improved language, social communication, and cognitive function (Sokhadze et al., 2014).

It is important to note that neurofeedback should be part of a comprehensive treatment plan that includes other interventions such as behavioral therapy, social skills training, and speech therapy.  Neurofeedback calms the brain, so a child on the spectrum can be more mentally available for new learning. 

7. CALM PEMF™

 

PEMF therapy can help reduce hyperactivity, improve sleep, and enhance communication and social interaction in individuals with autism. It may help normalize brainwave activity and increase the production of certain neurotransmitters, which can improve cognitive function and alleviate symptoms of autism. 

PEMF therapy uses low-frequency electromagnetic waves to stimulate cells and tissues in the body, promoting healing and regeneration. Some studies have shown positive results in using PEMF therapy for treating conditions, such as pain, inflammation, and depression (Uzunca et al., 2007).

How Does Autism Affect You Socially?

 

ASD can affect a child's social skills in various ways. For starters, they find engaging in conversations and building relationships challenging. They need help starting and maintaining small talk, making eye contact, and taking turns. 

Furthermore, they find it difficult to imagine the thoughts and feelings of others. As such, it becomes challenging for them to understand others' perspectives and engage in social situations. 

Children with ASD's sensory sensitivities also make social situations overwhelming and uncomfortable. For example, they avoid parties and concerts because they are sensitive to loud noises and bright lights. Sometimes these sensory difficulties can make an autistic very physically uncomfortable, which can be observable to others but may be misunderstood. 

What's the Link between ASD and Poor Social Skills?

 

What's the Link between ASD and Poor Social Skills

A study by Frye (2018) discusses the link between ASD and poor social skills. This includes deficits in social communication, repetitive behaviors, and restricted interests. The research reviews the biological origins of social function deficits associated with ASD, including abnormalities in brain circuits.

Brain growth in some people with ASD seems to increase during the first years of life. It is followed by sudden diminishment by early childhood, linked to increased brain volume, non-neural tissue, and extra-axial fluid. The study also discusses the association of tics and repetitive movement with basal ganglia and their response to antipsychotic medications.

Understanding what is behind your child's poor social skills may be confusing but the bottom line is that when a child struggles socially, they will benefit from direct support. Kids should be explicitly taught social skills and receive a lot of supported practice. The children that I have seen do the best in their life are those that received long-term social skills training. 

Citations

Baghdadli, A., Picot, M. C., Pascal, C., Pry, R., & Aussilloux, C. (2003). Relationship between age of recognition of first disturbances and severity in young children with autism. European Child & Adolescent Psychiatry, 12(3), 122–127. https://doi.org/10.1007/s00787-003-0314-6

Frye, R. E. (2018). Social Skills Deficits in Autism Spectrum Disorder: Potential Biological Origins and Progress in Developing Therapeutic Agents. CNS Drugs, 32(8), 713–734. https://doi.org/10.1007/s40263-018-0556-y

Lai, M.-C., Lombardo, M. V., Auyeung, B., Chakrabarti, B., & Baron-Cohen, S. (2015). Sex/Gender Differences and Autism: Setting the Scene for Future Research. Journal of the American Academy of Child & Adolescent Psychiatry, 54(1), 11–24. https://doi.org/10.1016/j.jaac.2014.10.003

Sokhadze, E. M., El-Baz, A. S., Tasman, A., Sears, L. L., Wang, Y., Lamina, E. V., & Casanova, M. F. (2014). Neuromodulation Integrating rTMS and Neurofeedback for the Treatment of Autism Spectrum Disorder: An Exploratory Study. Applied Psychophysiology and Biofeedback, 39(3-4), 237–257. https://doi.org/10.1007/s10484-014-9264-7

Uzunca, K., Birtane, M., & Taştekin, N. (2007). Effectiveness of pulsed electromagnetic field therapy in lateral epicondylitis. Clinical Rheumatology, 26(1), 69–74. https://doi.org/10.1007/s10067-006-0247-9

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She is the founder and director of The Global Institute of Children’s Mental Health and Dr. Roseann Capanna-Hodge. Dr. Roseann is a Board Certified Neurofeedback (BCN) Practitioner, a Board Member of the Northeast Region Biofeedback Society (NRBS), Certified Integrative Medicine Mental Health Provider (CMHIMP) and an Amen Clinic Certified Brain Health Coach.  She is also a member of The International Lyme Disease and Associated Disease Society (ILADS), The American Psychological Association (APA), Anxiety and Depression Association of America (ADAA) National Association of School Psychologists (NASP), International OCD Foundation (IOCDF) International Society for Neurofeedback and Research (ISNR) and The Association of Applied Psychophysiology and Biofeedback (AAPB).

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Disclaimer: This article is not intended to give health advice and it is recommended to consult with a physician before beginning any new wellness regime. *The effectiveness of diagnosis and treatment vary by patient and condition. Dr. Roseann Capanna-Hodge, LLC does not guarantee certain results.

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