Children with difficulties in relating and communicating may fall within a broad spectrum of disorders that includes language processing disorders, attention disorders, sensory or regulatory disorders, and what are often labeled as autistic spectrum disorders (ASD), such as Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS), Asperger’s syndrome, or autism.  These disorders often involve a number of different underlying problems, including:

• Taking in sensations or information: the child may be under or over reactive to the information received through his senses of vision, hearing, touch, smell, taste and body awareness.
• Processing information: the child may have difficulty understanding or organizing the sensory information he receives.
• Planning or executing responses:  the child may have trouble using his body or his thoughts to respond to the information he has taken in.   

A child may develop unusual or troubling behaviors in response to these difficulties.  For example, a child may be so under-reactive to sensation that he spins in circles in an attempt to increase his sensory input; another child, overwhelmed by the confusing information he’s receiving about his world, may withdraw, finding security in lining up his cars over and over again.  Examples of behaviors parents may observe, by area of difficulty, are:

Relating and emotion

• a tendency to avoid interaction; difficulty paying attention to
• or making eye contact with others
• repetitive statements, play, or behaviors
• failure to develop pretend play
• intense fears about ordinary objects, activities or events
  
  

Language/communication

• problems following simple directions
• echolalia, or repeating what has just been said
• difficulty making needs and desires known by gestures, words or play
  
  

Regulatory and sensory-motor

• difficulty dealing with changes in environment
• avoidance of hugs or light touch
• does not point to show you things
• poor coordination
• “self-stimulatory” behaviors: spinning, hand flapping, head banging
  
  

A child receives a diagnosis based on observation of the behaviors outlined above.  However, though a child may share a common diagnosis with other children, each has a unique pattern of development and functioning.  Each child is unique in his processing of sensory and other information, and his motor planning (the ability to plan and carry out actions).  Some children are over reactive to sensations, such as touch and sound, while others are under reactive.  Some children have relatively strong auditory memories, and can memorize entire scripts; others have relatively strong visual memories.  Some children are able to plan and carry out a number of actions in a row, such as going upstairs, getting a toy and bringing it back down, while others are only able to carry out one action at a time, becoming very fragmented in their behavior.

In addition to differences in sensory processing and motor planning, children differ in their basic mastery of the foundations for relating, communicating, and thinking. Some children with autistic spectrum disorders can form relationships and engage in two-way communication to a limited degree, while others are very self-absorbed and aimless. Some children can focus and attend, and engage with others, but can participate in a back-and-forth flow of communication in only a limited way, finding it difficult to use language meaningfully or connect ideas together for logical and reflective thinking.  Other children show some mastery of the basics, and the ability to engage in more complex communication as well as the ability to create ideas and use them logically, but are very limited in their capacity to apply these abilities to a broad range of situations.  Therefore, while some children may exhibit common symptoms that lead to a diagnosis of an autistic spectrum disorder, their individual patterns – and therefore their paths toward recovery - are quite varied.