It is beyond the scope of this article to address the clinical presentation of children with an ASD diagnosis. Moreover, as mentioned, both gender and individual differences must be taken into account. Within the ASD community, there is increasing awareness that the clinical presentation of girls and women varies from that of boys and men.

A characteristic feature or hallmark of autism is experiencing difficulty or impairment with social interaction and communication. There may be discomfort with eye-contact or touch, difficulty with initiating small talk or maintaining a conversation and other difficulties that may become apparent in attempting to form close relationships or shying from them. 

The ASD individual is often preoccuppied with deciphering and making sense of the other person’s intentions and verbal and nonverbal communications and may misinterpret some of them e.g., perhaps taking them at face value in a naive or literal fashion. People with ASD diagnoses tend to be mentally and emotionally overloaded by the very same social/relational processes which neuro-typical individuals might enjoy. Grandin, a scientist living with ASD, described feeling like “an anthropologist on Mars” in her attempts to make sense of the humans around her. 

The constant struggle to and inherent frustrations of trying to understand and keep up with others in varying contexts may lead to a difficulties with self -regulation. Moreover, in their struggle to belong, some individuals will invest considerable energy in “masking” or “camouflaging” their difficulties, in order to “pass” as apparently normal, even though they may feel quite alienated. Eventually, this may lead to what has been described as “autistic burnout or shutdown.” Whereas people with ASD may lack verbal skills, their visuospatial skills may be exceptional (Grandin, 1996).

In order to feel safe, ASD individuals are dependent on an established routine and tend to have trouble with unexpected changes. Certain ritualistic behaviors may emerge to provide cobtinuity of experience and bolster safety. In some cases, people with ASD may develop a great interest in a particular topic, and perhaps embark on a monologue on the subject, regardless of the degree of interest (or lack thereof) the other may exhibit.

It is crucial to differentiate between autism and other conditions. For example, it is important to differentiate between what we commonly refer to as depression in a neuro-typical individual and what some autistic people might refer to as “autistic shutdown,” a much-needed resting period in order to recover from the tremendous effort of engaging in everyday activities in over-stimulating environemnts, such as shopping for food in a large supermarket, working or attending a social event, whther big or small.

As with many medical or psychological conditions, there is also the possibility of co-morbity or overlap.