For convenience, I'll just follow along with the wikipedia article on Autism using the characteristics it describes. I'll then compare his "flavour" of autism with the new redefinition of Autistic Disorder.
His speech was delayed and he had only begun rudimentary speech at 18 months. Kenshin began to exhibit signs of noticeable developmental delay at age two. Walking was somewhat delayed, but within "norms" for boys.
Social Development
Aside from speech delays, we noticed that Kenshin did not typically register social greetings (hello, goodbye, how are you) and would not generally wave. He would only infrequently make eye contact. This is apparently typical for many autistic children. Although he went through a period of "screaming", this was not typically a tantrum in the commonly understood sense - in that he was reacting to not getting something he wanted, but he would scream when something he didn't like (certain foods, foods with sauce on them) was placed too close. Asking for things and looking someone in the eye while doing so is difficult for him. He will generally take an object if available without asking. This is problematic when trying to play with other children.
He was (and is) generally a "fearless" kid - he doesn't seem to mind wandering off from us (the parents) or other caregivers - he exhibits less need for attachment than peers his age.
Turn taking is also a problem, though he is slowly learning how that works through repetition and reinforcement.
He does not appear to be lonely; generally he seems quite happy to play independently, but I have noticed a preference to play in the vicinity of other children or adults. He will come into the room, situate himself within 1.5-3 metres, and then play on his own. If you move, he will tend to move to maintain that distance - close enough to be aware of your presence, but far enough not to be playing together. He will ask us as parents to accompany him to a different room while he plays, not necessarily to play with him, although he will now phrase it as "playing with me".
As he has grown, he has begun to seek out more interaction with other children, often by "clowning" or chasing. Interactive play is possible but usually only with prompting. He is beginning to interact more spontaneously with playmates, but progress is slow.
He is generally not aggressive at all; in fact I would characterize him as being a pretty peaceful child with a fairly even temper.
All of these aspects of social behaviour are fairly typical for autistic children of Kenshin's age.
Communications
As mentioned above, Kenshin was delayed in developing speech, and is probably currently speaking at a 2.5 to 3 year-old level (he is currently four and a half). As noted on this blog, development was very slow, with occasional bursts of advancement. We have noticed he has particular difficulty processing questions like "Why are you sad?" or "Why did you take that?" and also reverses pronouns (yours/mine, me/you), especially in questions or situations which deal with concepts of self. Joint attention is problematic, but not as much as it seems to be with some children, and inability to point or misunderstanding pointing is not as pronounced as would seem to be typical with other autistic children; he will generally understand what you mean when you point to something, though he will seldom indicate things by pointing himself.
I have noticed that he will repeat others' words or his own words in situations where he doesn't seem to understand what is being asked of him. This echolalia is most easily replicated by asking him a complicated "why" question; for example, "Why did you throw the jar of jam down the stairs?" - he will say in answer: "I throw the jar of jam down the stairs." On other occasions, he seems to be repeating words quietly to himself (sotto voce) for the pleasure of hearing the words again, or to reinforce something he has heard - not in response to a question or a situation, but because he wants to say the words to himself.
For example: He will be sitting in bed, quietly, and he will say, apropos of nothing, "Rainbow fish gives his tail," very quietly to himself. A few minutes later he will say the same thing. Marli and I jokingly refer to this as the "creepy movie kid voice". Fortunately he doesn't say things like, "When Mars is ascendant in the house of Ares, my unholy father will come to destroy the world," or else it would be a little too creepy.
In most respects his communications are typical for an autistic child, with the exceptions as noted above.
Behaviour
If there is one category that I would say Kenshin is most atypical for an autistic child, it is behaviour.
He does not engage in stereotypy - repetitive movement "such as hand flapping, making sounds, head rolling, or body rocking." There are one or two hand configurations, flexing his index finger underneath the tip of his middle finger and splaying out the little finger - looking a little like a an Buddhist mudra, which I have seem him do when he is somewhat anxious about something or wants something.
There is little compulsive behaviour - he does not line things up in a specific pattern, or stack things or make sure things are done in a specific order. Our developmental specialist did note that there is an aspect of clinical "compulsion" to his behaviour, but it is atypical in its manifestation.
He does not require sameness - we can switch up his daily routine or the positions of objects in the house with zero complaint from him. He does tend to resist being interrupted at times, but only slightly more so than I would expect from a neurotypical child.
I have only observed a few rituals - when I drop him off in the morning, after he takes off his coat and boots, he will invariably say "hug" (give me a hug) then say, "then a kiss," (and give me a kiss) and then say, "aaaand done," then walking determinedly (and without looking back) to join his peer group. However if we cannot perform this ritual or it is interrupted, it does not seem to phase him. I haven't seen many other rituals - perhaps Marli will chime in with some.
Restricted behaviour he has in spades. He only wants to play on the iPad or one of our game systems (PS3 or Gamecube), or on the computer. He will ask for it repeatedly, from the moment he gets up until he goes to bed. We allow him approximately 30 minutes per day. He would play all day, given the chance. This is one of the more worrisome (and stressful), not to mention socially embarassing behaviours he exhibits. It gives us the appearance of absentee parents, content to let him know nothing other than video games.
He does not self-injure to any extreme degree, though I have seen him bonk his head on walls as a joke for his brother or to act the clown.
Other Symptoms
Kenshin is sensitive to bright light or loud sounds, but actually doesn't mind bright light once established (in fact, he will sometimes become agitated if we turn off a light in a brightly lit room when there are two light sources on). Sudden loud noises seem to startle him, and he will turn down a TV if he finds it too loud. We have had his hearing tested and he is well within norms (in some frequencies, better than normal) for his age group.
He used to show poor coordination and muscle tone, but as he plays more often in parks and runs, this awkwardness is less pronounced. He's actually quite nimble on monkey bars and climbing equipment, and aided by his obliviousness to injury or danger, he seems quite proficient where some neurotypical children would balk or otherwise perform poorly.
Kenshin dislikes certain sauces, mixtures and presentations of foods. For example he will not eat hamburgers or hotdogs with anything on them - even the slightest appearance of ketchup or mustard will elicit complaint or, if there is a lot of sauce, tears. He seems to love Kraft dinner macaroni and cheese, which has a sauce component which doesn't bother him, but he balks at homemade macaroni and cheese, which is apparently "too saucy". Curiously, he is fine with pasta and meat sauce/ragus, despite its saucy nature. If he sees Daigoro with a burger or hotdog with sauce, he will immediately say "I don't want sauce on mine."
He used to be dead-set against vegetables, but he is much more accepting now. He loves rice (he will wolf it down) and most meat.
A common complaint, when he doesn't like the food, is "I want plain food." Marli and I believe this is a reaction to flavours and textures which may be too intense for him. Strangely he seems more tolerant of "spice" - spciy hot - than other kids. I've seen him eat some spicy chips and other salty snacks which I would have assumed would send him screaming for water, but he simply sits and munches away happily. I don't know how to reconcile this with his sensitity to other common spices like basil or oregano. For example, he recently ate a number of cinnamon hearts happily, while his brother was fanning his mouth and asking for water after eating two.
We have progressed to the point where he can eat a relatively nutritious meal, though I would still prefer more variety and less salty, pre-prepared foods.
He definitely has no appetite problems - presented with food he likes, he will eat voraciously. I am not aware of gastrointestinal issues.
Amusingly/ironically Kenshin never really ran around on his toes (apparently one common indicator), but Daigoro did.
Some children with autism have sensitivity in varying degrees to being touched. To my everlasting relief, Kenshin is a huggy, touchy-feely kid who doesn't mind being touched or hugged.
The proposed new AMA definition of Autistic Disorder:
Autistic Disorder
A. A total of six (or more) items from (1). (2), and (3). with at least two from (1) and one each from (2) and (3):
(1) qualitative impairment in social interaction, as manifested by at least two of the following:
a) marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression. body postures, and gestures to regulate social interaction
b) failure to develop peer relationships appropriate to developmental level
c) a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g. by a lack of showing, bringing or pointing out objects of interest)
d) lack of social or emotional reciprocity
(2) qualitative impairments in communication as manifested by at least one of the following
a) delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)
b) in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
c) stereotyped and repetitive use of language or idiosyncratic language.
d) lack of varied, spontaneous make-believe play or social interactive play
(3) Restrictive repetitive and stereotyped patterns of behavior, interests, and activities as manifested by at least one of the following:
a) encompassing preoccupation with one or more stereotyped andrestricted patterns of interest that is abnormal either in intensity or focus
b) apparently inflexible adherence to specific, nonfunctional routines or rituals
c) stereotyped and repetitive motor mannerisms (e.g. hand or finger flapping or twisting or complex whole body movements)
d) persistent preoccupation with parts of objects
B. Delays or abnormal functioning in at least one ofthe following areas. with onset prior to three years (1) social interaction, (2) language as used in social communication, or (3) symbolic or imaginative play.
C. The disturbance is not better accounted for by Rett's Disorder or Childhood Disintegrative Disorder.
So, in looking at these in order:
Section A:
1 a) applies
1 b) applies
1 c) partially applies
1 d) applies
2 a) applies
2 b) applies
2 c) applies to some extent
2 d) applies
3 a) applies
3 b) does not apply
3 c) does not apply
3 d) does not apply
Section B:
All three categories apply.
Section C:
Rett's Disorder or Childhood Disintegrative Disorder does not seem to account for the disturbance.
So, even by the new AMA definition, Kenshin could be classified as having austistic disorder.
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