Autism Spectrum Disorder

Autism can look very different from one child to another.

Parents may notice differences involving:

• Social connection or friendships
• Understanding social cues or navigating complex social situations
• Back-and-forth conversation
• Sensory sensitivities or sensory-seeking behaviors
• Strong or highly focused interests
• Difficulty with changes, transitions, or uncertainty
• Repetitive movements or behaviors
• A strong preference for routines or predictability
• Emotional or behavioral dysregulation
• Exhaustion after school or social interactions
• Difficulty managing everyday expectations despite strong intellectual abilities

Some children have significant developmental, communication, behavioral, and adaptive needs that make autism apparent relatively early.

For others, the picture is much less obvious.

Not every autistic child fits the stereotypical picture of autism.

Some children and adolescents learn to mask or compensate for their differences. They may observe and imitate peers, rehearse conversations, rely on learned social rules, suppress repetitive behaviors, force eye contact, or work extremely hard to appear comfortable in situations that actually require significant effort.

This can be particularly important when evaluating girls, highly verbal children, academically strong students, and socially motivated children and teens. A child may have friendships, make eye contact, demonstrate empathy, participate successfully in structured activities, or carry on a conversation and still be autistic.

Identifying these presentations requires looking beyond whether a child can perform individual social behaviors and considering how naturally those skills occur, how much effort they require, how the child functions across different environments, and the developmental patterns underlying their current presentation.

One of the most important parts of an autism evaluation is determining whether autism actually provides the best explanation for what a child is experiencing.

Autism can overlap with or resemble ADHD, anxiety disorders, learning disabilities, language differences, executive functioning difficulties, and other developmental or emotional concerns. Children can also have more than one condition.

For example, social withdrawal may reflect autism, anxiety, or both. Rigidity may arise for different reasons. Difficulty completing work may involve attention, anxiety, learning, executive functioning—or several factors interacting with one another.

That's why our evaluations emphasize differential diagnosis rather than simply looking for evidence to confirm autism. We consider multiple possibilities and ask which explanation—or combination of explanations—best accounts for your child's development and current functioning.

Families who complete an evaluation at TLC have access to ongoing consultation with Dr. Savaiano at a reduced rate of $200/hour, including help implementing recommendations and navigating school supports.