Social/Emotional Connections. Children with autism spectrum disorder typically have trouble with back-and-forth communication in conversations. For example, they may not wait their turn and instead, interrupt the person talking. They might decide the conversation is over in their mind and walk away while the other person is still speaking. Many children with autism spectrum disorder have a very limited understanding, or no understanding at all, of other people's feelings and ideas. They may have little understanding that their words and actions affect other people. It is impossible for some children with autism spectrum disorder to take another person's perspective without deliberate training on why this is important and how to do it.
Nonverbal Communication. Those with autism spectrum disorder also typically have trouble with nonverbal communication skills that are used when communicating with others. For example, they may not understand the purpose of waving to say hello or goodbye to someone. They typically have trouble making eye contact with others during conversation. They may not show any facial expressions or other nonverbal communications while talking with someone.
Developing/Maintaining Relationships. The final area of communication and social interactions that can be difficult for those with autism spectrum disorder is the ability to make or keep friends. As a young child, they may have problems with imaginative play with others or making friends. In older children/adolescents, they may state that they don't need or want friends and isolate themselves socially from others.
Given these social and communication issues, children with autism spectrum disorder experience the social world to be unpredictable and frightening. They find social interactions to be unnatural and very stressful. Rather than embracing relationships, most try to avoid them. They instead choose to stay in the comfort of their own isolated worlds. They do not play with others and they do not engage in normal play activities without prompting from an adult around them. They also avoid eye contact and tend instead to look away from people and focus on to objects or parts of objects nearby.
When those with mild autism spectrum disorder (sometimes referred to as "high functioning autism spectrum disorder") choose to be social, their issues in social understanding and empathy prevent them from smoothly engaging with others. For example, the child may know he is supposed to use words to start a conversation with other children. However, he may not know quite how to use them. Because of this, he may walk up to a group of children and attempt to start a conversation by echoing an out-of-context phrase he heard previously instead of making eye contact and saying hello. This behavior is, of course, quite confusing to children who don't already understand autism spectrum disorder.
People with less severe cases of autism spectrum disorder end up having life-long difficulty navigating through social situations. However, they are likely to develop language and to be able to function independently to some extent. They can use language to communicate with other people. But their core communication problems often make it impossible for them to learn language in the normal way which relies heavily on social context and non-verbal communications. Instead, they must learn language intellectually. Because of this they are highly literal in how they use and understand language, in contrast to the figurative way most other people use language. Sarcasm and irony and other forms of communication where one thing is said while another is meant are very difficult. They have difficulty with body language and nonverbal communication. Because of this, they often cannot pick up on hints and clues that people drop to indicate interest or disinterest in what is being discussed or an activity that is happening. In addition to difficulty with figurative language, conversation tends to come across with little animation or inflection in their speech.
People with the most severe cases of autism spectrum disorder typically require very substantial support from others. They may be completely isolated. They may not use language at all, or they may be very limited in their ability to communicate.