A nurse assesses a 3-year-old diagnosed with an autism spectrum disorder. Which finding is most associated with the child's disorder?

Choice A reason: The inability to read at age 3 is developmentally appropriate for all children. Literacy skills typically begin to emerge between ages 4 and 6. Therefore, this finding is not a clinical indicator of autism spectrum disorder, which is characterized by social, communicative, and behavioral deviations rather than academic milestones. Choice B reason: Occasional toileting accidents are common in 3-year-olds as they are still in the process of mastering bladder and bowel control. While children with autism may have delayed toilet training due to sensory sensitivities or communication barriers, it is not a hallmark diagnostic feature of the disorder. Choice C reason: Repetitive, stereotyped motor mannerisms, such as rocking, hand-flapping, or spinning, are core diagnostic criteria for autism spectrum disorder according to the DSM-5. These "stimming" behaviors often serve as a way for the child to regulate sensory input or express anxiety and excitement in a self-soothing manner. Choice D reason: Crying when separated from a parent is a sign of separation anxiety, which is a normal developmental stage for toddlers and young children. In contrast, many children with autism may actually show a lack of attachment behaviors or an indifferent response to the presence or absence of primary caregivers.