A nurse is caring for a 4-year-old child who has autism spectrum disorder. Which of the following behaviors should the nurse expect? (Select all that apply).

A. Lack of eye contact. Children with autism spectrum disorder (ASD) often have difficulty maintaining eye contact due to challenges with social interactions and communication. Avoiding eye contact is a common characteristic of ASD. B. Inability to play quietly. While some children with ASD may display hyperactivity, many engage in repetitive, focused activities rather than excessive movement or loud play. An inability to play quietly is more commonly associated with attention-deficit hyperactivity disorder (ADHD) rather than ASD. C. Constant spinning of a toy. Repetitive behaviors (stimming), such as spinning objects, hand-flapping, or rocking, are common in children with ASD. These behaviors provide sensory stimulation or help with self-soothing in stressful situations. D. Withdrawal from physical contact. Many children with ASD experience sensory sensitivities, leading them to avoid hugs, hand-holding, or other physical contact. This can be due to hypersensitivity to touch or discomfort with unfamiliar interactions. E. Repeated voiding in clothes. Toileting difficulties can occur in children with ASD, but repeated voiding in clothes is more commonly associated with enuresis, which may be caused by developmental delays, stress, or medical conditions rather than ASD itself.