Confusion with figurative expressions
Throughout the day, many of us use figurative expressions without even noticing it. However, it can be extremely difficult for children with autism to understand what is being implied when figurative expressions are utilized - especially because the reinforcement of demeanor, tone, and facial expressions do not aid them in understanding.
This also ties into the difficulty autistic children have with understanding what is real and pretend, as it is nearly impossible for them to draw that line. The imagination of autistic children tends to be particularly active.