Autism spectrum disorder (ASD) is a developmental disorder that is marked by two unusual kinds of behaviors: deficits in communication and social skills, and restricted or repetitive behaviors.
In the psychiatric community, thinking about autism has changed over the last few years. In the past, children with autism-related behaviors were diagnosed with one of a set of distinct developmental disorders—autism, Asperger’s disorder, childhood disintegrative disorder (CDD), and pervasive developmental disorder not otherwise specified (PDD-NOS). Now these separate diagnoses are combined into one disorder, ASD, that presents along a spectrum of symptoms and behaviors of varying severity. ASD includes all of those earlier diagnoses.
Experts group signs of ASD into the following groups of symptoms:
Social Communication and Social Interaction
- Aversion to displays of affection and a preference for solitary play
- Under the age of 3: failure to respond to his own name, disinterest in giving, sharing, or pointing to objects of interest
- Older children: Limited understanding of others’ emotions or the basic meaning of social relationships
- Speaking later than the norm (hasn’t spoken a word by 18 months, or can’t string together 2-word phrases by 2 years)
- Speaking in a robotic tone or an exaggerated singsong, odd tones or speech patterns
- Possessing “non-functional knowledge”—information she can recite but not apply
- Limited eye contact or limited use of gestures to communicate a need or describe something
- Monopolizing conversations while showing little capacity for reciprocity or understanding
Restrictive or Repetitive behaviors:
- Repeating actions and rituals
- Fixating on minute details
- Troubled by changes in daily routine
- Putting toys in order instead of playing with them
- Consuming interest in a specific topic or object
Children with autism also often have sensory processing problems—unusual sensitivity to sounds, lights, textures or smells. They may be overwhelmed by too much sensory input, or be disturbed and uncomfortable because of a lack of sensory input, which they may try to get by bumping into things, and excessively touching and smelling things.
Signs of autism often appear before age 2, though some children develop normally and then “regress” at 1 or 2, losing skills they had previously developed. If your child shows impairment in social communication and social interaction but doesn’t have restrictive and repetitive behaviors, he is more likely to be diagnosed with a new disorder called social communication disorder.
Autism cannot be cured at the present time, but a structured educational program and tailored therapy have been shown to help children develop skills they are lacking and minimize behaviors that are problematic.
Applied behavior analysis is a psychotherapeutic regimen that actively teaches and encourages desired social and communication behaviors that other children learn intuitively. An approach called developmentally based intervention uses subjects, words, and stimuli to model a typical developmental progression for an a child who doesn’t develop them independently. As every child is different, other appropriate therapies may include occupational, physical, and speech-language.
There is no medicine that can treat autism itself, but there are medications that target associated behaviors that create problems for children with autism and their families, such as sleep disturbance and violent tantrums.