What is autism spectrum disorder?
Autism spectrum disorder (ASD) is a developmental disorder. It affects children in two big ways. First, it can make it harder for them to communicate and socialize with others. Second, it can cause kids to have repetitive behaviors and limited interests. Children who have autism are born with it. It’s not usually noticed until they start to have trouble interacting with other children their age.
In psychiatry, the thinking about autism has changed over time. In the past, children were diagnosed with one of several different conditions known as pervasive developmental disorders:
- Asperger’s disorder
- Childhood disintegrative disorder (CDD)
- Pervasive developmental disorder not otherwise specified (PDD-NOS)
Now, these different conditions are all considered autism. Kids with autism can have a range of different symptoms and behaviors, so autism is considered a spectrum instead of just one condition.
One in 59 children are diagnosed with ASD. Boys are diagnosed with ASD about three to four times more than girls.
What are the symptoms of autism spectrum disorder?
Children with autism often show symptoms before they are two years old. Some children begin to lose language or social skills (or “regress”) at the age of one or two. Autism looks different in each child. Not every child shows every symptom, and some have more severe symptoms.
Symptoms of ASD are grouped into two categories:
Social Communication and Social Interaction
- Doesn’t like to cuddle or hug
- Likes to play alone
- Under the age of three:
- Doesn’t answer to their name
- Doesn’t want to give, share or show off things they like
- Doesn’t use motions to communicate
- Older children:
- Doesn’t understand how others feel
- Cannot show how they feel
- Doesn’t understand relationships
- Has trouble reading and using body language
- Speaks later than normal:
- Hasn’t spoken a word by 18 months
- Cannot say two-word phrases by two years old
- Speaks differently than other children:
- Sounds like a robot when speaking
- Speaks in a very singsong way
- Repeats phrases or puts words in the wrong order
- Can recite information but not use it to solve problems or have a conversation
- Rarely or never makes eye contact
- Has trouble carrying on a conversation and letting the other person talk
- Repeats the same action over and over again
- Focuses on small details and nothing else
- Struggles with changes in their routine
- Puts toys in order instead of playing with them
- Gets extremely focused on specific topics or objects
Additionally, children with autism are often sensitive to sounds, lights, textures or smells. This is called a sensory processing problem. For example, loud noises or bright lights can make them very uncomfortable. Or, they may need more sensations to feel comfortable, so they will try to bump into things or constantly touch or smell things.
How is autism diagnosed?
ASD is diagnosed by a medical professional. To be diagnosed with autism, a child must have symptoms that include both social challenges and repetitive behaviors. These symptoms must get in the way of the child’s daily life. Symptoms must exist by the time the child is two years old, even if they are not obvious until the child is older. Autism can be diagnosed in kids as young as two years old.
An autism diagnosis will list all of the child’s symptoms. For each symptom, the diagnosis will say how much support the child will need. The level of support is based on how severe the symptoms are. There are three levels of support:
- Requiring support
- Requiring substantial support
- Requiring very substantial support
Children with autism often have problems with reasoning and learning as well. This is called an intellectual development disorder. A child should only be diagnosed with autism if their social struggles cannot be explained by an intellectual development disorder.
Children who only have problems with social behaviors and do not show repetitive behaviors are not diagnosed with autism. Instead, they are usually diagnosed with a condition called social communication disorder.
What are the risk factors for autism?
Risk factors for autism include:
- Low birth weight
- Being exposed to a medication called valproate during the mother’s pregnancy
- Older parents
Boys are diagnosed with ASD more often than girls.
Studies have shown that there is no link between vaccines and autism. Learn more about vaccines and autism from the CDC.
How is autism treated?
There is no cure currently available for autism. However, specific programs and therapy can help children develop skills and decrease behaviors that cause them problems.
There are several therapies that work well for children with ASD:
- Applied behavior analysis (ABA): Hundreds of studies have proven this therapy works well for all kids with autism, from mild to severe. It teaches children how to communicate with others. It also teaches them to avoid negative behaviors such as hurting themselves.
- Occupational therapy (OT): OT teaches children the skills they need to perform the activities of daily life. This includes motor skills, learning how to manage sensitivity to light, sound and touch (sensory processing skills), and more.
- Speech or physical therapy: Some children may also need help with their speech or physical movements.
Many parents also find a tool called “Social Stories” to be helpful. These are a fun way to prepare kids for social situations. The stories are written from the child’s point of view. They use words, photos and drawings to show the child what to expect.
There is no medicine for autism, but there are medications that can help with problems like trouble sleeping or violent tantrums. Children may also be prescribed medication to help with other problems that often occur with autism. These include depression, anxiety and hyperactivity.
Alternative therapies: Many people talk about alternative treatments and even so-called cures for autism, but there is no scientific proof that these work. Some of these treatments can be very dangerous, especially a chemical treatment called chelation. It’s very important that parents work with a doctor if they want to try an alternative therapy.
Risk for other disorders
Children with autism are more likely to have certain medical problems, including:
- Sleep disorders
- Digestive problems
- Tic disorders (like Tourette’s)
- Cognitive issues
16 by 16 Lookbooks is a handbook that outlines behaviors children should show by 16 months of age. It can help parents and caregivers spots signs of autism early. The handbook is free to download from the FIRST WORDS Project, which is a research study at the Florida State University Autism Institute.
The Autism Speaks 100 Day Kit helps families of children ages four and under learn more about autism and how to get treatment. Families whose children have been diagnosed in the last six months may request a free copy of the 100 Day Kit from Autism Speaks. The kit is also available in Spanish.