Quick Guide to Autism Spectrum Disorder

Autism spectrum disorder (ASD) is a neurodevelopmental disorder. It affects children in two big ways. First, it can make it harder for them to communicate and socialize with others. Second, it causes kids to have, to varying degrees, repetitive behaviors, limited interests, inflexibility, and unusual sensory processing. Children who have autism are born with it. Symptoms can appear as early as at 6 to 18 months, in aspects of social communication. For others it may be noticeable between 12 months and 3 years. But for some it’s not noticed until preschool age, when they start to have trouble interacting with other children.  

Over the last two decade, research has led to changes in how autism is understood. In the past, children were diagnosed with one of several different conditions known as pervasive developmental disorders: 

• Autism  
• Asperger’s disorder 
• Pervasive developmental disorder not otherwise specified (PDD-NOS) 

Now, these different conditions are all diagnosed as autism. Autism is considered a spectrum because kids with autism can have a range of different symptoms and behaviors. 

One in 36 children are diagnosed with autism. Among children with average and higher intelligence, boys are diagnosed more often than girls. For children with intellectual disability, boys and girls are diagnosed at the same rate.

For more, read our Complete Guide to Autism Spectrum Disorder.

Many children with autism show symptoms before they are two years old. Some children, at around age 1 or 2, plateau in development of social skills, and it can look like they are regressing. 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/social interaction and repetitive behaviors.  Both must be present for an autism diagnosis

Social Communication and Social Interaction 

• Doesn’t like to cuddle or hug  
• Likes to play alone 
• Rarely or never makes eye contact

Under the age of three:

• Doesn’t answer to their name  
• Doesn’t give, share or show off things they like 
• Doesn’t use gestures to communicate 
• Has limited or slow-onset language development, such as not saying two-word phrases by two years old
• Hasn’t spoken a word by 18 months  

Older children:

• May have trouble understanding how others feel  
• May have trouble making and keeping friends
• May not understand relationships   
• Has trouble reading and using body language
• Has trouble adapting behavior to fit social situations 

Speaks differently than other children:

• Speaks in a flat or sing-song voice   
• Repeats phrases
• Uses very formal language or a very sophisticated vocabulary
• Can talk about facts but has trouble talking about personal experience    
• Has trouble carrying on a conversation and letting the other person talk 

Repetitive Behaviors 

• Repeats the same action over and over again 
• Focuses on small details  
• Struggles with changes in their routine 
• Puts toys in order instead of playing with them 
• Gets extremely focused on specific topics or objects 
• Has unusually low, or high reactivity to sensory stimulation
• Has strong interest in particular sensations, their look or feel

Autism is diagnosed by a medical professional. To be diagnosed with autism, a child must have symptoms that include both a lack of age-level social skills and the presence of repetitive behaviors. These symptoms must get in the way of the child’s daily life. Symptoms must be present in early development, such as before the age of 5. Autism can be diagnosed in kids as young as 12 months, if symptoms have appear by that time.  

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 

Most children with autism have co-ocurring disorders, including intellectual disability, learning disorders, ADHD, anxiety, depression, sleep, feeding, and gastrointestinal problems. A child should only be diagnosed with autism if their social struggles cannot be explained by intellectual disability.  

Children who only have problems with social understanding and do not show repetitive behaviors are not diagnosed with autism. Instead, they are usually diagnosed with a condition called social communication disorder.  

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. 

Autism is a lifelong condition, but specific programs and therapy can help children develop critical skills that will have a significant impact on their quality of life.

There are several therapies that work well for children with ASD:  

Applied behavior analysis (ABA)

Hundreds of studies have shown that applied behavior analysis (ABA) works well for many kids with autism. ABA identifies skills kids are not picking up naturally that are important for their development. Those crucial skills are broken down into increments in order to teach them to the child.

ABA teaches children skills for verbal and nonverbal communication, playing and interacting with other kids, how to be successful in new environments, and life skills to foster independence.  

Occupational therapy (OT)

OT teaches children the skills they need to perform the activities of daily living, including fine motor skills like buttoning buttons and using writing implements. They also help kids learning how to manage sensitivity to light, sound, and touch (sensory processing skills) and develop appropriate accommodations. 

Speech or physical therapy

Some children may also need help with their speech, from the development of language to pragmatic speech, or use of language in social situaitons.

Alternative therapies

Many people talk about alternative treatments for autism, but there is no scientific proof that these work. Some of these treatments can be dangerous, so it’s important that parents work with a doctor if they want to try an alternative therapy. 

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. 

Children with autism are more likely to have certain medical problems, including:  

• Epilepsy  
• Sleep disorders 
• Allergies 
• Digestive problems  
• Tic disorders (like Tourette’s) 
• Anxiety  
• Depression 
• 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.