AUTISM

Autism  spectrum disorder is a complex developmental disorder that has the following three defining core features:

  • Problems with social interactions
  • Impaired verbal and nonverbal communication
  • A pattern of repetitive behavior with narrow, restricted interests

Autism spectrum disorder has no single known cause. Given the complexity of the disorder, and the fact that symptoms and severity vary, there are probably many causes. Both genetics and environment may play a role.

Autism spectrum disorder affects children of all races and nationalities, but certain factors increase a child’s risk. They include:

  • Your child’s sex. Boys are about four times more likely to develop ASD than girls are.
  • Family history. Families who have one child with ASD have an increased risk of having another child with the disorder.
  • Other disorders. Children with certain medical conditions have a higher than normal risk of ASD or ASD-like symptoms. Examples of these conditions include fragile X syndrome, an inherited disorder that causes intellectual problems; tuberous sclerosis, a condition in which benign tumors develop in the brain; the neurological disorder Tourette syndrome; and Rett syndrome, a genetic condition occurring almost exclusively in girls, which causes slowing of head growth, intellectual disability and loss of purposeful hand use.
  • Extremely preterm babies. Babies born before 26 weeks of pregnancy may have a greater risk of ASD.
  • Parents’ ages. There may also be a connection between children born to older parents and ASD, but more research is necessary to establish this link.

Core symptoms

The severity of symptoms varies greatly, but all people with autism have some core symptoms in the areas of:

Social interactions and relationships. Symptoms may include:

  • Significant problems developing nonverbal communication skills, such as eye-to-eye gazing, facial expressions, and body posture.
  • Failure to establish friendships with children the same age.
  • Lack of interest in sharing enjoyment, interests, or achievements with other people.
  • Lack of empathy. People with autism may have difficulty understanding another person’s feelings, such as pain or sorrow.

Verbal and nonverbal communication. Symptoms may include:

  • Delay in, or lack of, learning to talk. As many as 40% of people with autism never speak.1
  • Problems taking steps to start a conversation. Also, people with autism have difficulties continuing a conversation after it has begun.
  • Stereotyped and repetitive use of language. People with autism often repeat over and over a phrase they have heard previously (echolalia).
  • Difficulty understanding their listener’s perspective. For example, a person with autism may not understand that someone is using humor. They may interpret the communication word for word and fail to catch the implied meaning.

Limited interests in activities or play. Symptoms may include:

  • An unusual focus on pieces. Younger children with autism often focus on parts of toys, such as the wheels on a car, rather than playing with the entire toy.
  • Preoccupation with certain topics. For example, older children and adults may be fascinated by video games, trading cards, or license plates.
  • A need for sameness and routines. For example, a child with autism may always need to eat bread before salad and insist on driving the same route every day to school.
  • Stereotyped behaviors. These may include body rocking and hand flapping.

Symptoms during childhood

Symptoms of autism are usually noticed first by parents and other caregivers sometime during the child’s first 3 years. Although autism is present at birth (congenital), signs of the disorder can be difficult to identify or diagnose during infancy. Parents often become concerned when their toddler does not like to be held; does not seem interested in playing certain games, such as peekaboo; and does not begin to talk. Sometimes, a child with autism will start to talk at the same time as other children the same age, then lose his or her language skills. Parents also may be confused about their child’s hearing abilities. It often seems that a child with autism does not hear, yet at other times, he or she may appear to hear a distant background noise, such as the whistle of a train.

With early and intensive treatment, most children improve their ability to relate to others, communicate, and help themselves as they grow older. Contrary to popular myths about children with autism, very few are completely socially isolated or “live in a world of their own.”

Symptoms during teen years

During the teen years, the patterns of behavior often change. Many teens gain skills but still lag behind in their ability to relate to and understand others. Puberty and emerging sexuality may be more difficult for teens who have autism than for others this age. Teens are at an increased risk for developing problems related to depression, anxiety, and epilepsy.

Symptoms in adulthood

Some adults with autism are able to work and live on their own. The degree to which an adult with autism can lead an independent life is related to intelligence and ability to communicate.

Some adults with autism need a lot of assistance, especially those with low intelligence who are unable to speak. Part- or full-time supervision can be provided by residential treatment programs. At the other end of the spectrum, adults with high-functioning autism are often successful in their professions and able to live independently, although they typically continue to have some difficulties relating to other people. These individuals usually have average to above-average intelligence.

DIAGNOSIS

Because there aren’t specific medical tests for autism, it’s best to get a diagnosis from a physician or psychologist who specializes in developmental disabilities and has experience diagnosing Autism Spectrum Disorders (ASDs).

The diagnosis of autism is made by taking into account the child’s complete medical and behavioral history, lengthy observation of the child’s behavior, and ruling out other problems that may cause some of the same symptoms. It is important to distinguish autism from other disorders, because a misdiagnosis may result in delayed, inappropriate, or ineffective treatment.

For your child to be diagnosed with autism spectrum disorder, he or she must meet the symptom criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association. This manual is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.

ASD includes problems with social interaction and communication skills and restricted, repetitive patterns of behavior, interests or activities that cause significant impairment in social, occupational or other areas of functioning.

 

RECOMMENDED MEDICATIONS

The goal of treatment is to maximize your child’s ability to function by reducing ASD symptoms and supporting development and learning. Your health care provider can help identify resources in your area. Treatment options may include:

  • Behavior and communication therapies. Many programs address the range of social, language and behavioral difficulties associated with ASD. Some programs focus on reducing problem behaviors and teaching new skills. Others focus on teaching children how to act in social situations or how to communicate better with others. Though children don’t always outgrow ASD symptoms, they may learn to function well.
  • Educational therapies. Children with ASD often respond well to highly structured educational programs. Successful programs often include a team of specialists and a variety of activities to improve social skills, communication and behavior. Preschool children who receive intensive, individualized behavioral interventions often show good progress.
  • Family therapies. Parents and other family members can learn how to play and interact with their children in ways that promote social interaction skills, manage problem behaviors, and teach daily living skills and communication.
  • Medications. No medication can improve the core signs of ASD, but certain medications can help control symptoms. For example, antidepressants may be prescribed for anxiety, and antipsychotic drugs are sometimes used to treat severe behavioral problems. Other medications may be prescribed if your child is hyperactive.

Related Articles

XEROSTOMIA

Overview and FactsTypes and SymptomsDiagnosis & MedicationsOverview and Facts Xerostomia, or also called dry mouth, is a condition wherein your [...]

WEST SYNDROME

Overview and FactsTypes and SymptomsDiagnosis & MedicationsOverview and Facts West Syndrome is an atypical epileptic seizure disease that was first coined by [...]

WEIL’S DISEASE

Overview and FactsTypes and SymptomsDiagnosis & MedicationsOverview and Facts Weil's disease is a type of bacterial infection caused by Leptospira [...]