What Is Autism?
Autism spectrum disorder is a developmental disorder that affects a person's behavior and makes it hard for a person to communicate and interact with others. The term "spectrum" refers to the fact that some people have a few mild symptoms while others have severe symptoms that are disabling.
In 2013, the official names for autism spectrum disorders were changed. For example, in the U.S., mild autism used to be called Asperger syndrome, but is now called “autism spectrum disorder.” Autism spectrum disorder is now classified in levels one through three, ranging from mild to severe impairment and need for support.
What Are Symptoms of Autism?
Symptoms of autism spectrum disorder are categorized into two general areas:
- Problems with social interaction and communication
- Inability to speak or understand
- Showing no interest in communicating
- Difficulty with or lack of interaction with family and friends
- Difficulty learning to interact with others
- Little or no interest in developing friendships
- Children may play alone
- Lack of understanding of social conventions or needs of others
- Lack of interest in sharing activities, interests, or achievements (called “impaired joint attention”)
- Difficulty using and interpreting nonverbal behaviors such as eye contact, facial expression, gestures, and body postures
- Babies may resist cuddling, avoid eye contact, or not spread arms in anticipation of being picked up
In patients who have mild autism (level 1) social communication skills may be improved with support. Without supports in place, deficits in social communication can cause noticeable impairments.
Restricted and repetitive behavior, activities, and interests
- Repetitive body movements, such as hand or finger flapping or twisting, rocking, swaying, dipping, or walking on tip-toe
- Insistence on specific routines or rituals that must be followed exactly
- Changes in routine can be upsetting or frustrating, even resulting in a tantrum or meltdown
- Restricted interests
- Overly sensitive to sounds, tastes, or touch
- Refusal to eat foods with certain tastes or textures
- Resistance to being touched or increased sensitivity to certain kinds of touch
- Apparent indifference to pain
- Hypersensitivity to certain frequencies or types of sound or lack of response to sounds close by or sounds that would startle other children
In patients who have mild autism (level 1) inflexibility of behavior can cause significant interference with functioning in one or more areas, such as problems with organization and planning.
Other features of autism spectrum disorder include:
- Uneven cognitive skills
- For example, may be able to perform tasks that require memorization but have difficulty with tasks that require reasoning, interpretation, or abstract thinking
- May have “savant” skills in memory, mathematics, music, art, or puzzles, despite significant difficulties in other areas
- Delayed or absent language skills
- Ability to understand may also be impaired
- Language is not used as a tool for communication (e.g., may consist of repeating phrases or words spoken by others, called echolalia)
- May have difficulty starting or sustaining a conversation
- Abnormally large head
What Causes Autism?
The cause of autism spectrum disorder is not fully understood, but it is believed that genetics may play a role and the condition tends to run in families.
Certain environmental factors are also thought to increase the risk of developing autism spectrum disorders, including:
- Older parental age
- Exposure to the drug valproate in utero
- Low birth weight
How Is Autism Diagnosed?
Autism spectrum disorder is diagnosed with a medical history, physical exam, neurologic exam, and testing of a child's social, language, and cognitive skills.
Experts in the condition, such as child psychologists, developmental-behavioral pediatricians, neurologists, psychiatrists, speech therapists, and other professionals will evaluate a child’s signs and symptoms to either diagnose autism spectrum disorder or rule out another condition that could be causing the symptoms.
What Is the Treatment for Autism?
There is no cure for autism spectrum disorder but a comprehensive treatment plan can help a child reach his or her full potential. Treatment plans depend upon a child's age, the diagnosis and severity of the symptoms, any underlying medical problems, and other individual factors.
Treatments for autism spectrum disorder includes therapy, medications, and school support for children:
- Cognitive behavioral therapy (CBT) for anxiety
- Speech-language therapy
- Physical and occupational therapy for coordination
- Social skills training to help with conversational skills and understanding social cues
- Joint attention therapy
- Nutritional therapy
- Parent-mediated therapy
- School support
- Help with organization
- Help with reading and writing
- Educational and school-based therapies
- Not used to treat autism spectrum disorder, but used for anxiety, depression, attention deficit and hyperactivity disorder (ADHD), and seizure disorders that may accompany the disorder
- Antidepressants such as selective serotonin re-uptake inhibitors (SSRIs) and tricyclics
- Psychoactive or anti-psychotic medications
- Anti-anxiety medications