Autism Spectrum Disorder
Understanding ASD: A comprehensive guide to characteristics, diagnosis, and support
Autism Spectrum Disorder (ASD) is a neurological and developmental disorder that affects how people interact with others, communicate, learn, and behave.
Although autism can be diagnosed at any age, it is described as a "developmental disorder" because symptoms generally appear in the first two years of life. ASD is known as a "spectrum" disorder because people with autism have a wide range of characteristics, needs, strengths, and challenges.
People of all ages, races, ethnicities, sexes, and economic backgrounds can be diagnosed with ASD. Although ASD can be a lifelong condition, treatments, services, and supports can improve a person's health, well-being, and daily functioning.
Core Features of ASD
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), people with ASD often have persistent challenges in three main areas that affect their ability to function in school, work, and other areas of life.
Social Communication & Interaction
Difficulty with social communication and interaction with other people. This may include challenges with back-and-forth conversation, sharing interests or emotions, understanding nonverbal communication, and developing age-appropriate relationships.
Restricted Interests & Repetitive Behaviors
Restricted interests and repetitive behaviors, including repetitive motor movements, inflexible adherence to routines, highly focused interests, and unusual responses to sensory input.
Sensory Differences
Being more sensitive or less sensitive than other people to sensory input such as light, sound, clothing, or temperature. These sensory differences can significantly impact daily functioning and comfort.
Signs and Symptoms
Not all people with ASD will have all behaviors, but most will have several of the behaviors listed below. The presentation can vary greatly from person to person.
Social Communication and Social Interaction
- Making little or inconsistent eye contact
- Appearing not to look at or listen to people who are talking
- Infrequently sharing interest, emotion, or enjoyment of objects or activities
- Not responding or being slow to respond to one's name or other verbal bids for attention
- Having difficulties with the back and forth of conversation
- Often talking at length about a subject without considering social cues
- Having trouble understanding another person's point of view
- Difficulties adjusting behavior to different social situations
- Difficulties sharing in imaginative play or making friends
Restrictive/Repetitive Behaviors
- Repeating certain behaviors or having unusual behaviors, such as repeating words or phrases (echolalia)
- Having a lasting intense interest in specific topics, such as numbers, details, or facts
- Showing overly focused interests, such as with moving objects or parts of objects
- Becoming upset by slight changes in routine and having difficulty with transitions
- Being more or less sensitive than other people to sensory input
Causes and Risk Factors
Researchers do not know the primary causes of ASD, but studies suggest that a person's genes and aspects of their environment may affect development in ways that lead to ASD. Some factors that are associated with an increased likelihood of developing ASD include:
- Having a sibling with ASD
- Having older parents
- Having certain genetic conditions (such as Down syndrome or Fragile X syndrome)
- Having a very low birth weight
Important note: Not everyone who has these factors will develop ASD.
Diagnosis Process
Early Screening and Evaluation
Health care providers diagnose ASD by evaluating a person's behavior and development. ASD can usually be reliably diagnosed by the age of 2. The American Academy of Pediatrics recommends that all children receive screening for developmental delays at their 9-, 18-, and 24-month well-child visits, with specific autism screenings at 18 and 24 months.
Comprehensive Diagnostic Evaluation
A team of health care providers with experience diagnosing ASD conducts the diagnostic evaluation. This team may include child neurologists, developmental behavioral pediatricians, speech-language pathologists, child psychologists and psychiatrists, educational specialists, and occupational therapists.
The diagnostic evaluation typically includes:
- Medical and neurological examinations
- Assessment of cognitive abilities
- Assessment of speech and language abilities
- Observation of behavior
- In-depth conversation with caregivers about behavior and development
- Assessment of age-appropriate daily living skills
- Questions about family history
Treatment and Support
Interventions, services, and supports for ASD are most effective when they begin as soon as possible after diagnosis. There is no single best approach, as people with ASD have a wide range of issues and needs.
Types of Interventions and Services
People with ASD may be referred to specialists in behavioral, psychological, educational, occupational, physical, or speech-language therapy. These programs are often highly structured and intensive and may help people:
- Learn social, communication, and language skills
- Manage behaviors that interfere with daily functioning
- Increase or build on strengths
- Learn life skills for living independently
- Find housing, educational supports, and job coaching
Medication
While there is no medication to treat the core symptoms of ASD, healthcare providers may prescribe medication to treat specific symptoms, including aggression, anxiety and depression, attention issues, hyperactivity, irritability, repetitive behavior, or self-injurious behavior.
Recognizing Strengths
People on the autism spectrum often have many strengths, including being able to learn things in detail and remember information for long periods of time, being strong visual and auditory learners, and excelling in math, science, music, or art. Many people with ASD live fulfilling, independent lives with the right supports.
Frequently Asked Questions
What is the difference between autism and Autism Spectrum Disorder?
Autism Spectrum Disorder (ASD) is the current diagnostic term that encompasses what was previously called autism, Asperger's syndrome, and other related conditions. The term "spectrum" reflects the wide range of symptoms, skills, and levels of impairment that people with ASD can have.
At what age can autism be diagnosed?
ASD can usually be reliably diagnosed by age 2, though it can be diagnosed at any age. The American Academy of Pediatrics recommends autism screening at 18 and 24 months during regular well-child visits. Some signs may be apparent earlier, while others might not become evident until social demands exceed the person's capacity.
Is there a cure for autism?
There is no cure for autism, but early intervention and appropriate treatments and services can greatly improve a person's symptoms and ability to function. Many people with ASD live fulfilling, independent lives. Treatment focuses on maximizing strengths and teaching new skills to help with challenges.
What causes autism?
The exact causes of autism are not known, but research suggests that a combination of genetic and environmental factors likely plays a role. Risk factors include having a sibling with ASD, older parents, certain genetic conditions, and very low birth weight. However, not everyone with these risk factors will develop ASD.
Do vaccines cause autism?
No, vaccines do not cause autism. Extensive scientific research has consistently shown no link between vaccines and autism. This misconception has been thoroughly debunked by the medical and scientific communities through numerous large-scale studies.
Are boys more likely to have autism than girls?
Yes, ASD is diagnosed more often in boys than girls. However, recent research suggests that girls may not show autism in the same way as boys and might go undiagnosed because of different presentation patterns. This has led to increased awareness of how autism may manifest differently in girls.
What should I do if I think my child might have autism?
If you have concerns about your child's development, talk to your child's healthcare provider immediately. Early screening and diagnosis are crucial for accessing appropriate services and supports. The provider can conduct screenings and refer you to specialists for comprehensive evaluation if needed.
What are some strengths commonly associated with autism?
Many people with autism have significant strengths, including:
- Excellent attention to detail and memory
- Strong visual and auditory learning abilities
- Expertise in specific areas of interest
- Logical and systematic thinking
- Honesty and reliability
- Excellence in math, science, music, or art