What is an Autism Spectrum Disorder?
Autism spectrum disorders (ASD) are a range of complex neurodevelopmental disorders, characterized by social impairments, communication difficulties, and restricted, repetitive, and stereotyped patterns of behavior. Autistic Disorder is the most severe form of ASD, while other conditions along the spectrum include a milder form known as Asperger Syndrome and Pervasive Developmental Disorder, Not Otherwise Specified (PDD-NOS). Although ASD varies significantly in character and severity, it occurs in all ethnic and socioeconomic groups and affects every age group. Experts estimate that six children out of every 1,000 will have an ASD. Furthermore, males are four times more likely to have an ASD than females.
What are some common signs of autism?
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 (e.g., eye contact, facial expressions). • Failure to establish friendships with children the same age. • Lack of interest in sharing enjoyment, interests, or achievements with other people.
Verbal and nonverbal communication. Symptoms may include: • Delay in, or lack of, learning to talk. • Problems initiating and maintaining a conversation. • Stereotyped and repetitive use of language (e.g., repeating a phrase over and over). • Difficulty understanding their listener’s perspective (e.g., inability to understand sarcasm).
Restrictive and stereotyped behaviors. Symptoms may include: • An unusual focus on pieces. (e.g., focus on the wheels on a car rather than playing with the entire toy). • Significant preoccupation with certain topics or objects (e.g., balloons, cars). • A need for sameness and routines. • Stereotyped behaviors (e.g., hand-flapping, body rocking, spinning).
How is autism diagnosed?
Several diagnostic instruments are available. Two are commonly used in autism research: the Autism Diagnostic Interview-Revised (ADI-R) is a semistructured parent interview, and the Autism Diagnostic Observation Schedule (ADOS) uses observation and interaction with the child. A pediatrician commonly performs a preliminary investigation by taking developmental history and physically examining the child. If warranted, diagnosis and evaluations are conducted with help from ASD specialists (e.g., psychologists, developmental pediatricians, neuropsychologists) who then observe and assess cognitive, communication, family, and other factors using standardized assessment tools. In particular, comprehensive evaluations aid to diagnose and to help recommend interventions. What causes autism?
Scientists aren’t certain about what causes ASD, but it’s likely that both genetics and environment play a role. Researchers have identified a number of genes associated with the disorder. Additionally, studies of people with ASD have found irregularities in several regions of the brain. While these findings are intriguing, they are preliminary and require further study. Most importantly, the theory that parental practices are responsible for ASD has long been disproved.
How is autism treated?
An early, intensive, appropriate treatment program will greatly improve the outlook for most young children with autism. Treatment is most successful when it is geared toward the child’s particular needs. An experienced specialist or team should design the program for the individual child. A variety of therapies are available and the best treatment plan may use a combination of techniques. Treatments include: • Applied behavior analysis (ABA) • Medications • Occupational therapy • Physical therapy • Speech-language therapy Autism remains a challenging condition for children and their families, but the outlook today is much better than it was a generation ago. Today, with the right therapy, many of the symptoms of autism can be improved. Specifically, the outlook depends on the severity of the autism and the level of therapy the person receives.
References American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th, text revision (DSM-IV-TR) ed. 2000. Dover CJ, Le Couteur A. How to diagnose autism. Arch Dis Child. 2007;92(6):540–5. Johnson CP, Myers SM; American Academy of Pediatrics Council on Children with Disabilities. Identification and evaluation of children with autism spectrum disorders. Pediatrics. 2007;120:1183-1215. Kanne SM, Randolph JK, Farmer JE. Diagnostic and assessment findings: a bridge to academic planning for children with autism spectrum disorders. Neuropsychol Rev. 2008;18(4):367–84.