Autism

What Is Autism?

Autism, also called autism spectrum disorder (ASD), is a complicated condition that includes problems with communication and behavior. It can involve a wide range of symptoms and skills. ASD can be a minor problem or a disability that needs full-time care in a special facility.

People with autism have trouble with communication. They have trouble understanding what other people think and feel. This makes it hard for them to express themselves, either with words or through gestures, facial expressions, and touch.

People with autism might have problems with learning. Their skills might develop unevenly. For example, they could have trouble communicating but be unusually good at art, music, math, or memory. Because of this, they might do especially well on tests of analysis or problem-solving.

More children are diagnosed with autism now than ever before. But the latest numbers could be higher because of changes in how it’s diagnosed, not because more children have a disorder.

Autism Signs and Symptoms

Symptoms of autism usually appear before a child turns 3. Some people show signs from birth.

Common symptoms of autism include:

  • A lack of eye contact
  • A narrow range of interests or intense interest in certain topics
  • Doing something over and over, like repeating words or phrases, rocking back and forth, or flipping a lever
  • High sensitivity to sounds, touches, smells, or sights that seem ordinary to other people
  • Not looking at or listening to other people
  • Not looking at things when another person points at them
  • Not wanting to be held or cuddled
  • Problems understanding or using speech, gestures, facial expressions, or tone of voice
  • Talking in a sing-song, flat, or robotic voice
  • Trouble adapting to changes in routine

Some children with autism may also have seizures. These might not start until adolescence.

Autism Spectrum Disorders

These types were once thought to be separate conditions. Now, they fall under the range of autism spectrum disorders. They include:

  • Asperger's syndrome. These children don't have a problem with language; in fact, they tend to score in the average or above-average range on intelligence tests. But they have social problems and a narrow scope of interests.
  • Autistic disorder. This is what most people think of when they hear the word "autism." It refers to problems with social interactions, communication, and play in children younger than 3 years.
  • Childhood disintegrative disorder. These children have typical development for at least 2 years and then lose some or most of their communication and social skills.
  • Pervasive developmental disorder (PDD or atypical autism). Your doctor might use this term if your child has some autistic behavior, like delays in social and communications skills, but doesn’t fit into another category.

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Autism Causes

Exactly why autism happens isn't clear. It could stem from problems in parts of your brain that interpret sensory input and process language.

Autism is four times more common in boys than in girls. It can happen in people of any race, ethnicity, or social background. Family income, lifestyle, or educational level doesn’t affect a child’s risk of autism.

Autism runs in families, so certain combinations of genes may increase a child’s risk.

A child with an older parent has a higher risk of autism.

If a pregnant woman is exposed to certain drugs or chemicals, like alcohol or anti-seizure medications, her child is more likely to be autistic. Other risk factors include maternal metabolic conditions such as diabetes and obesity. Research has also linked autism to untreated phenylketonuria (also called PKU, a metabolic disorder caused by the absence of an enzyme) and rubella (German measles).

There is no evidence that vaccinations cause autism.

Autism Screening and Diagnosis

It can be hard to get a definite diagnosis of autism. Your doctor will focus on behavior and development.

For children, diagnosis usually takes two steps.

  • A developmental screening will tell your doctor whether your child is on track with basic skills like learning, speaking, behavior, and moving. Experts suggest that children be screened for these developmental delays during their regular checkups at 9 months, 18 months, and 24 or 30 months of age. Children are routinely checked specifically for autism at their 18-month and 24-month checkups.
  • If your child shows signs of a problem on these screenings, they’ll need a more complete evaluation. This might include hearing and vision tests or genetic tests. Your doctor might want to bring in someone who specializes in autism disorders, like a developmental pediatrician or a child psychologist. Some psychologists can also give a test called the Autism Diagnostic Observation Schedule (ADOS).

If you weren’t diagnosed with autism as a child but notice yourself showing signs or symptoms, talk to your doctor.

Autism Treatment

There’s no cure for autism. But early treatment can make a big difference in development for a child with autism. If you think your child shows symptoms of ASD, tell your doctor as soon as possible.

What works for one person might not work for another. Your doctor should tailor treatment for you or your child. The two main types of treatments are:

  • Behavioral and communication therapy to help with structure and organization. Applied Behavior Analysis (ABA) is one of these treatments; it promotes positive behavior and discourages negative behavior. Occupational therapy can help with life skills like dressing, eating, and relating to people. Sensory integration therapy might help someone who has problems with being touched or with sights or sounds. Speech therapy improves communication skills.
  • Medications to help with symptoms of ASD, like attention problems, hyperactivity, or anxiety.

Talk to your doctor before trying something different, like a special diet.

WebMD Medical Reference Reviewed by Smitha Bhandari, MD on October 22, 2019

Sources

SOURCE: 

American Academy of Pediatrics: Pediatrics 2010. 

Parker, S., Zuckerman, B., and Augustyn, M. (editors). Developmental and Behavioral Pediatrics: A Handbook for Primary Care, Lippincott, 2005.

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders version 5 (DSM-5).

CDC: “Autism Spectrum Disorder (ASD).”

National Institute of Mental Health: “Autism Spectrum Disorder.”

Acta Psychiatrica Scandinavica: “Advanced parental age and autism risk in children: a systematic review and meta-analysis.”

Autism Speaks: “What Are the Symptoms of Autism?” “Treatments,” “Pervasive Developmental Disorder -- Not Otherwise Specified (PDD-NOS).”

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