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Jai Ganesh

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Registered: 2005-06-28

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Autism Spectrum Disorder

Autism Spectrum Disorder

Gist

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 2 years of life.

Summary:

Overview

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 2 years of life.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a guide created by the American Psychiatric Association that health care providers use to diagnose mental disorders, people with ASD often have:

* Difficulty with communication and interaction with other people
* Restricted interests and repetitive behaviors
* Symptoms that affect their ability to function in school, work, and other areas of life

Autism is known as a “spectrum” disorder because there is wide variation in the type and severity of symptoms people experience.

People of all genders, races, ethnicities, and economic backgrounds can be diagnosed with ASD. Although ASD can be a lifelong disorder, treatments and services can improve a person’s symptoms and daily functioning. The American Academy of Pediatrics recommends that all children receive screening for autism. Caregivers should talk to their child’s health care provider about ASD screening or evaluation.

Signs and symptoms of ASD

The list below gives some examples of common types of behaviors in people diagnosed with ASD. Not all people with ASD will have all behaviors, but most will have several of the behaviors listed below.

Social communication / interaction behaviors may include:

* 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 (including infrequent pointing at or showing things to others)
* Not responding or being slow to respond to one’s name or to other verbal bids for attention
* Having difficulties with the back and forth of conversation
* Often talking at length about a favorite subject without noticing that others are not interested or without giving others a chance to respond
* Displaying facial expressions, movements, and gestures that do not match what is being said
* Having an unusual tone of voice that may sound sing-song or flat and robot-like
* Having trouble understanding another person’s point of view or being unable to predict or understand other people’s actions
* Difficulties adjusting behaviors to social situations
* Difficulties sharing in imaginative play or in making friends

Restrictive / repetitive behaviors may include:

* Repeating certain behaviors or having unusual behaviors, such as repeating words or phrases (a behavior called 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 a routine and having difficulty with transitions
* Being more sensitive or less sensitive than other people to sensory input, such as light, sound, clothing, or temperature

People with ASD may also experience sleep problems and irritability.

People on the autism spectrum also may 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
* Excelling in math, science, music, or art

Details

Autism spectrum disorder (ASD) is a developmental disability caused by differences in the brain. Some people with ASD have a known difference, such as a genetic condition. Other causes are not yet known. Scientists believe there are multiple causes of ASD that act together to change the most common ways people develop. We still have much to learn about these causes and how they impact people with ASD.

People with ASD may behave, communicate, interact, and learn in ways that are different from most other people. There is often nothing about how they look that sets them apart from other people.  The abilities of people with ASD can vary significantly. For example, some people with ASD may have advanced conversation skills whereas others may be nonverbal. Some people with ASD need a lot of help in their daily lives; others can work and live with little to no support.

ASD begins before the age of 3 years and can last throughout a person’s life, although symptoms may improve over time. Some children show ASD symptoms within the first 12 months of life. In others, symptoms may not show up until 24 months of age or later. Some children with ASD gain new skills and meet developmental milestones until around 18 to 24 months of age, and then they stop gaining new skills or lose the skills they once had.

As children with ASD become adolescents and young adults, they may have difficulties developing and maintaining friendships, communicating with peers and adults, or understanding what behaviors are expected in school or on the job. They may come to the attention of healthcare providers because they also have conditions such as anxiety, depression, or attention-deficit/hyperactivity disorder, which occur more often in people with ASD than in people without ASD.

Signs and Symptoms

People with ASD often have problems with social communication and interaction, and restricted or repetitive behaviors or interests. People with ASD may also have different ways of learning, moving, or paying attention. These characteristics can make life very challenging. It is important to note that some people without  ASD might also have some of these symptoms.

Diagnosis

Diagnosing ASD can be difficult since there is no medical test, like a blood test, to diagnose the disorder. Doctors look at the child’s behavior and development to make a diagnosis. ASD can sometimes be detected at 18 months of age or younger. By age 2, a diagnosis by an experienced professional can be considered reliable.1 However, many children do not receive a final diagnosis until they are much older. Some people are not diagnosed until they are adolescents or adults. This delay means that people with ASD might not get the early help they need.

Treatment

Current treatments for ASD seek to reduce symptoms that interfere with daily functioning and quality of life. ASD affects each person differently, meaning that people with ASD have unique strengths and challenges and different treatment needs.2  Treatment plans usually involve multiple professionals and are catered to the individual.

Risk Factors

There is not just one cause of ASD. There are many different factors that have been identified that may make a child more likely to have ASD, including environmental, biologic, and genetic factors.

Although we know little about specific causes, the available evidence suggests that the following may put children at greater risk for developing ASD:

* Having a sibling with ASD
* Having certain genetic or chromosomal conditions, such as fragile X syndrome or tuberous sclerosis
* Experiencing complications at birth
* Being born to older parents

CDC (Centers for Disease Control and Prevention) is currently working on one of the largest U.S. studies to date on ASD. This study called the Study to Explore Early Development (SEED), was designed to look at the risk factors and behaviors related with ASD.  CDC is now conducting a follow-up study of older children who were enrolled in SEED to determine the health, functioning, and needs of people with ASD and other developmental disabilities as they mature.

How Often ASD Occurs

CDC’s Autism and Developmental Disabilities Monitoring (ADDM) Network has been estimating the number of 8-year-old children with ASD in the United States since 2000.

ASD occurs in all racial, ethnic, and socioeconomic groups. It is more than 4 times more common among boys than among girls.

If You’re Concerned

As a parent, you already have what it takes to help your young child learn and grow. CDC has developed materials to help you track your child’s developmental milestones and share that progress, or any concerns, with your child’s doctor at every check-up.

Contact your child’s doctor if you think your child might have ASD or if you have any other concerns about the way your child plays, learns, speaks, or acts.

If you are still concerned, ask the doctor for a referral to a specialist who can do a more in-depth evaluation of your child. Specialists who can do a more in-depth evaluation and make a diagnosis include

* Developmental pediatricians (doctors who have special training in child development and children with special needs)
* Child neurologists (doctors who work on the brain, spine, and nerves)
* Child psychologists or psychiatrists (doctors who know about the human mind)

At the same time, call your state’s public early childhood system to request a free evaluation, sometimes called a Child Find evaluation, to find out if your child qualifies for intervention services.  You do not need to wait for a doctor’s referral or a medical diagnosis to make this call.

Where to call for a free evaluation from the state depends on your child’s age:

* If your child is not yet 3 years old, contact your local early intervention system.
* You can find the right contact information for your state by calling the Early Childhood Technical Assistance Center (ECTA) at 919-962-2001.
* If your child is 3 years old or older, contact your local public school system.

Even if your child is not yet old enough for kindergarten or enrolled in a public school, call your local elementary school or board of education and ask to speak with someone who can help you have your child evaluated.
* If you’re not sure who to contact, call the ECTA at 919-962-2001.

Research shows that early intervention services can greatly improve a child’s development. In order to make sure your child reaches their full potential, it is very important to receive services as soon as possible.

Additional Information

Autism, formally called autism spectrum disorder (ASD) or autism spectrum condition (ASC), is a neurodevelopmental disorder characterized by deficits in social communication and social interaction, and repetitive or restricted patterns of behaviors, interests, or activities, which can include hyper- and hyporeactivity to sensory input. Autism is a spectrum disorder, meaning that it can manifest very differently in each person. For example, some are nonspeaking, while others have proficient spoken language. Because of this, there is wide variation in the support needs of people across the autism spectrum.

There are many theories about what causes autism; it is highly heritable and mainly genetic, but many genes are involved, and environmental factors may also be relevant. The syndrome frequently co-occurs with other conditions, including attention deficit hyperactivity disorder, epilepsy, and intellectual disability. Disagreements persist about what should be included as part of the diagnosis, whether there are meaningful subtypes of autism, and the significance of autism-associated traits in the wider population. The combination of broader criteria, increased awareness, and potentially increasing actual prevalence, has led to a trend of steadily increasing estimates of autism prevalence, perpetuating the disproven myth that it is caused by vaccines.

Psychiatry has traditionally classified autism as a mental disorder, but the autism rights movement and a small but increasing number of researchers see autism as part of neurodiversity, the natural diversity in human thinking and experience, with strengths, differences, and weaknesses. From this point of view, autistic people often still have a disability, but need to be accommodated rather than cured. This perspective has led to significant controversy among those who are autistic and advocates, practitioners, and charities. Some therapies for autism, such as applied behavior analysis, are controversial in the autism rights movement, with many considering them unhelpful and unethical.

There is no known way to prevent or cure autism. Many forms of therapy, such as speech and occupational therapy, have been developed that may help autistic people. Some forms of therapy, such as applied behavior analysis, have been shown to improve certain symptoms of autism, such as socialization, communication, expressive language, intellectual functioning, language development, and acquisition of daily living skills. Intervention can require accommodations such as alternative modes of communication. The use of pharmaceutical medicine is usually focused on associated conditions such as epilepsy or certain symptoms.

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