What Is Autism?

Autism refers to neurological and developmental abnormalities most often observed within the first few years of a child’s life. Each child with autism may exhibit different symptoms. However, most have difficulty communicating and interacting with other children and adults. They also have limited interests and may seem obsessed with one subject at a time. Repetitive behaviors are also common among those with autism.

Autism Vs. Autism Spectrum Disorder

Autism and autism spectrum disorder (ASD) are often talked about as being the same thing. However, ASD represents a broad term under which multiple disorders fall, including autism. Each disorder has specific behavior and cognitive challenges that help doctors distinguish them from one another. Someone with ASD may have:

• Autism, which affects the nervous system, causing developmental disabilities.
• Asperger syndrome, which is a developmental disorder causing deficits in socialization and communication.
• Childhood disintegrative disorder, which is rare and occurs when a child loses communication, socialization, and motor skills functioning.
• Pervasive developmental disorder not otherwise specified (PDD-NOS), which refers to a child that has some symptoms of autism but not all; they may also have milder symptoms.
• Rett Syndrome, which is extremely rare and refers to symptoms that onset after a child is six months old. Symptoms include loss of coordination, speech, and use of hands. However, symptoms can be stable for years.

Autism is one of many factors that make up the entire spectrum, and each person can be affected in different ways. The severity of symptoms also helps doctors differentiate a child’s place on the ASD.

According to the Centers for Disease Control and Prevention, 1 in 36 children are on the autism spectrum. It is four times more common in boys, and about one-third of the children have an intellectual disability, and 17% have a developmental disability.

ASD Criteria

To be diagnosed with ASD, a person must meet specific criteria published in the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5). A child must have the following deficits in social communication and interactions:

• Challenges in social and emotional reciprocity
• Difficulty in non-verbal communication for interacting socially
• Trouble developing and maintaining relationships with others

A child must also exhibit two of the following deficits regarding restrictive and repetitive behaviors or interests:

• Repeats words or phrases
• Follows routines or rituals
• Becomes hyper-focused on subjects or objects

Criteria alone are not enough to diagnose someone with ASD. Doctors must also determine how intensely the symptoms affect a person before deciding on a final diagnosis.

ASD Levels Of Intensity

The severity of a person’s symptoms is a crucial piece of information to know when deciding where on the autism spectrum a person’s diagnosis falls. There are three intensity levels regarding ASD, from level one, which requires the least support, to level three, which requires the most support:

Level One – Requiring Support

Level one represents someone with challenges in social settings who may lack interest in social interactions. They may also have repetitive behaviors and fixed interests, making completing tasks at school or home hard.

Level Two – Requiring Substantial Support

Level two refers to people with significant verbal and nonverbal communication delays. Even with support, it is hard for them to interact socially. Their restricted and repetitive behaviors are apparent, and when distracted from them, the child may exhibit distress.

Level Three – Requiring Very Substantial Support

Level three refers to people with ASD symptoms that interfere with daily functioning. Any change in their routine causes extreme distress, and it is hard to refocus them. They have minimal social abilities.

Understanding symptom intensity levels helps doctors and therapists choose the most appropriate treatments. However, intensity should not be the only factor in diagnosing autism. Doctors must consider a child’s symptoms in various environments and around certain people.

What Are The Symptoms Of Autism?

ASD symptoms fall into four categories: communication, social behavior, stereotyped behavior, and other behavior. Every child will exhibit different symptoms, but there are commonly seen behaviors, which are categorized below.

Communication Symptoms

Communication symptoms include verbal and nonverbal language and a disruption in a child’s ability to send a message. Most doctors will notice delays like the following at a child’s first-year checkup, possibly sooner:

• They do not respond to their name when it is called.
• They cannot show or tell someone what they want.
• They do not follow directions.
• They go back and forth between hearing and not hearing.
• They don’t point or wave goodbye.
• They don’t say words or babble, even though they did so previously.

Communication problems can be frustrating for parents. They want to help but don’t know how. By working with doctors and therapists, they can learn more about the disorder and how to help their child progress.

Social Behavior Symptoms

Playdates and social outings are important social milestones for parents, children, and children with autism. Knowing potential social behavioral symptoms that a child with ASD might present with makes it easier to adapt to social situations:

• They do not return a smile to someone smiling at them.
• They have poor eye contact.
• They like to play alone.
• They are not bothered by the noises around them.
• They seem very independent.
• They are not interested in other children or adults.
• They do not like attention.

It is crucial not to isolate children with autism. Although it can feel frustrating and overwhelming, socialization is good for parents and children dealing with autism. Joining a playgroup or a support group with other families is highly recommended.

Stereotyped Behavior Symptoms

Stereotyped behaviors are actions that are repeated and usually involuntary movements. The behaviors often do not have a function or use. They may also include:

• Becoming overly attached to objects, toys, or routines.
• Exhibiting signs of obsessive-compulsive disorder, like lining up or putting objects in order.
• Repeating words, phrases, or actions and can’t seem to move on from them.
• Rocking, nail-biting, banging, handshaking, waving, and mouthing objects.

Stereotyped behavior symptoms tend to increase in stressful situations. Caring for someone with symptoms is essential to prevent injuries or accidents.

Other Behavior Symptoms

Every child with autism can exhibit unique symptoms that others may or may not have. They may show one set of symptoms at home and a different set at school or public places. Additional behaviors may include:

• Not playing pretend by the time they are 18 months old.
• Having odd movements, including walking on their toes.
• Throwing tantrums that can be violent.
• Being overly sensitive to some sensations, like loud noises or the sun.
• Staring into space or roaming with no purpose.

The National Institute of Mental Health lists even more symptoms to look for in a child on the autism spectrum. For example:

• Talking at length about a favorite subject without concern for others.
• Having facial expressions or movements that do not match their words.
• Speaking in a robot-like tone.
• Becoming upset when slight changes occur.
• Having sleep disturbances.
• Learning something in detail and remembering the information for a long time.
• Excelling in math, science, art, or music.
• Learning best through visual or auditory methods.

Children may exhibit many symptoms not listed here. Explaining all symptoms to a child’s doctor is crucial to giving them an accurate picture of their behavior. Document any unusual symptoms at the first sign and share them with a medical provider.

What Causes Autism?

Autism is a highly researched topic, with many wanting to learn more about its causes and why some people develop the disorder. Many theories suggest genetics play the most significant role.

Research to date shows autism has between 70% and 90% hereditability, with more than 800 genes connected to the disorder. Having the gene does not guarantee that a person will have autism. There are many gene mutations, gene-protein interactions, and metabolic disturbances at work to cause autism. Researchers are finding that at least half of people with ASD have chromosome deletions or duplication, syndromes, or single gene disorders.

While genetics plays the most considerable role in the development of ASD, it is not the only risk factor.

What Are The Risk Factors For Autism?

Risk factors are the things that make it more likely that a child will develop autism. The more risk factors a person has, the more likely they may develop the disorder. Risk factors include the following:

• Having a sibling with autism
• Having advanced parental age at the time of birth
• Being born with low birth weight
• Being exposed to contaminants pre-birth and in early life
• Experiencing obesity, diabetes, or an immune disorder while pregnant
• Being deprived of oxygen during birth

While genetics are the main risk factors, environmental factors, even the ones we can’t see, contribute to the disorder. Parents cannot control most risk factors, making noticing early symptoms crucial.

What Are The Complications Of Autism?

The three core clinical features of autism include social and communication problems, restricted and fixated interests, and language delay. Children with ASD may experience complications that lead to additional disorders, behavior problems, or psychiatric issues. Examples of comorbid complications include:

• Anxiety
• Obsessive-compulsive behavior
• ADHD
• Sleep disorders
• Epilepsy
• Accidents and injuries
• Genetic disorders
• Metabolic disorders
• Immune system disorders
• Gastrointestinal problems
• Neurological disorders
• Allergies
• Motor dysfunction
• Agitation and aggression
• Sensory dysfunction
• Intellectual disability

Medical complications can further impact a child’s development. Parents should discuss any abnormal symptoms with their doctor at the first sign of any, as some complications are much easier to treat than others.

Asperger Vs. Autism

Asperger syndrome may also be called ASD without intellectual or language impairment. It is a disorder in the ASD, a category under pervasive developmental disorders. Someone with Asperger Syndrome may appear to have trouble fitting in socially and seem awkward when trying to relate to peers. They may also have obsessive interests.

A child with Asperger syndrome can function well in social and academic activities at school. Most do not require as much support as with other disorders of ASD. However, they may sometimes not know how to respond in specific social contexts. They may not realize when someone is joking, being sarcastic,  or using body language to communicate. To be diagnosed with Asperger syndrome, the following criteria must be met:

• There are two symptoms of social impairment: one is communication, and the other is restricted and repetitive behavior
• One symptom of impaired functioning in social interaction, social language, or imaginative play
• Does not meet the diagnostic criteria for autistic disorder

Asperger syndrome no longer has a separate diagnosis, as it now falls under ASD at level one intensity, requiring minimal support. While there is no cure for Asperger syndrome, there are many ways to improve symptoms at home and school, such as social and behavioral interventions that make children feel more comfortable in the environments where they spend the most time.

What Is High-Functioning Autism?

A high-functioning autism (HFA) diagnosis is given to someone who meets the criteria for ASD, except they do not have an intellectual disability. They have an intelligence quotient (IQ) of 70 or higher. High-functioning autism is sometimes confused with Asperger syndrome because a person requires minimal support, and they can form relationships, gain employment, and experience greater independence.

Is ADHD On The Autism Spectrum?

Attention-deficit/hyperactivity disorder (ADHD) is a mental health disorder with noticeable signs of inattention, hyperactivity, and lack of impulse control. ADHD is not on the ASD, but it can accompany autism, be triggered by it, or be a result of it. Kids with ADHD may struggle to sit still, concentrate, complete tasks, follow directions, and attend to details. Overlapping symptoms with autism spectrum disorder include being unable to wait their turn, interrupting others, and doing things without first asking permission.

About 75% of people diagnosed with autism spectrum disorder have a comorbid disease, such as ADHD. Typically, the diseases are chronic.

How Is Autism Diagnosed?

According to the National Institute of Mental Health, children should have regular well-check visits with the delivering doctor or pediatrician. The doctors and nurses test for signs showing the child’s growth is progressing normally. If not, they will recommend further testing in certain areas. If a child is sent for ASD testing, multiple specialists may participate. When testing for autism, the specialists may have backgrounds in neurology, speech and language, growth and development, education, psychology, psychiatry, and occupational therapy.

Parents play a crucial role in diagnosing autism, and specific reporting of a child’s behaviors will aid in getting a proper diagnosis. Provide examples of a child’s abnormal behaviors and include videos so the doctor can review and decide.

How Is Autism Treated?

Autism treatment is based on each person’s unique symptoms and circumstances. Getting an accurate diagnosis is essential for creating the best treatment plan. There is no cure for autism, but doctors can prescribe mental health medications to treat the symptoms they are having. For example, medications can help control ADHD, anxiety, and depressive symptoms. The most beneficial treatments may include a combination of the following:

• Behavioral therapies, such as using a reward system to train children to communicate and engage socially
• Speech therapy to train children in speaking and language
• Physical therapy to help children control movements
• Medication to treat symptoms, typically antidepressants and antianxiety medicines
• Sensory enrichment or environmental therapy to help parents create a home suitable for autism

Doctors and therapists can create treatment plans for home, school, and social settings. Working with a licensed mental health professional is also good for the loved ones of someone with ASD to ensure everyone’s needs are met and that they can support one another while learning how to cope with ASD symptoms. Family therapy for parents and siblings to develop coping skills and receive psychoeducation about autism is beneficial for families since everyone is affected by ASD symptoms.

Can Autism Be Prevented?

Because genetics are the primary cause of autism, it is not likely that it can be prevented. However, there may be many things parents can do to reduce the risk factors associated with ASD. Tips include the following:

• Focusing on prenatal care, including eating a healthy diet full of nutrients and supplemental vitamins
• Living in an environment with a low level of toxins and contaminants
• Consulting with a genetic counselor to determine a child’s predisposition
• Ensuring mental and physical health problems are treated effectively during pregnancy
• Avoiding misusing drugs or alcohol during pregnancy, including smoking
• Consulting with a doctor about medications and their effects on unborn children

After a child is born, parents can participate in early intervention programs, create a supportive environment, and engage in activities where the child feels included in the community. Parents can benefit from working with a therapist or interventionist to learn parenting techniques for autistic children. The most important tip is to avoid waiting too long to seek help.

Learn More About ASD

Autism spectrum disorder is complex and can be challenging to understand in the beginning. However, the more you know about autism, the better you can help your child. Many resources exist to help you gather more information about ASD, including:

• Local and online mental health specialist who specializes in ASD
• Autism Speaks
• American Academy of Child and Adolescent Psychiatry
• Autism Society
• National Institute of Child Health and Human Development
• Local and online Autism support groups
• Teachers or school counselors with ASD training
• Books, journals, and websites dedicated to ASD education

Understanding ASD is essential to support and nurture the unique needs and strengths of a child on the autism spectrum. With this knowledge, you can advocate for your child and ultimately create an environment that helps them thrive.