Autism Spectrum Disorder

If your child has been diagnosed with autism [AW-tiz-uhm] spectrum disorder (ASD), you may wonder, “What is autism?” It’s a brain disorder that makes it hard to interact with others or communicate well.

In Utah, autism is diagnosed in 1 out of every 80 males, and it is diagnosed 6 times more often in boys than in girls. It is sometimes not diagnosed until a person is an adult. It usually shows up during a child’s first three years of life, and it can be seen in some babies.

Symptoms tend to fall into a few main areas:

• Problems with social interactions. Your child might want to play alone instead of with other kids.
• Trouble communicating. Your child might seem odd, difficult, or rude to some people because they act differently or don’t communicate the same way as other kids.
• Repeating patterns of behaviors, interests, and activities. This might be a movement, such as flapping their hands or rocking, and they might focus on following a routine. They might have an unusual attachment to objects.
• Sensitivity to sensory input. Your child might not want to be touched.

These symptoms happen on a spectrum, which is like a range or scale. They may be present in different combinations and with different degrees of severity in each child.

If your child has autism, they will have the condition for their whole life. With treatment, they might have fewer symptoms. With the right help, they can learn skills that will help them to live fulfilling, happy lives.

Prior to 2013, doctors thought of Asperger’s syndrome as a separate condition from autism. Asperger’s, autism, and similar diseases were all part of a category called pervasive developmental disorders (PDD). When a child’s symptoms didn’t quite fit either autism or Asperger’s, doctors would use a diagnosis of PDD-NOS (not otherwise specified).

In 2013, doctors changed the way they put these disorders into categories. Today, doctors think Asperger’s is a kind of high-functioning autism, and they’re more likely to diagnose autism, Asperger’s, and PDD-NOS as ASDs.

If your child has autism, they will have at least one of the following symptoms in each of these areas:

Problems with social interactions

• Not using or responding to social cues, like eye-to-eye contact, facial expressions, or body postures
• Trouble making friends and mixing with others
• Appearing aloof and seeming to prefer spending time
• Lacking interest in sharing ideas, fun activities, or achievements with others
• Not wanting to cuddle or be cuddled
• Not engaging in play where they pretend

Trouble communicating

• Delayed language development
• Trouble starting or keeping up a conversation
• Talking at, and not with, others in one-sided conversations
• Repeating words or phrases
• Struggling to express needs, maybe gesturing or pointing instead of using words
• Not responding to verbal cues or appearing to be deaf

Repeating patterns

• Intense preoccupations with certain topics
• Unusual attachments to particular objects
• Insisting on schedules, routines, and rituals
• Displaying sustained odd play or gestures (for example, spinning objects, hand or finger flapping, or rocking)
• Hurting themselves (for example, biting their own arms) or physically attacking others
• Being over-active or under-active
• Having uneven development of motor skills (for example, can stack blocks, but not kick a ball)

Sensitivity

• Being overly sensitive to sounds, sights, sensations, and smells (for example, gagging at particular smells, drawing back when around bright lights or when offered a hug)
• Being overly sensitive to pain or not noticing pain as much as other people
• Showing little or no fear of danger

High-functioning Autism

Sometimes it is more difficult to see signs in high-functioning children with autism. Like children with more severe symptoms, they can:

• Have routines or rituals that they need to repeat
• Struggle with social skills
• Be very literal
• Be highly sensitive to light, sound, texture, and taste
• Have delayed development in speech, motor, and other skills

When some cases of autism were diagnosed as Asperger’s syndrome, a main symptom was an intense focus on a single subject. They might become an expert on that subject with an obsession for every detail.

Other signs and symptoms

Children with autism can and do give affection. But because their brains process things in a different way, they have different ways of giving and accepting love. You need to be patient in learning how to be affectionate on your child’s terms.

People with autism have a wide range of IQ scores. Only 10 percent of them have special skills in a narrow area.

If you have concerns, be sure to share them with your child’s doctor. An autism spectrum disorder can be diagnosed as early as 12 to 18 months, and early treatment is one of the best ways to manage the symptoms of autism. Your child’s doctor should check your child’s development at their well-baby checkups, including looking for signs of autism. Before age 2, they look for signs of NO:

• Eye contact at three to four months
• Babbling, pointing, or gesturing by age 12 months
• Single words spoken by age 16 months
• Two-word phrases by age 24 months, just repeating others’ words or sounds
• Loss of language or social skills (at any age)

Autism was first identified in 1943. Doctors still don’t know what causes it, but they do know that ASD is not caused by the way a parent raises their child. Because people are either born with it or with a tendency to develop it, scientists study both:

• Genetic factors. Scans show differences in brain shape and structure in people with autism. Scientists think these changes are genetic, meaning part of your child’s DNA.
• Environmental factors. Autism is a biological disorder. Outside factors don’t cause it, but they might trigger autism behaviors. Scientists are studying whether or not viral infections, metabolic imbalances, and exposure to certain chemicals are triggers.

There is no single test that can be used to diagnose ASD, so doctors will use several different approaches to decide whether your child has this disorder, such as:

• Checklists and surveys from parents, school staff, and other doctors who have observed the person in various situations. The questionnaires ask about the person’s behaviors, relationships with others, body use, verbal communication, and play habits.
• Standard medical criteria. A doctor diagnoses autism only if the information gathered meets standard criteria for the disorder. Along with using the checklists and questionnaires above, your doctor gathers this information by interviewing and observing your child.
• Medical tests. Additional tests might be used to get more information. These tests don’t diagnose autism. They can help rule out or discover other conditions that may be causing symptoms (or making them worse).
• Evaluations. Hearing evaluations rule out hearing problems. Speech and language evaluations assess speech, language, and overall communication abilities. These evaluations are very important because autism has a big effect on overall communication skills.
• Evaluation by specialists. Consulting with one or more specialists can often be helpful in the complex process of diagnosing autism.

Your doctor might also look at other conditions that could be causing the same symptoms. Your child might have these conditions in addition to or instead of autism:

• Other behavior disorders like ADHD, oppositional defiant disorder, or conduct disorder
• Other developmental disorders, learning disabilities, or mental retardation
• Hearing loss
• Anxiety or depression
• Epilepsy

Treatment for your child’s autism should be:

• Started as soon as possible
• Made to fit your child’s symptoms
• Intensive

Studies show that early, individualized, and intensive treatment has the most positive impact on the abilities of a person with autism. Therapy for specific problems might even begin before a formal diagnosis is complete.

An intensive approach means your child is engaged in meaningful activities for several hours per week. Ask your child’s doctor for how many hours would be right for your child. These hours can be spent with a treatment provider, family members, caregivers, or teachers.

Your child’s treatment should include three parts:

1. A home plan. Commit to your child’s treatment, and practice acceptance.
2. A school plan. Get involved, and know your rights. If your child needs special services, federal laws outline your child’s right to a free and appropriate public education (FAPE).
3. A medical plan. Develop a treatment plan, follow through with it, and work with your child’s doctors to make any needed changes. If treatment includes medicine, make sure your child takes it as prescribed.

The medical plan may include both therapy and medicine, and you might also consider counseling. Behavioral and communication training aims to change autism behaviors and improve communication skills. This training can use several approaches, including:

• Sensory integration therapy, which repeatedly exposes children to sensory stimulation in an organized way
• SCERTS model (social communication, emotional regulation, and transaction supports), which helps children with social communication
• Applied behavioral analysis (ABA), which helps with behavior change
• Intensive behavioral intervention (EIBI), which focuses on therapy early in a child’s life

Other treatments that might help your child include:

• Therapy sessions with a counselor or psychologist
• Occupational therapy for social, daily living, feeding, and other skills
• Speech-language therapy to improve language and learning skills

Alternative approaches

Be careful with alternative therapies, including vitamin therapy, special diets, and others. Most alternative therapies have not been tested in scientific studies, and some can be dangerous, such as chelation [kee-LEY-shun] (the use of chemicals to remove metals from the body). Other therapies are expensive and ineffective, such as treatment with the hormone secretin.

Unfortunately, there is no known way to prevent autism spectrum disorders, and there is no way to cure them. Research studies have found NO links between autism and either vaccines or mercury. It’s important that your child gets their vaccines to prevent a serious illness.

• Autism Speaks

Autism spectrum disorder (ASD) is a diagnosis range that covers high-functioning autism behaviors (what used to be called Asperger’s syndrome) to more severe cases. All children with ASD have trouble with social skills, communication, and sensory input. They also engage in repetitive acts (such as hand flapping) or fixate on subjects to the point where they become an expert in a single topic.