Autism Spectrum Disorder (ASD)
What is Autism
Autism spectrum disorder (ASD) is a developmental disability caused by differences in the brain in both children and adults. The exact causes of ASD are still unknown, though it is widely believed most cases are related to genetics. The medical community believes there are multiple causes of ASD that change the way people develop. ASD is becoming more common and is currently thought to impact 1 out of every 44 children born in the United States each year.
There is no one definitive “type” of autism but rather many subtypes, most influenced by a combination of genetic and environmental factors. Autism is a spectrum disorder, which means each person with autism has a distinct set of strengths and challenges. For example, how people with autism learn to think and problem-solve can range considerably. Some are highly skilled and often considered “gifted,” while others are severely challenged to comprehend essential education topics. The range of care people with ASD requires also varies greatly. Some can function independently in society as they grow older, while others need consistent daily care as they become adults.
Signs and Symptoms of Autism
Signs of Autism Spectrum disorder generally begin to appear by age 2 or 3. However, some associated development delays may occur even earlier. One example of an early developmental delay would be a child not responding to their name by age of 9 or 10 months. Because this is a spectrum disorder, signs and symptoms can vary greatly. This is why ASD is generally definitively diagnosed as a child approaches the age of three.
Research shows that early intervention leads to positive outcomes later in life for people with autism. Although ASD signs may vary considerably, common indicators appear across many diagnoses. In addition, the severity of these signs may vary depending on where on the spectrum the individual may be.
Challenges with Social Skills & Interactions
Social communication and interaction skills may be very challenging for people with ASD. These challenges manifest themselves differently, from avoiding eye contact to acting irrationally in large group settings for no apparent reason. According to the CDC, these are the most common signs to watch for by age:
- Avoids or does not keep eye contact
- Does not respond to name by 9 months of age
- Does not show facial expressions like happy, sad, angry, and surprised by 9 months of age
- Does not play simple interactive games like pat-a-cake by 12 months of age
- Uses few or no gestures by 12 months of age (e.g., does not wave goodbye)
- Does not share interests with others (e.g., shows you an object that they like by 15 months of age)
- Does not point or look at what you point to by 18 months of age
- Does not notice when others are hurt or sad by 24 months of age
- Does not pretend in play (e.g., does not pretend to “feed” a doll by 30 months of age)
- Shows little interest in peers
- Has trouble understanding other people’s feelings or talking about own feelings at 36 months of age or older
Does not play games with turn-taking by 60 months of age
Restricted and/or Repetitive Behaviors and Interests
Other examples of restricted/repetitive behavior from the CDC are:
- Lines up objects and gets upset when order is changed
- Repeats words or phrases over and over (i.e., echolalia)
- Plays with toys the same way every time
- Is focused on parts of objects (e.g., wheels)
- Gets upset by minor changes
- Has obsessive interests
- Must follow certain routines
- Flaps hands, rocks body, or spins self in circles
- Has unusual reactions to the way things sound, smell, taste, look or feel
Other Related Signs or Symptoms
Although common signs of ASD include challenges with social skills and interactions and restricted or repetitive behavior, there are other signs and indications to watch for. In younger children, parents may often overlook signs such as delayed speech or movement skills. Many parents simply think a child may be a “late bloomer” and often miss other related signs that ASD may be causing developmental delays.
Other signs to look for include:
- Delayed language skills
- Delayed movement skills
- Delayed cognitive or learning skills
- Hyperactive, impulsive, and/or inattentive behavior
- Epilepsy or seizure disorder
- Unusual eating and sleeping habits
- Gastrointestinal issues (e.g., constipation)
- Unusual mood or emotional reactions
- Anxiety, stress, or excessive worry
- Lack of fear or more fear than expected
ASD signs vary significantly from person to person. It is possible for an individual with ASD not to display any of the signs, with ASD manifesting differently. The most important thing to remember is that early intervention is vital. If a parent suspects a child may be impacted by ASD, seeking a professional evaluation is critical to the child’s future development.
Adults with Autism Spectrum Disorder
It is important to note that ASD also impacts adults. Until 2013, Asperger’s syndrome was widely used to describe adults on the spectrum. Although Asperger’s syndrome has since been included under the Autism Spectrum, the term is still commonly used today.
Signs and symptoms of ASD in adults vary greatly, just as they do in children. Typically, an adult with ASD has gone undiagnosed most of their life because symptoms are mild or favorable in many ways. For example, positive signs may manifest as exceptional vocabulary and above-average intelligence. However, adults with ASD may experience other symptoms such as sensitivity to light, sounds, and touch. These symptoms may cause negative impacts on personal and professional relationships.
How Autism Is Treated
Because Autism Spectrum Disorder manifests so differently in both children and adults, finalized treatment plans are uniquely tailored for each individual. However, the first step to getting a personalized treatment plan is to schedule a professional evaluation with a neuropsychologist. Evaluations are different for children and adults, but they allow for a proper condition diagnosis. The evaluations also include a high-level look at the individual’s strengths weaknesses and allow for input from family and teachers.
Although every plan may look different, the most commonly used and evidence-based approach is applied behavioral analysis as a teaching method. This approach helps individuals with ASD develop appropriate skills to integrate more naturally into our society. In this approach, the child’s behavior functions are analyzed, and this information is used to set up preventative modifications and consequence modifications. This way, targeted behaviors can be addressed consistently before and after they occur.
ABA therapy is used by trained teachers in the classroom or provided by a psychologist or board-certified behavioral analyst (BCBA), who may direct treatment administered by a behavior technician.