AUTISM

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Autism spectrum disorder (ASD) is a broad term used to describe a group of neurodevelopmental disorders.

These disorders are characterized by problems with communication and social interaction. People with ASD often demonstrate restricted, repetitive, and stereotyped interests or patterns of behavior.

ASD is found in individuals around the world, regardless of race, culture, or economic background. According to the Centers for Disease Control and Prevention (CDC)Trusted Source, autism does occur more often in boys than in girls, with a 4 to 1 male-to-female ratio.

The CDC estimated in 2014 that nearly 1 in 59 children have been identified with ASD.

There are indications that instances of ASD are on the rise. Some attribute this increase to environmental factors. However, experts debate whether there’s an actual increase in cases or just more frequent diagnoses.

Autism spectrum disorder is a condition related to brain development that impacts how a person perceives and socializes with others, causing problems in social interaction and communication. The disorder also includes limited and repetitive patterns of behavior. The term “spectrum” in autism spectrum disorder refers to the wide range of symptoms and severity.

Autism spectrum disorder includes conditions that were previously considered separate — autism, Asperger’s syndrome, childhood disintegrative disorder and an unspecified form of pervasive developmental disorder. Some people still use the term “Asperger’s syndrome,” which is generally thought to be at the mild end of autism spectrum disorder.

Autism spectrum disorder begins in early childhood and eventually causes problems functioning in society — socially, in school and at work, for example. Often children show symptoms of autism within the first year. A small number of children appear to develop normally in the first year, and then go through a period of regression between 18 and 24 months of age when they develop autism symptoms.

While there is no cure for autism spectrum disorder, intensive, early treatment can make a big difference in the lives of many children.

What are the different types of autism?

The DSM (Diagnostic and Statistical Manual of Mental Disorders) is published by the American Psychiatric Association (APA) and is used by clinicians to diagnose a variety of psychiatric disorders.

The fifth and most recent edition of the DSM was released in 2013. The DSM-5 currently recognizes five different ASD subtypes, or specifiers. They are:

• with or without accompanying intellectual impairment
• with or without accompanying language impairment
• associated with a known medical or genetic condition or environmental factor
• associated with another neurodevelopmental, mental, or behavioral disorder
• with catatonia

Someone can be diagnosed with one or more specifiers.

Prior to the DSM-5, people on the autism spectrum may have been diagnosed with one of the following disorders:

• autistic disorder
• Asperger’s syndrome
• pervasive development disorder-not otherwise specified (PDD-NOS)
• childhood disintegrative disorder

It’s important to note that a person who received one of these earlier diagnoses hasn’t lost their diagnosis and won’t need to be reevaluated.

According to the DSM-5, the broader diagnosis of ASD encompasses disorders such as Asperger’s syndrome.

What are the symptoms of autism?

Autism symptoms typically become clearly evident during early childhood, between 12 and 24 months of age. However, symptoms may also appear earlier or later.

Early symptoms may include a marked delay in language or social development.

The DSM-5 divides symptoms of autism into two categories: problems with communication and social interaction, and restricted or repetitive patterns of behavior or activities.

Problems with communication and social interaction include:

• issues with communication, including difficulties sharing emotions, sharing interests, or maintaining a back-and-forth conversation
• issues with nonverbal communication, such as trouble maintaining eye contact or reading body language
• difficulties developing and maintaining relationships

Restricted or repetitive patterns of behavior or activities include:

• repetitive movements, motions, or speech patterns
• rigid adherence to specific routines or behaviors
• an increase or decrease in sensitivity to specific sensory information from their surroundings, such as a negative reaction to a specific sound
• fixated interests or preoccupations

Individuals are evaluated within each category and the severity of their symptoms is noted.

In order to receive an ASD diagnosis, a person must display all three symptoms in the first category and at least two symptoms in the second category.

What causes autism?

The exact cause of ASD is unknown. The most current research demonstrates that there’s no single cause.

Some of the suspected risk factors for autism include:

• having an immediate family member with autism
• genetic mutations
• fragile X syndrome and other genetic disorders
• being born to older parents
• low birth weight
• metabolic imbalances
• exposure to heavy metals and environmental toxins
• a history of viral infections
• fetal exposure to the medications valproic acid (Depakene) or thalidomide (Thalomid)

According to the National Institute of Neurological Disorders and Stroke (NINDS), both genetics and environment may determine whether a person develops autism.

Multiple sources, old and new Trusted Source, have concluded that the disorder isn’t caused by vaccines, however.

A controversial 1998 study proposed a link between autism and the measles, mumps, and rubella (MMR) vaccine. However, that study has been debunked by other research and was eventually retracted in 2010

What tests are used to diagnose autism?

An ASD diagnosis involves several different screenings, genetic tests, and evaluations.

Developmental screenings

The American Academy of Pediatrics (AAP) recommends that all children undergo screening for ASD at the ages of 18 and 24 months.

Screening can help with early identification of children who could have ASD. These children may benefit from early diagnosis and intervention.

The Modified Checklist for Autism in Toddlers (M-CHAT) is a common screening tool used by many pediatric offices. This 23-question survey is filled out by parents. Pediatricians can then use the responses provided to identify children that may be at risk of having ASD.

It’s important to note that screening isn’t a diagnosis. Children who screen positively for ASD don’t necessarily have the disorder. Additionally, screenings sometimes don’t detect every child that has ASD.

Other screenings and tests

Your child’s physician may recommend a combination of tests for autism, including:

• DNA testing for genetic diseases
• behavioral evaluation
• visual and audio tests to rule out any issues with vision and hearing that aren’t related to autism
• occupational therapy screening
• developmental questionnaires, such as the Autism Diagnostic Observation Schedule (ADOS)

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Diagnoses are typically made by a team of specialists. This team may include child psychologists, occupational therapists, or speech and language pathologists.

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How is autism treated?

There are no “cures” for autism, but therapies and other treatment considerations can help people feel better or alleviate their symptoms.

Many treatment approaches involve therapies such as:

• behavioral therapy
• play therapy
• occupational therapy
• physical therapy
• speech therapy

Massages, weighted blankets and clothing, and meditation techniques may also induce relaxing effects. However, treatment results will vary.

Alternative treatments

Alternative treatments for managing autism may include:

• high-dose vitamins
• chelation therapy, which involves flushing metals from the body
• hyperbaric oxygen therapy
• melatonin to address sleep issues

Research on alternative treatments is mixed, and some of these treatments can be dangerous.

Before investing in any of them, parents and caregivers should weigh the research and financial costs against any possible benefits.

Can diet have an impact on autism?

There’s no specific diet designed for people with ASD. Nevertheless, some autism advocates are exploring dietary changes as a way to help minimize behavioral issues and increase overall quality of life.

A foundation of the autism diet is the avoidance of artificial additives. These include preservatives, colors, and sweeteners.

An autism diet may instead focus on whole foods, such as:

• fresh fruits and vegetables
• lean poultry
• fish
• unsaturated fats
• lots of water

Some autism advocates also endorse a gluten-free diet. The protein gluten is found in wheat, barley, and other grains.

Those advocates believe that gluten creates inflammation and adverse bodily reactions in certain people with ASD. However, scientific research is inconclusive on the relationship between autism, gluten, and another protein known as casein.

Some studies, and anecdotal evidence, have suggested that diet can help improve symptoms of attention-deficit hyperactivity disorder (ADHD), a condition similar to autism. Find out more about the ADHD diet.

How does autism affect kids?

Children with autism may not reach the same developmental milestones as their peers, or they may demonstrate loss of social or language skills previously developed.

For instance, a 2 year old without autism may show interest in simple games of make-believe. A 4 year old without autism may enjoy engaging in activities with other children. A child with autism may have trouble interacting with others or dislike it altogether.

Children with autism may also engage in repetitive behaviors, have difficulty sleeping, or compulsively eat nonfood items. They may find it hard to thrive without a structured environment or consistent routine.

If your child has autism, you may have to work closely with their teachers to ensure they succeed in the classroom.

Many resources are available to help children with autism as well as their loved ones.

Local support groups can be found through the national nonprofit The Autism Society. The organization Autism Speaks also provides targeted toolkits intended for the parents, siblings, grandparents, and friends of children with autism.

Autism and exercise

Children with autism may find that certain exercises can play a role in alleviating frustrations and promoting overall well-being.

Any type of exercise that your child enjoys can be beneficial. Walking and simply having fun on the playground are both ideal.

Swimming and being in water can serve as both exercise and a sensory play activity. Sensory play activities can help people with autism who may have trouble processing signals from their senses.

Sometimes contact sports can be difficult for children with autism. You can instead encourage other forms of challenging yet strengthening exercises.

How does autism affect girls?

Because of its gender-specific prevalence, autism is often stereotyped as a boys’ disease. According to the trusted source ASDs are about 4 times more common in boys than in girls.

However, this doesn’t mean that autism doesn’t occur in girls. In fact, the CDC estimates that 0.66 percent, or around 1 in every 152 girls, have autism. Autism may even present differently in women.

In comparison to recent decades, autism is being tested earlier and more often now. This leads to higher reported rates in both boys and girls.

How does autism affect adults?

Families who have loved ones with ASD may worry about what life with autism looks like for an adult.

A minority of adults with ASD may go on to live or work independently. However, many adults with ASD require continued aid or intervention throughout their lives.

Introducing therapies and other treatments early in life can help lead to more independence and better quality of life.

Sometimes people who are on the spectrum aren’t diagnosed until much later in life. This is due, in part, to a previous lack of awareness among medical practitioners.

Seek help if you suspect you have adult autism. It’s not too late to be diagnosed.

Why is autism awareness important?

April is World Autism Month. It’s also been deemed National Autism Awareness Month in the United States. However, many advocates have rightly called for the need to increase awareness about ASDs year-round, and not just during 30 select days.

Autism awareness also requires empathy and an understanding that ASDs are different for everyone.

Certain treatments and therapies can work for some people but not others. Parents and caregivers can also have differing opinions on the best way to advocate for a child with autism.

Understanding autism and people who are on the spectrum starts with awareness, but it doesn’t end there.

Risk factors

The number of children diagnosed with autism spectrum disorder is rising. It’s not clear whether this is due to better detection and reporting or a real increase in the number of cases, or both.

Autism spectrum disorder affects children of all races and nationalities, but certain factors increase a child’s risk. These may include:

• Your child’s sex. Boys are about four times more likely to develop autism spectrum disorder than girls are.
• Family history. Families who have one child with autism spectrum disorder have an increased risk of having another child with the disorder. It’s also not uncommon for parents or relatives of a child with autism spectrum disorder to have minor problems with social or communication skills themselves or to engage in certain behaviors typical of the disorder.
• Other disorders. Children with certain medical conditions have a higher than normal risk of autism spectrum disorder or autism-like symptoms. Examples include fragile X syndrome, an inherited disorder that causes intellectual problems; tuberous sclerosis, a condition in which benign tumors develop in the brain; and Rett syndrome, a genetic condition occurring almost exclusively in girls, which causes slowing of head growth, intellectual disability and loss of purposeful hand use.
• Extremely preterm babies. Babies born before 26 weeks of gestation may have a greater risk of autism spectrum disorder.
• Parents’ ages. There may be a connection between children born to older parents and autism spectrum disorder, but more research is necessary to establish this link.

Complications

Problems with social interactions, communication and behavior can lead to:

• Problems in school and with successful learning
• Employment problems
• Inability to live independently
• Social isolation
• Stress within the family
• Victimization and being bullied

Prevention

There’s no way to prevent autism spectrum disorder, but there are treatment options. Early diagnosis and intervention is most helpful and can improve behavior, skills and language development. However, intervention is helpful at any age. Though children usually don’t outgrow autism spectrum disorder symptoms, they may learn to function well.

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