Autism Spectrum Disorder, or ASD, is a developmental disorder characterized by its effects on communication, social skills, and behavior. Autism can impair language development, motor skills, social interaction, and emotional regulation. It frequently causes sensory processing difficulties, wherein people with ASD may feel over or under-stimulated by everyday situations. Autism can also coincide with a host of health problems, such as allergies, an increased risk of psychiatric disorders, metabolic disorders, epilepsy, even gastrointestinal issues like constipation or diarrhea.
As many as 1 in 6 children have a developmental disability, with an estimated 1 in 54 children identified with ASD specifically. The causes of ASD remain unknown, but contemporary research points to genetic factors which disrupt brain development in early age. Many children with specific genetic disorders and mutations, such as Fragile X Syndrome, also experience much higher rates of ASD. ASD is also more common in children who are born prematurely.
One of the difficult aspects of determining if a child has ASD is its varied presentation. Dr. Stephen Shore coined the now-famous phrase, “If you’ve met one person with autism, you’ve met one person with autism.” There is no singular presentation of autism spectrum disorder, as ASD manifests differently in everyone. The first signs of ASD can occur at different times in a child’s development. Studies show that “one third to one half of parents of children with an ASD noticed a problem before their child’s first birthday, and nearly 80%–90% saw problems by 24 months of age.” The CDC notes many of these “red flags” of possible autism spectrum disorder:
- – persistent avoidance of eye contact
- – speaking in a monotone voice
- – a lack of apparent interest in interaction with others
- – a lack of emotional expression
- – difficulties with understanding the emotions of others
- – a misunderstanding of body language and social cues
- – avoiding physical contact
- – repetitive physical motions
- – high sensitivity to physical and emotional stimuli (sensory processing issues)
- – emotional and physical outbursts known as “meltdowns” in response to feeling over-stimulated
- – intense focus or obsessive interest with a particular subject or object
- – a strong reliance and attachment to a regular routine
Early Signs of ASD:
- – not responding to one’s name
- – delays in language development
- – the loss of previously developed language or social skills (regression)
- – verbal “echoing” where a child may repeat a phrase rather than answering a question or instruction
- – not physically gesturing or not responding to the gesturing of others
Language Use Issues
Some children with autism may not develop the use of language. This is often referred to as nonverbal autism. Some prefer the term “pre-verbal” since some children with delayed speech later acquire the use of language. A child diagnosed with nonverbal autism at a young age may still be able to learn language with regular therapy and help. Children with nonverbal autism may go on to use language fluently or they may learn to use language in a very limited way via simple phrases or yes-or-no answers to questions. Some may not learn to use language at all as they grow older. The outcomes of treatments for nonverbal autism vary by patient, the therapist, the types of therapies used, and other factors.
The above signs and symptoms are only some of the ways that autism can present. Parents may witness some of these behaviors in their child and wonder how they can know for sure whether ASD is the cause. In such a case, consultation with a medical professional is vital. Experts recommend screenings for ASD at 18 and 24 months. There is no single medical test that can reliably diagnose autism spectrum disorder. Instead, regular developmental checkups can determine if further evaluation is necessary. The NIH notes that such evaluations usually involve a team of medical professionals from different fields, who coordinate their evaluations with specific neurological, cognitive and behavioral tests to determine whether ASD is present.
Similar and Co-Occurring Conditions
Because of its wide range of presentations, ASD can share symptoms with numerous other conditions. For instance, an anxiety disorder such as selective mutism can share some of the social symptoms of autism spectrum disorder. ASD can also occur alongside other conditions, which can complicate diagnosis and treatment. These can include Attention Deficit/Hyperactivity Disorder (ADHD), anxiety disorders, and depression. The only way to know for sure is to seek evaluation by a medical or clinical professional, to be communicative, and to ask relevant questions about signs and symptoms your child may be experiencing.
An autism diagnosis can be frightening, saddening, and overwhelming for parents. Autism also does not occur exclusively in children. Some cases may not be apparent in childhood and may occur in adolescents and adults as well. There are a variety of important next steps to take once a diagnosis has been made, from communicating the diagnosis to family and friends, to seeking proper treatment. Learn more about what you can do here.