 Autism Spectrum Disorder

⌂ Autism

What Is Autism Spectrum Disorder?

Autism spectrum disorder (ASD) is a complex developmental condition involving persistent challenges
with social communication, restricted interests, and repetitive behavior. While autism is considered a
lifelong disorder, the degree of impairment in functioning because of these challenges varies between
individuals with autism.

Diagnosis of Autism Spectrum Disorders

Early signs of this disorder can be noticed by parents/caregivers or pediatricians before a child reaches
one year of age. However, symptoms typically become more consistently visible by the time a child is 2 or
3 years old. In some cases, the functional impairment related to autism may be mild and not apparent until
the child starts school, after which their deficits may be pronounced when amongst their peers.

 Social communication deficits may include(1):

Decreased sharing of interests with others

Difficulty appreciating their own & others’ emotions
Aversion to maintaining eye contact
Lack of proficiency with use of non-verbal gestures
Stilted or scripted speech
Interpreting abstract ideas literally
Difficulty making friends or keeping them

Restricted interests and repetitive behaviors may include(1):

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IDifficulty
agree tolerating changes in routine and new experiences
Sensory hypersensitivity, e.g., aversion to loud noises
Stereotypical movements such as hand flapping, rocking, spinning
 Arranging things, often toys, in a very particular manner

Parent/caregiver/teacher concerns about the child’s behavior should lead to a specialized evaluation by a
developmental pediatrician, pediatric psychologist, child neurologist and/or a child & adolescent
psychiatrist. This evaluation involves interviewing the parent/caregiver, observing, and interacting with the
child in a structured manner, and sometimes conducting additional tests to rule out other disorders. In
some ambiguous cases, the diagnosis of autism may be deferred, but otherwise an early diagnosis can
greatly improve a child’s functioning by providing the family early access to supportive resources in the
community.

The first step is seeking an evaluation. Most parents start with their pediatrician who is checking on
developmental milestones. If your child is under the age of 3 years, you can obtain an evaluation through
your local early intervention system. (Learn more about early intervention and find local contact
information.)  If your child is over the age of 3, you can get an evaluation through your local school (even if
your child does not go there).  Contact your local school’s preschool special education team to request an
evaluation. (Learn more about requesting an evaluation.)

Risk Factors
The current science suggests that several genetic factors may increase the risk of autism in a complex
manner. Having certain specific genetic conditions such as Fragile X Syndrome and Tuberous Sclerosis
has been identified as conferring a particularly increased risk for being diagnosed with autism. Certain
medications, such as valproic acid and thalidomide, when taken during pregnancy, have been linked with a
higher risk of autism as well.(2) Having a sibling with autism also increases the likelihood of a child being
diagnosed with autism. Parents being older at the time of pregnancy is additionally linked with greater risk
of autism. Vaccines on the other hand have not been shown to increase the likelihood of an autism
diagnosis, and race, ethnicity or socioeconomic status does not seem to have a link either. Male children
tend to be diagnosed with autism more often than those assigned female sex at birth, albeit this ratio is
changing over time.

Treatment
While there is no “cure” for autism, there are several effective interventions that can improve a child’s
functioning:

Applied behavioral analysis: It involves systematic study of the child’s functional challenges, which is used
toAs
create a structured
described behavioral
in the Privacy plan
Policy of for
theimproving
American their adaptive
Psychiatric skills and decreasing
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Social skills training: Done in group or individual settings, this intervention helps   children with autism
improve their ability to navigate social situations
ISpeech
agree & language therapy: It can improve the child’s speech patterns and understanding of language
 Occupational therapy: This address adaptive skills deficits with activities of daily living, as well as
problems with handwriting
Parent management training: Parents learn effective ways of responding to problematic behavior and
encouraging appropriate behavior in their child. Parent support groups help parents cope with the
stressors of raising a child with autism
Special education services: Under an Individual Education Plan provided by their school, which
accommodates for their social communication deficits, restricted interests, and repetitive behaviors,
children with autism can achieve their fullest potential academically. This includes special day classes
for very young children to address language, social, and life skills. 
Treating co-occurring conditions: Children with autism experience insomnia, anxiety, and depression
more often than peers without autism. They also more often have ADHD. Children with autism may
have intellectual disability and this needs to be addressed. The impact of these conditions can be
reduced with the proper services, which include all of the above, in addition psychotherapy and/or
medication treatment
Medication: A child psychiatrist can evaluate for co-morbid depression, anxiety, and impulsivity. If
appropriate medications can be helpful. For example, autism-related irritability can be reduced by
medications such as aripiprazole and risperidone (the two medications approved by the Food and Drug
Administration for irritability associated with autism), prescribed judiciously by a knowledgeable
clinician in collaboration with the child’s parents.

Several complementary and alternative interventions involving special diets and supplements have been
tried over the years by parents/caregivers seeking ways to help their child with autism function better. To
date compelling evidence has not been found to clearly recommend any such specific interventions.
Research into these types of interventions continues, and parents/caregivers interested in them should
discuss them with their child’s treating clinician.

Additional information can be found in the Expert Q&A and Resources sections.

Tips For Parents

Learn as much as possible about autism spectrum disorder
Provide consistent structure and routine
Connect with other parents of children with autism
Seek professional help for specific concerns
Take time for yourself and other family members

Having a child with autism affects the whole family. It can be stressful, time-consuming and expensive.
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Related Conditions
 Attention-deficit/hyperactivity disorder
Social communication disorder
Specific learning disorder
Intellectual disability

References

1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5). Arlington,
VA: American Psychiatric Association Publishing.
2. Dietert, R.R, Dietert, J. C., Dewitt, J. C (2011). Environmental Risk Factors for Autism, Emerg. Heath Threats J., 2011,
4:10:3402/ehtj.v4i0.7111
3. CDC. (2021, April 29). Autism Spectrum Disorder (ASD). Retrieved August 19, 2021, from:
https://www.cdc.gov/ncbddd/autism/index.html
4. Höfer, J., Hoffmann, F., & Bachmann, C. (2017). Use of complementary and alternative medicine in children and
adolescents with autism spectrum disorder: A systematic review. Autism: The International Journal of Research and
Practice, 21(4), 387–402.
5. Hyman, S. L., Levey, S. E., & Myers, S. M. (2020). Council on Children with Disabilities, Section on Developmental and
Behavioral Pediatrics.

Physician Review By:

Mandar Jadhav, M.D.

and

Mary Ann Schaepper, M.D., M.Ed, DFAPA

August 2021

Expert Q & A: Autism

Find answers to your questions about Autism written by leading psychiatrists.

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Patient Stories: Autism

 Patient Stories: Autism

Read patient stories about Autism and learn how to share your story.

View More 

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