What is Autism Spectrum Disorder (ASD)?
Autism Spectrum Disorder (ASD) is a complex developmental condition that affects 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.
Common Signs and Symptoms
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.
Social communication and interaction
- Fails to respond to his or her name or appears not to hear you at times
- Resists cuddling and holding, and seems to prefer playing alone, retreating into his or her own world
- Has poor eye contact and lacks facial expression
- Doesn't speak or has delayed speech, or loses previous ability to say words or sentences
- Can't start a conversation or keep one going, or only starts one to make requests or label items
- Speaks with an abnormal tone or rhythm and may use a singsong voice or robot-like speech
- Repeats words or phrases verbatim, but doesn't understand how to use them
- Doesn't appear to understand simple questions or directions
- Doesn't express emotions or feelings and appears unaware of others' feelings
- Doesn't point at or bring objects to share interest
- Inappropriately approaches a social interaction by being passive, aggressive or disruptive
- Has difficulty recognizing nonverbal cues, such as interpreting other people's facial expressions, body postures or tone of voice
Patterns of behavior
- Performs repetitive movements, such as rocking, spinning or hand flapping
- Performs activities that could cause self-harm, such as biting or head-banging
- Develops specific routines or rituals and becomes disturbed at the slightest change
- Has problems with coordination or has odd movement patterns, such as clumsiness or walking on toes, and has odd, stiff or exaggerated body language
- Is fascinated by details of an object, such as the spinning wheels of a toy car, but doesn't understand the overall purpose or function of the object
- Is unusually sensitive to light, sound or touch, yet may be indifferent to pain or temperature
- Doesn't engage in imitative or make-believe play
- Fixates on an object or activity with abnormal intensity or focus
- Has specific food preferences, such as eating only a few foods, or refusing foods with a certain texture
Causes
Autism spectrum disorder has no single known cause. Given the complexity of the disorder, and the fact that symptoms and severity vary, there are probably many causes. Both genetics and environment may play a role.
- Genetics. Several different genes appear to be involved in autism spectrum disorder. For some children, autism spectrum disorder can be associated with a genetic disorder, such as Rett syndrome or fragile X syndrome. For other children, genetic changes (mutations) may increase the risk of autism spectrum disorder. Still other genes may affect brain development or the way that brain cells communicate, or they may determine the severity of symptoms. Some genetic mutations seem to be inherited, while others occur spontaneously.
- Environmental factors. Researchers are currently exploring whether factors such as viral infections, medications or complications during pregnancy, or air pollutants play a role in triggering autism spectrum disorder.
Risk factors
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.
Diagnosis
Diagnosing autism spectrum disorder (ASD) can be difficult because there is no medical test, like a blood test, to diagnose the disorder. Doctors look at the child's developmental history and behavior to make a diagnosis. ASD can sometimes be detected at 18 months or younger. By age 2, a diagnosis by an experienced professional can be considered very reliable. However, many children do not receive a final diagnosis until much older. This delay means that children with ASD might not get the early help they need.
Diagnosing an ASD takes two steps:
- Developmental Screening is a short test to tell if children are learning basic skills when they should, or if they might have delays. During developmental screening, the doctor might ask the parent some questions or talk and play with the child during an exam to see how she learns, speaks, behaves, and moves. A delay in any of these areas could be a sign of a problem.
- Comprehensive Diagnostic Evaluation is a thorough review that may include looking at the child's behavior and development and interviewing the parents. It may also include a hearing and vision screening, genetic testing, neurological testing, and other medical testing.
Treatment and Support
While there is no cure for autism spectrum disorder, intensive, early treatment can make a big difference in the lives of many children. The goal of treatment is to maximize your child's ability to function by reducing autism spectrum disorder symptoms and supporting development and learning.
Therapeutic Interventions
- Applied Behavior Analysis (ABA)
- Speech and Language Therapy
- Occupational Therapy
- Physical Therapy
- Social Skills Training
- Cognitive Behavioral Therapy
Educational Support
- Individualized Education Programs (IEP)
- Special Education Services
- Classroom Accommodations
- Visual Supports and Schedules
- Assistive Technology
- Parent Training Programs
Myths and Truths about Autism
Myths
- Autism is caused by vaccines
- People with autism don't want friends
- Autism can be cured
- All individuals with autism have savant skills
- Autism only affects children
- People with autism can't feel emotions
Truths
- Autism is a spectrum disorder with varying levels of severity
- Early intervention can significantly improve outcomes
- People with autism can lead fulfilling lives
- Autism affects people of all races, ethnicities, and socioeconomic backgrounds
- Many adults with autism can work and live independently
- People with autism have feelings and can form meaningful relationships
IEP and 504 Plan
For children with autism in the United States, there are two main types of educational support plans: Individualized Education Programs (IEPs) and 504 Plans. Understanding the differences between these plans is crucial for parents and educators.
Individualized Education Program (IEP)
An IEP is a written document developed for students with disabilities who require special education services.
- Covered under the Individuals with Disabilities Education Act (IDEA)
- Provides individualized special education and related services
- Includes specific, measurable annual goals
- Regularly reviewed and updated
- Requires a comprehensive evaluation
- Offers more extensive services and accommodations
504 Plan
A 504 Plan is a plan developed to ensure that a child with a disability receives accommodations that will ensure their academic success and access to the learning environment.
- Covered under Section 504 of the Rehabilitation Act
- Provides accommodations and modifications in a general education setting
- Does not require annual goals
- More flexible and less comprehensive than an IEP
- Requires evidence of a disability that substantially limits a major life activity
- Focuses on equal access to education
Both IEPs and 504 Plans can be valuable tools in supporting students with autism. The choice between an IEP and a 504 Plan depends on the individual needs of the student and the extent of support required.
Resources
Unico Health provides connections to local resources and providers specializing in ASD support. Use our provider directory to find services in your area, or contact us for more information about available resources.