Information on Autism & Links to Resources

About Autism

Understanding autism

Autism is a spectrum of closely related disorders with a shared core of symptoms. Autism spectrum disorders appear in infancy and early childhood, causing delays in many basic areas of development such as learning to talk, play, and interact with others.

The signs and symptoms of autism vary widely, as do its effects. Some autistic children have only mild impairments, while others have more obstacles to overcome. However, every child on the autism spectrum has problems, at least to some degree, in the following three areas:

  • Communicating verbally and non-verbally
  • Relating to others and the world around them
  • Thinking and behaving flexibly

There are different opinions among doctors, parents, and experts about what causes autism and how best to treat it, and much that we still don’t know. But on one fact, everyone agrees: early and intensive intervention helps. For children at risk and children who show early signs, it can make all the difference.

Early detection of autism is up to parents

As a parent, you’re in the best position to spot the earliest warning signs of autism. You know your child better than anyone and observe behaviors and quirks that a pediatrician, in a quick fifteen-minute visit, might not have the chance to see. Your child’s pediatrician can be a valuable partner, but don’t discount the importance of your own observations and experience. The key is to educate yourself so you know what’s normal and what’s not.

  • Monitor your child’s development. Autism involves a variety of developmental delays, so keeping a close eye on when—or if—your child is hitting the key social, emotional, and cognitive milestones is an effective way to spot the problem early on. While developmental delays don’t automatically point to autism, they may indicate a heightened risk.
  • Take action if you’re concerned. Every child develops at a different pace—so you don’t need to panic if your child is a little late to talk or walk. When it comes to healthy development, there’s a wide range of “normal.” But if your child is not meeting the milestones for his or her age, or you suspect a problem, share your concerns with your child’s doctor immediately. Don’t wait.
  • Don’t accept a wait-and-see approach. Many concerned parents are told, “Don’t worry” or “Wait and see.” But waiting is the worst thing you can do. You risk losing valuable time at an age where your child has the best chance for improvement. Furthermore, whether the delay is caused by autism or some other factor, developmentally delayed kids are unlikely to simply “grow out” of their problems. In order to develop skills in an area of delay, your child needs extra help and targeted treatment.
  • Trust your instincts. Ideally, your child’s doctor will take your concerns seriously and perform a thorough evaluation for autism or other developmental delays. But sometimes, even well-meaning doctors miss red flags or underestimate problems. Listen to your gut if it’s telling you something is wrong and be persistent. Schedule a follow-up appointment with the doctor, seek a second opinion, or ask for a referral to a child development specialist.

Regression of any kind is a serious autism warning sign

Some children with autism spectrum disorders start to develop communication skills and then regress, usually between 12 and 24 months. For example, a child who was communicating with words such as “mommy” or “up” may stop using language entirely, or a child may stop playing social games he or she used to enjoy such as peek-a-boo, patty cake, or waving “bye-bye.” Any loss of speech, babbling, gestures, or social skills should be taken very seriously, as regression is a major red flag for autism.

Signs and symptoms of autism in babies and toddlers

If autism is caught in infancy, treatment can take full advantage of the young brain’s remarkable plasticity. Although autism is hard to diagnose before 24 months, symptoms often surface between 12 and 18 months. If signs are detected by 18 months of age, intensive treatment may help to rewire the brain and reverse the symptoms.

The earliest signs of autism involve the absence of normal behaviors—not the presence of abnormal ones—so they can be tough to spot. In some cases, the earliest symptoms of autism are even misinterpreted as signs of a “good baby,” since the infant may seem quiet, independent, and undemanding. However, you can catch warning signs early if you know what to look for.

Some autistic infants don't respond to cuddling, reach out to be picked up, or look at their mothers when being fed.

Early signs of autism in babies and toddlers

  • Doesn’t make eye contact (e.g. look at you when being fed).
  • Doesn't smile when smiled at.
  • Doesn't respond to his or her name or to the sound of a familiar voice.
  • Doesn’t follow objects visually.
  • Doesn't point or wave goodbye or use other gestures to communicate.
  • Doesn’t follow the gesture when you point things out.
  • Doesn’t make noises to get your attention.
  • Doesn’t initiate or respond to cuddling.
  • Doesn’t imitate your movements and facial expressions.
  • Doesn’t reach out to be picked up.
  • Doesn’t play with other people or share interest and enjoyment.
  • Doesn’t ask for help or make other basic requests.

The following delays warrant an immediate evaluation by your child’s pediatrician.

  • By 6 months: No big smiles or other warm, joyful expressions.
  • By 9 months: No back-and-forth sharing of sounds, smiles, or other facial expressions.
  • By 12 months: Lack of response to name.
  • By 12 months: No babbling or “baby talk.”
  • By 12 months: No back-and-forth gestures, such as pointing, showing, reaching, or waving.
  • By 16 months: No spoken words.
  • By 24 months: No meaningful two-word phrases that don’t involve imitating or repeating.

Signs and symptoms of autism in older children

As children get older, the red flags for autism become more diverse. There are many warning signs and symptoms, but they typically revolve around impaired social skills, speech and language difficulties, non-verbal communication difficulties, and inflexible behavior.

Signs and symptoms of social difficulties in autism

Basic social interaction can be difficult for children with autism spectrum disorders. Many kids on the autism spectrum seem to prefer to live in their own world, aloof and detached from others.

  • Appears disinterested or unaware of other people or what’s going on around them.
  • Doesn’t know how to connect with others, play, or make friends.
  • Prefers not to be touched, held, or cuddled.
  • Doesn’t play "pretend" games, engage in group games, imitate others, or use toys in creative ways.
  • Has trouble understanding or talking about feelings.
  • Doesn’t seem to hear when others talk to him or her.
  • Doesn't share interests or achievements with others (drawings, toys).

Signs and symptoms of speech and language difficulties in autism

Children with autism spectrum disorders have difficulty with speech and language. Often, they start talking late.

  • Speaks in an abnormal tone of voice, or with an odd rhythm or pitch (e.g. ends every sentence as if asking a question).
  • Repeats the same words or phrases over and over.
  • Responds to a question by repeating it, rather than answering it.
  • Refers to themselves in the third person.
  • Uses language incorrectly (grammatical errors, wrong words).
  • Has difficulty communicating needs or desires.
  • Doesn’t understand simple directions, statements, or questions.
  • Takes what is said too literally (misses undertones of humor, irony, and sarcasm).

Signs and symptoms of nonverbal communication difficulties in autism

Children with autism spectrum disorders have trouble picking up on subtle nonverbal cues and using body language. This makes the "give-and-take" of social interaction very difficult.

  • Avoids eye contact.
  • Uses facial expressions that don't match what he or she is saying.
  • Doesn’t pick up on other people’s facial expressions, tone of voice, and gestures.
  • Makes very few gestures (such as pointing). May come across as cold or “robot-like.”
  • Reacts unusually to sights, smells, textures, and sounds. May be especially sensitive to loud noises.
  • Abnormal posture, clumsiness, or eccentric ways of moving (e.g. walking exclusively on tiptoe).

Signs and symptoms of inflexibility in autism

Children with autism spectrum disorders are often restricted, inflexible, and even obsessive in their behaviors, activities, and interests.

  • Follows a rigid routine (e.g. insists on taking a specific route to school)
  • Has difficulty adapting to any changes in schedule or environment (e.g. throws a tantrum if the furniture is rearranged or bedtime is at a different time than usual).
  • Unusual attachments to toys or strange objects such as keys, light switches, or rubber bands.
  • Obsessively lines things up or arranges them in a certain order.
  • Preoccupation with a narrow topic of interest, often involving numbers or symbols (e.g. memorizing and reciting facts about maps, train schedules, or sports statistics).
  • Spends long periods of time arranging toys in specific ways, watching moving objects such as a ceiling fan, or focusing on one specific part of an object such as the wheels of a toy car.
  • Repeats the same actions or movements over and over again, such as flapping hands, rocking, or twirling (known as self-stimulatory behavior, or “stimming”). Some researchers and clinicians believe that these behaviors may soothe children with autism more than stimulate them.

Common self-stimulatory behaviors:

  • Hand flapping
  • Rocking back and forth
  • Spinning in a circle
  • Finger flicking
  • Head banging
  • Staring at lights
  • Moving fingers in front of the eyes
  • Snapping fingers
  • Tapping ears
  • Scratching
  • Lining up toys
  • Spinning objects
  • Wheel spinning
  • Watching moving objects
  • Flicking light switches on and off
  • Repeating words or noises

Causes of autism

Until recently, most scientists believed that autism is caused mostly by genetic factors. But groundbreaking new research indicates that environmental factors may be just as important in the development of autism—if not more so—than genes.

It appears that certain babies are born with a genetic vulnerability to autism that is then triggered by something in the external environment, either while he or she is still in the womb or sometime after birth.

It’s important to note that the environment, in this context, means anything outside the body. It’s not limited to things like pollution or toxins in the atmosphere. In fact, one of the most important environments appears to be the prenatal environment.

Prenatal Factors that may contribute to autism

  • Taking antidepressants during pregnancy, especially in the first 3 months
  • Nutritional deficiencies early in pregnancy, particularly not getting enough folic acid
  • The age of the mother (children born to older fathers also have a higher risk of autism)
  • Complications at or shortly after birth, including very low birth weight and neonatal anemia
  • Maternal infections during pregnancy
  • Exposure to chemical pollutants, such as metals and pesticides, while pregnant

What to do if you’re worried

If your child is developmentally delayed, or if you’ve observed other red flags for autism, schedule an appointment with your pediatrician right away. In fact, it’s a good idea to have your child screened by a doctor even if he or she is hitting the developmental milestones on schedule. The American Academy of Pediatrics recommends that all children receive routine developmental screenings, as well as specific screenings for autism at 9, 18, and 30 months of age.

  • Schedule an autism screening. A number of specialized screening tools have been developed to identify children at risk for autism. Most of these screening tools are quick and straightforward, consisting of yes-or-no questions or a checklist of symptoms. Your pediatrician should also get your feedback regarding your child’s behavior.
  • See a developmental specialist. If your pediatrician detects possible signs of autism during the screening, your child should be referred to a specialist for a comprehensive diagnostic evaluation. Screening tools can’t be used to make a diagnosis, which is why further assessment is needed. A specialist can conduct a number of tests to determine whether or not your child has autism. Although many clinicians will not diagnose a child with autism before 30 months of age, they will be able to use screening techniques to determine when a cluster of symptoms associated with autism is present.
  • Seek early intervention services. The diagnostic process for autism is tricky, and can sometimes take awhile. But you can take advantage of treatment as soon as you suspect your child has developmental delays. Ask your doctor to refer you to early intervention services. Early intervention is a federally funded program for infants and toddlers with disabilities. Children who demonstrate several early warning signs may have developmental delays. They will benefit from early intervention whether or not they meet the full criteria for an autism spectrum.

Authors: Melinda Smith, M.A., Jeanne Segal, Ph.D., and Ted Hutman, Ph.D (UCLA Center for Autism Research & Treatment). Last updated: November 2012.

 

 

 
 
 
 

 

 

Resources & References

 

 

 

 

 

 

 


 

Helpguide.org
 
 
Autism is a complex developmental disability that typically appears during the first three years of life and affects a person’s ability to communicate and interact with others. Autism is defined by a certain set of behaviors and is a "spectrum disorder" that affects individuals differently and to varying degrees. There is no known single cause of autism, but increased awareness and funding can help families today.

In March 2012, the Centers for Disease Control and Prevention issued their ADDM autism prevalence report. The report concluded that the prevalence of autism had risen to 1 in every 88 births in the United States and almost 1 in 54 boys. The spotlight shown on autism as a result of the prevalence increase opens opportunities for the nation to consider how to serve these families facing a lifetime of supports for their children.

Currently, the Autism Society estimates that the lifetime cost of caring for a child with autism ranges from $3.5 million to $5 million, and that the United States is facing almost $90 billion annually in costs for autism (this figure includes research, insurance costs and non-covered expenses, Medicaid waivers for autism, educational spending, housing, transportation, employment, in addition to related therapeutic services and caregiver costs).

Know the Signs: Early Identification Can Change Lives

Autism is treatable. Children do not "outgrow" autism, but studies show that early diagnosis and intervention lead to significantly improved outcomes.

Here are some signs to look for in the children in your life:

  • Lack of or delay in spoken language
  • Repetitive use of language and/or motor mannerisms (e.g., hand-flapping, twirling objects)
  • Little or no eye contact
  • Lack of interest in peer relationships
  • Lack of spontaneous or make-believe play
  • Persistent fixation on parts of objects

Symptoms:

The characteristic behaviors of autism spectrum disorders may or may not be apparent in infancy (18 to 24 months), but usually become obvious during early childhood (24 months to 6 years).

As part of a well-baby/well-child visit, your child's doctor should do a "developmental screening," asking specific questions about your baby's progress. The National Institute of Child Health and Human Development (NICHD) lists five behaviors that signal further evaluation is warranted:

  • Does not babble or coo by 12 months
  • Does not gesture (point, wave, grasp) by 12 months
  • Does not say single words by 16 months
  • Does not say two-word phrases on his or her own by 24 months
  • Has any loss of any language or social skill at any age

Having any of these five "red flags" does not mean your child has autism. But because the symptoms of the disorder vary so much, a child showing these behaviors should have further evaluations by a multidisciplinary team. This team may include a neurologist, psychologist, developmental pediatrician, speech/language therapist, learning consultant, or other professionals knowledgeable about autism.

Diagnosis

    When parents or support providers become concerned that their child is not following a typical developmental course, they turn to experts, including psychologists, educators and medical professionals, for a diagnosis.

At first glance, some persons with autism may appear to have an intellectual disability, a sensory integration disorder, or problems with hearing or vision. To complicate matters further, these conditions can co-occur with autism (see Related Conditions). However, it is important to distinguish autism from other conditions, since an accurate diagnosis and early identification can provide the basis for building an appropriate and effective educational and treatment program. There are also other medical conditions or syndromes that can present symptoms that are confusingly similiar to autism. This is known as differential diagnosis.

A brief observation in a single setting cannot present a true picture of an individual's abilities and behaviors. Parental (and caregiver) and/or teachers’ input and developmental history are important components of making an accurate diagnosis.

There are many differences between a medical diagnosis and an educational determination, or school evaluation, of a disability. A medical diagnosis is made by a physician based on an assessment of symptoms and diagnostic tests. A medical diagnosis of autism, for instance, is most frequently made by a physician according to the Diagnostic and Statistical Manual (DSM-IV-TR) of the American Psychological Association (2000). This manual guides physicians in diagnosing Autistic Disorder, Asperger's Disorder and Pervasive Developmental Disorder-Not Otherwise Specified according to a specific number of symptoms (see Diagnostic Classifications).

An educational determination, in contrast, is made by a multidisciplinary evaluation team comprised of various school professionals. The evaluation results are looked at by a team of qualified professionals and the parents to determine whether a student qualifies for special education and related services under the Individuals with Disabilities Education Act (IDEA) (Hawkins, 2009). 

Causes

There is no known single cause for autism, but it is generally accepted that it is caused by abnormalities in brain structure or function. Brain scans show differences in the shape and structure of the brain in children with autism versus neuro-typical children. Researchers are investigating a number of theories, including the link between heredity, genetics and medical problems. In many families, there appears to be a pattern of autism or related disabilities, further supporting a genetic basis to the disorder. While no one gene has been identified as causing autism, researchers are searching for irregular segments of genetic code that children with autism may have inherited. It also appears that some children are born with a susceptibility to autism, but researchers have not yet identified a single "trigger" that causes autism to develop.

Other researchers are investigating the possibility that under certain conditions, a cluster of unstable genes may interfere with brain development, resulting in autism. Still other researchers are investigating problems during pregnancy or delivery as well as environmental factors, such as viral infections, metabolic imbalances, and exposure to environmental chemicals.

Genetic Vulnerability

Autism tends to occur more frequently than expected among individuals who have certain medical conditions, including Fragile X syndrome, tuberous sclerosis, congenital rubella syndrome, and untreated phenylketonuria (PKU). Some harmful substances ingested during pregnancy also have been associated with an increased risk of autism. Read more about related conditions.

Environmental Factors

Research indicates that other factors besides the genetic component are contributing to the rise in increasing occurrences of autism, such as environmental toxins (e.g., heavy metals such as mercury), which are more prevalent in our current environment than in the past. Those with autism (or those who are at risk) may be especially vulnerable, as their ability to metabolize and detoxify these exposures can be compromised. Read more about environmental health and autism. 
 


 

 

 

 

 

 


 


 

 

SelectionFile type iconFile nameDescriptionSizeRevisionTimeUser