What is autism?
Autism is classified as a “spectrum disorder,” meaning the onset and severity of symptoms vary from child to child. The condition is characterized by difficulty with social interactions, behavioral challenges, and unusual interests. It’s estimated that 1 in 68 children will be diagnosed with autism spectrum disorder (ASD) by age 8, with boys being diagnosed 5 times more often than girls. The American Academy of Pediatrics (AAP) recommends that all children be screened for ASD at their 18- and 24-month well-child checkups.
What are the signs of autism?
The CDC reports that some children show signs of ASD within months of birth while others develop symptoms closer to 2 years of age. Children who exhibit signs of ASD characteristically:
- do not respond when their name is called at 12 months
- do not point or show interest in objects at 14 months
- do not engage in pretend games at 18 months
- avoid eye contact and prefer to be alone
- have delayed speech and language skills
- repeat words, phrases, or motions
- get upset by unexpected events
- engage in obsessive interests
- flap their hands, rock their body, or spin in circles
Learn more about the early signs of autism in infants, toddlers, and preschoolers here.
How is autism diagnosed?
There is no blood test for ASD, so parents and doctors must closely monitor a child’s behavior and development to determine a diagnosis. While some health professionals identify signs of autism in children at an early age (infants or toddlers), most health professionals won’t diagnose children with autism until they are 4–6 years old. A diagnosis of ASD is based on two elements—a developmental screening and a comprehensive evaluation.
Developmental screening. During a child’s physical exam, his doctor will question the parents about their child’s development and engage the child. Items of particular interest are the child’s speech, behavior, and movement. If a sibling has ASD, or if behaviors characteristic of ASD are present, additional screening may be recommended. If any concerns are raised during the developmental screening, the doctor will suggest a comprehensive evaluation.
Comprehensive evaluation. The comprehensive evaluation requires a thorough assessment of the child through observations during various forms of play and activities, as well as interviews with the child’s parents. Parents will be asked to complete forms describing their child’s behaviors and habits. The doctor may also recommend a vision and hearing test and may refer the child to a developmental pediatrician, child neurologist, child psychologist, or psychiatrist for further testing. All of these observations, interviews, and exams are reviewed in order to determine if the child has ASD.
What causes autism?
Scientists don’t know exactly what causes ASD. According to the Centers for Disease Control (CDC), "there are likely many causes for multiple types of ASD. And there may be many different factors that make a child more likely to have an ASD, including environmental and genetic factors."
- Most scientists agree that genes are one of the risk factors that can make a person more likely to develop ASD.
- Children who have a sibling with ASD are at a higher risk of also having ASD.
- ASD tends to occur more often in people who have certain genetic or chromosomal conditions, such as fragile X syndrome or tuberous sclerosis.
- When taken during pregnancy, the prescription drugs valproic acid and thalidomide have been linked with a higher risk of ASD.1
- There is some evidence that the critical period for developing ASD occurs before, during, and immediately after birth.
- Children born to older parents are at greater risk for having ASD.
Do vaccines cause autism?
Extensive research clearly shows that common childhood vaccines do not cause autism. (Learn more here.)
How do you treat a child with autism?
As a spectrum disorder, each child with autism is unique and requires a tailored approach to manage their symptoms. Early intervention can include speech, behavior, and occupational therapy with a specialist in the child’s home or educational setting. Once parents and siblings learn the therapy, they can create situations that allow the therapy to be routinely practiced.
Conventional medications are often used to improve the fundamental behaviors of ASD, reduce anxiety, and treat severe behavioral problems. Children with ASD may have other medical conditions as well that require medication, so it’s essential that each family talk with their child’s health care provider to develop a safe and suitable treatment plan tailored to their child.
Many families turn to complementary and alternative treatments (CATs) to manage some of the challenges children with ASD face, such as the use of melatonin for insomnia and omega-3 fatty acids for hyperactivity. However, the CDC and other researchers note that there is “sparse evidence on the usefulness” of complementary treatments in ASD.
The US Food and Drug Administration (FDA) also warns against products or treatments that claim to “cure” or “treat” autism, as there is no known cure for the condition. Some products that include these misleading claims can be dangerous.
Living with autism
Without treatment, ASD can have serious, lifelong effects. Fortunately, increased awareness has led to improved access to programs and services for children and their families. For the latest research and a list of organizations that can provide guidance on diagnosis, treatment, education, health insurance and support groups, visit the CDC’s Autism Spectrum Disorder website.