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Autism Spectrum Disorder

What is autism spectrum disorder?

Autism spectrum disorder (ASD) is a problem that affects a child’s nervous system and growth and development. It usually shows up during a child’s first 3 years of life. Some children with ASD seem to live in their own world. They are not interested in other children and lack social awareness. A child with ASD focuses on following a routine that may include usual behaviors. A child with the disorder also often has problems communicating with others and may not start speaking as soon as other children. He or she may not want to make eye contact with other people.

ASD can keep a child from developing social skills. This is in part because a child with ASD may not be able to interpret facial expressions or emotions in other people. A child with ASD may:

  • Not want to be touched

  • Want to play alone

  • Not want to change routines

A child with ASD may also repeat movements. This might be flapping his or her hands or rocking. He or she may also have unusual attachments to objects. But a child with ASD may also do certain mental tasks very well. For example, the child may be able to count or measure better than other children. Children with ASD may do well in art or music, or be able to remember certain things very well.

What causes ASD?

Researchers don’t know what causes ASD. It may be caused by certain genes. A child with ASD may also have problems with the structure of the brain or with certain chemicals in the brain. Researchers do know that ASD is not caused by what a parent does to raise a child.

Who is affected by ASD?

About 1 in 68 children in the U.S. has an autism spectrum disorder, according to the CDC. The disorder happens much more often in boys than girls. Four to 5 times as many boys as girls have ASD.

What are the symptoms of ASD?

Each child may have slightly different symptoms, but below are the most common symptoms of ASD.

Social symptoms

  • Has problems making eye contact with others

  • Has problems making friends or interacting with other children

Communication symptoms

  • Does not communicate well with others

  • Starts speaking at a later age than other children or doesn’t speak at all

  • When the child is able to speak, doesn’t use speech in social interactions

  • Repeats words or phrases (echolalia) or repeats parts of dialogue from TV or movies

Behavior symptoms

  • Does repeated movements such as rocking or flapping fingers or hands

  • May be too sensitive to certain things around him or her, such as lights, sounds, touch, or taste. Or the child may be less sensitive to these things than other children.

  • Has rituals

  • Needs routines

The symptoms of ASD may look like other health conditions. Be sure your child sees his or her healthcare provider for a diagnosis.

How is ASD diagnosed?

There is no single medical test for ASD. Healthcare providers use certain guidelines to help diagnose ASD in children before age 2. In the past, doctors often did not diagnose the disorder until a child was late preschool-age or older. The guidelines can help diagnose the disorder early. Children diagnosed with ASD early can be treated right away.

The guidelines say that all children should be screened for ASD and other development disorders before age 2. The screening is done at well-child checkups. Children who have symptoms of development or behavior disorders will need to get additional testing for ASD.

Healthcare providers look for the following problems during well-child visits before age 2:

  • No babbling, pointing, or gesturing by age 12 months

  • No single words spoken by age 16 months

  • No 2-word phrases by age 24 months. These phrases aren’t just repeating words or sounds of others.

  • Loss of any language or social skills at any age

  • No eye contact at 3 to 4 months

If a child has any of the above problems, the healthcare provider will do more screening. This will help show whether your child has ASD or another developmental disorder. Your child may need to see a doctor with special training to diagnose and treat ASD. Your child may also need these screening tests:

  • Nervous system exam

  • Genetic tests, to look for gene problems that cause ASD or other developmental disorders

  • Imaging tests such as CT scan, MRI, or PET scan

  • Psychological tests

Genetic tests

ASD may be caused by several gene problems that can be passed down through families. Your child may need genetic testing to help find out which problem he or she has. The testing is done by a medical geneticist. This is a healthcare provider with special training in genes and gene problems.

ASD may be caused by these gene disorders that can run in families:

  • Fragile-X

  • Phenylketonuria (PKU)

  • Neurofibromatosis

  • Tuberous sclerosis

  • Chromosome problems

The healthcare specialist can let you know the chances of having another child with the gene problem. For example, PKU carries a 1 in 4 chance of happening in another pregnancy. For tuberous sclerosis, the chances are 1 in 2.

Even when no gene problem is found, you are at a slightly higher chance of having another child with ASD. Researchers think this is because several genes from both parents may act together to cause ASD.

How is ASD treated?

ASD can be treated with behavior change and special education programs. Behavior change programs teach social skills, movement skills, and thinking (cognitive) skills. These programs can help a child change problem behaviors. Special education programs focus on social skills, speech, language, self-care, and job skills.

Each child with ASD needs his or her own special treatment program. This is because children with ASD can vary a lot in how much help they need. Programs that work best are those that are started as early as possible and involve the parents.

Your child may also need medicine to help treat some of the symptoms of ASD. 

Your child and your family may also need to see a mental health provider. This provider can give you parent counseling, social skills training, and one-on-one therapy. This provider can also help you find the treatment programs that are best for your child.

Online Medical Reviewer: Ballas, Paul, DO
Online Medical Reviewer: Nelson, Gail A., MS, APRN, BC
Date Last Reviewed: 11/1/2016
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