Autism spectrum disorder is a condition related to brain development that affects the way a person perceives and socializes with others, causing problems in social interaction and communication. The disorder also involves restricted and repetitive patterns of behavior. The term “spectrum” in autism spectrum disorder refers to the wide range of symptoms and severity.
Autism spectrum disorder includes conditions that were previously considered separate
– Autism
– Asperger’s syndrome
– Children’s disintegrative disorder
– and an unspecified form of pervasive developmental disorder.
Some people still use the term “Asperger syndrome”, which is generally thought to be on the milder end of the autism spectrum disorder.
Autism spectrum disorder begins in early childhood and eventually causes problems that affect social relationships, school and work, for example. Children often 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 the ages of 18 and 24 months, when they develop symptoms of autism.
Symptoms
Some children show signs of autism spectrum disorder from early infancy, such as poor eye contact, lack of response to their own name, or indifference to caregivers. Other children may develop normally for the first months or years of life, but then suddenly become withdrawn or aggressive, or lose language skills they have already acquired. Signs are usually seen by age 2.
Each child with autism spectrum disorder is likely to have a unique pattern of behavior and level of severity – from low functioning to high functioning.
Some children with autism spectrum disorder have learning difficulties, and some have signs of lower than normal intelligence. Other children with the disorder have normal to high intelligence – they learn quickly, but have problems communicating and applying what they know in everyday life and adapting to social situations.
Because of the unique mix of symptoms in each child, severity can sometimes be difficult to determine. It is generally based on the level of impairments and how they affect the ability to function.
Below are some common signs shown by people who have autism spectrum disorder.
Communication and social interaction
A child or adult with autism spectrum disorder may have problems with social interaction and communication skills, including any of these signs:
– Fails to respond to his or her name or seems to not hear you at times.
– Resists petting and holding, and seems to prefer to play alone, retreating into his or her own world.
– Has poor eye contact and lacks facial expression.
– Does not speak or has speech delay, or loses the previous ability to say words or sentences.
– Can’t start a conversation or continue it.
– Speaks in an abnormal tone or rhythm and may use a singing or robot-like voice.
– Repeats words or phrases verbatim, but does not understand how to use them.
– Does not seem to understand simple questions or instructions.
– Does not express emotions or feelings and is not aware of the feelings of others.
– Do not point out or bring objects to share with others.
– Approaches a social interaction inappropriately by being passive, aggressive or disruptive.
– Has difficulty recognizing non-verbal cues, such as interpreting other people’s facial expressions, body postures or tone of voice.
Behavior patterns
A child or adult with autism spectrum disorder may have restricted and repetitive patterns of behavior, interests, or activities, including any of these signs:
– Performs repetitive movements, such as rocking, rolling, or flapping the hands.
– Performs actions that may cause self-harm, such as biting or hitting the head.
– Develops specific routines or rituals and frets over the slightest change.
– Has problems with coordination or has strange movement patterns, such as clumsiness or tiptoeing, and has strange, stiff or exaggerated body movements.
– Is fascinated by the details of an object, such as the spinning wheels of a toy car, but does not understand the object’s overall purpose or function.
– Is extremely sensitive to light, sound or touch, however may be indifferent to pain or temperature.
– Does not involve imitative or imaginary play.
– Fixates on an object or activity with intensity or obsession
abnormal sleep.
– Has specific food preferences, such as eating only certain foods, or refusing certain types of foods.
As they grow older, some children with autism spectrum disorder become more engaged with others and show fewer behavioral disturbances. Some, usually those with fewer problems, can eventually lead normal or near-normal lives. However, others continue to struggle with speech or social skills, and the teenage years can bring worse behavioral and emotional problems.
When you should see a doctor
Children develop at their own pace, and many do not follow the exact timelines found in some parenting books. But children with autism spectrum disorder usually show some signs of developmental delay before age 2.
If you are concerned about your child’s development or suspect that your child may have autism spectrum disorder, discuss your concerns with the doctor. Symptoms associated with the disorder may also be associated with other developmental disorders.
Signs of autism spectrum disorder often appear early in development when there are marked delays in language skills and social interactions. The doctor may recommend developmental tests to identify if your child has delays in cognitive, language and social skills if your child:
– Does not respond with a smile or happy expression since age 6 months
– Does not imitate sounds or facial expressions by 9 months
– Will not fight or socialize with others when 12 months old
– Does not make gestures – such as pointing or hand – when he turns 14 months
– He doesn’t say a single word when he turns 16 months old
– Does not play “imagination” or pretend games when he turns 18 months
– Doesn’t say two-word phrases when he turns 24 months old
– Loses language skills or social skills at any age.
Complications of the Autism Spectrum
Problems with social interactions, communication and behavior can lead to:
– Problems at school and with successful learning
– Employment problems
– Inability to live independently
– Social isolation
– Stress within the family
– Victimization and harassment.
Diagnostic
Your child’s doctor will look for signs of developmental delays during regular checkups. If the child shows any symptoms of autism spectrum disorder, you will likely be referred to a specialist who treats children with autism spectrum disorder, such as a child psychiatrist or psychologist, pediatric neurologist, or developmental pediatrician, for an evaluation.
Because autism spectrum disorder varies widely in symptoms and severity, finding a diagnosis can be difficult. There is no specific medical test to determine the disorder. Instead, a specialist can:
– Observe your child and ask how your child’s social interactions, communication skills and behavior have developed and changed over time.
– Give the child tests that cover hearing, speech, language, developmental level, and social and behavioral issues.
– Introduce your child to structured social and communication interactions and mark performance.
– Use the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.
– To involve other specialists in determining a diagnosis.
– Recommend genetic testing to identify if the child has a genetic disorder such as Rett syndrome or fragile X syndrome.
Causes of Autistic Spectrum
Autism spectrum disorder has no known cause. Given the complexity of the disorder and the fact that symptoms and severity vary, there are likely many. Genetics and environment can also play a role.
– Genetics
Several different genes appear to be involved in autism spectrum disorder. For some children, autism spectrum disorder may 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. Other genes may also affect brain development or the way brain cells communicate, or may determine the severity of symptoms. Some genetic mutations appear 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.
Conventional Autism Spectrum Treatment
No cure exists for autism spectrum disorder, and there is no treatment that covers the entire condition. The goal of treatment is to maximize your child’s ability to function while reducing symptoms
autism spectrum disorder and supporting development and learning. Early intervention during the preschool years can help a child learn critical social, communication, functional, and behavioral skills.
The range of home and school-based treatments and interventions for autism spectrum disorder can be overwhelming, and a child’s needs can change over time. Your health care provider can recommend options and help identify resources in your area.
Treatment options may include:
– Behavioral and communication therapies. Many programs address the range of social, language, and behavioral difficulties associated with autism spectrum disorder. Some programs focus on reducing problem behaviors and teaching new skills. Other programs focus on teaching children how to act in social situations or communicate better with others. Applied behavior analysis (ABA) can help children learn new skills and generalize these skills to multiple situations through a reward-based motivation system.
– Educational therapies. Children with autism spectrum disorder often respond well to highly structured educational programs. Successful programs usually involve a team of specialists and a variety of activities to improve social skills, communication and behavior. Preschoolers who receive intellectual, individualized behavioral interventions often show good progress.
– Family therapies. Parents and other family members can learn how to play and interact with their children in ways that promote social interaction skills, manage problem behaviors, and teach daily life skills and communication.
– Other therapies. Depending on the child’s needs, speech therapy to improve communication skills, occupational therapy to learn activities of daily living, and physical therapy to improve movement and balance may be helpful. A psychologist can recommend ways to address problem behavior.
– Medicines. No chemical medication can improve the core symptoms of autism spectrum disorder, but specific medications can help control symptoms. For example, certain medications may be prescribed if the child is hyperactive; antipsychotic drugs are sometimes used to treat severe behavioral problems; and antidepressants may be prescribed for anxiety.
Common chemical medications used for this include:
Citalopram (Celexa)
● Escitalopram (Lexapro)
● Fluoxetine (Prozac)
● Fluvoxamine (Luvox, Luvox CR)
● Paroxetine (Paxil, Paxil CR)
● Sertraline (Zoloft)
These medicines can cause unwanted and serious side effects, such as:
– Some people, especially children and young adults, may be more likely to have suicidal thoughts when taking SSRIs.
– A condition called serotonin syndrome may develop.
– Headache
– Blurred vision
– Dry mouth
– Damage and suppression of immune system function
– Feeling dizzy
– Pain in joints or muscles
– Stomach pain, vomiting or diarrhea
– Appetite reduction and weight loss
– Aggressive reaction
– Sensitivity
– Confusion
– Drowsiness
– Increased body movements
– Excessive sweating
– Lack of energy
– Loss of bladder control
– Muscle spasms
– Redness of the skin
– Abdominal or stomach pain
– Blood in the urine
– Chest pain or discomfort
– Cough
– Difficulty breathing
– Dry skin and hair
– Hair loss
– Sores, ulcers or white spots in the mouth or on the lips
– Swelling of the face, legs or hands
– Uncontrolled movements, especially of the face, neck and back.
Management of other health and mental conditions
In addition to autism spectrum disorder, children, teens, and adults may also experience:
– Medical health issues. Children with autism spectrum disorder may also have medical issues, such as epilepsy, sleep disorders, restricted food preferences, or stomach problems. Ask your child’s doctor how to best manage these conditions together.
– Problems with the transition to adulthood. Adolescents and young adults with autism spectrum disorder may have difficulty understanding body changes. Also, social situations become increasingly complex in adolescence, and there may be less tolerance for individual differences. Behavioral problems can be challenging during the teenage years.
– Other mental health disorders. Adolescents and adults with autism spectrum disorder often experience other mental health disorders, such as anxiety and depression.
Planning for the futureChildren with autism spectrum disorder usually continue to learn and compensate throughout life, but most will continue to require some support. Planning for your child’s future opportunities, such as employment, college, living situation, independence, and required support services can make this process smoother.
