Autism, or autism spectrum disorder (ASD), refers to a broad range of conditions characterized by challenges with social skills, repetitive behaviors, speech and nonverbal communication. According to the Centers for Disease Control, autism affects an estimated 1 in 54 children in the United States today.
We know that there is not one autism but many subtypes, most influenced by a combination of genetic and environmental factors. Because autism is a spectrum disorder, each person with autism has a distinct Autism, or autism spectrum disorder (ASD), refers to a broad range of conditions characterized by challenges with social skills, repetitive behaviors, speech and nonverbal communication. According to the Centers for Disease Control, autism affects an estimated 1 in 54 children in the United States today.
We know that there is not one autism but many subtypes, most influenced by a combination of genetic and environmental factors. Because autism is a spectrum disorder, each person with autism has a distinct
set of strengths and challenges. The ways in which people with autism learn, think and problem-solve can range from highly skilled to severely challenged. Some people with ASD may require significant support in their daily lives, while others may need less support and, in some cases, live entirely independently.
Several factors may influence the development of autism, and it is often accompanied by sensory sensitivities and medical issues such as gastrointestinal (GI) disorders, seizures or sleep disorders, as well as mental health challenges such as anxiety, depression and attention issues.
Signs of autism usually appear by age 2 or 3. Some associated development delays can appear even earlier, and often, it can be diagnosed as early as 18 months. Research shows that early intervention leads to positive outcomes later in life for people with autism.
SIGNS AND SYMPTOMS OF AUTISM
Autism can look different in different people. It’s a developmental disability that affects the way people communicate, behave, or interact with others. There’s no single cause for it, and symptoms can be very mild or very severe.
A child with ASD has a hard time interacting with others. Problems with social skills are some of the most common signs. They might want to have close relationships but not know how.
If your child is on the spectrum, they might show some social symptoms by the time they’re 8 to 10 months old. These may include any of the following:
•They don’t respond to their name by their first birthday.
•Playing, sharing, or talking with other people don’t interest them.
•They prefer to be alone.
•They avoid or reject physical contact.
•They avoid eye contact.
•When they’re upset, they don’t like to be comforted.
•They may not stretch out their arms to be picked up or guided with walking.
About 40% of kids with autism spectrum disorders don’t talk at all, and between 25% and 30% develop some language skills during infancy but then lose them later. Some children with ASD start talking later in life.
Most have some problems with communication, including these:
•Delayed speech and language skills
•Flat, robotic speaking voice, or singsong voice
•Echolalia (repeating the same phrase over and over)
•Problems with pronouns (saying “you” instead of “I,” for example)
•Not using or rarely using common gestures (pointing or waving), and not responding to them
•Inability to stay on topic when talking or answering questions
Patterns of Behavior
Children with ASD also act in ways that seem unusual or have interests that aren’t typical. Examples of this can include:
•Repetitive behaviors like hand-flapping, rocking, jumping, or twirling
•Constant moving (pacing) and “hyper” behavior
•Fixations on certain activities or objects
•Extreme sensitivity to touch, light, and sound
•Not taking part in “make-believe” play or imitating others’ behaviors
•Fussy eating habits
•Lack of coordination, clumsiness
•Impulsiveness (acting without thinking)
•Aggressive behavior, both with self and others
Spotting Signs and Symptoms
The earlier treatment for autism spectrum disorder begins, the more like it is to be effective. That’s why knowing how to identify the signs and symptoms is so important.
Make an appointment with your child’s pediatrician if they don’t meet these specific developmental milestones, or if they meet but lose them later on:
•Smiles by 6 months
•Imitates facial expressions or sounds by 9 months
•Coos or babbles by 12 months
•Gestures (points or waves) by 14 months
•Speaks with single words by 16 months and uses phrases of two words or more by 24 months
•Plays pretend or “make-believe” by 18 months
Early diagnosis can make a huge difference in the lives of children with autism spectrum disorder (ASD) and their families.
But it’s not always easy to make an ASD diagnosis. There’s no lab test for it, so doctors rely on observing the behaviors of very young children and listening to the concerns of their parents.
ASD has a very wide range of symptoms. Some people who are “on the spectrum” have severe mental disabilities. Others are highly intelligent and able to live independently.
Wherever your child falls on the spectrum, getting an autism diagnosis is a two-stage process, and it starts with your pediatrician.
Pediatricians are the first step in the autism diagnosis process. Every child gets an assessment at their 18- and 24-month checkups to make sure they’re on track, even if they don’t seem to have any symptoms.
At these visits, your child’s pediatrician will watch them and talk to them. They’ll ask you questions about family history (whether anyone in the family is on the spectrum), and about your child’s development and behavior.
Here are some milestones doctor will be looking for:
•Did your baby smile by 6 months?
•Did they mimic sounds and facial expressions by 9 months?
•Were they babbling and cooing by 12 months?
•Are any of their behaviors unusual or repetitive?
•Do they have trouble making eye contact?
•Do they interact with people and share experiences?
•Do they respond when someone tries to get their attention?
•Is their tone of voice “flat”?
•Do they understand other people’s actions?
•Are they sensitive to light, noise, or temperature?
•Any problems with sleep or digestion?
•Do they tend to get annoyed or angry?
If your child needs more tests, your next appointment probably will be with a team of ASD specialists, child psychologist, speech-language pathologist, and occupational therapist. You may also meet with a developmental pediatrician and a neurologist.
This evaluation is usually to check things like your child’s cognitive level, language abilities, and other life skills like eating, dressing themselves, and going to the bathroom.
For an official diagnosis, your child must meet the standards of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.
Your child must have problems with two categories to fall on the autism spectrum.
1.Challenges with communication and social interaction. For kids with ASD, it’s hard to “connect” with or predict the reactions of other people, read social cues, make eye contact, or have a conversation. They might not begin to speak as early as other children do. They might also have a hard time with the muscle skills needed for things like playing sports or drawing and writing.
2.Restricted and repetitive patterns of behavior. Children with ASD might rock their bodies, repeat phrases, or become upset with changes in their routines. They’re often deeply interested in one subject. They also have sensory issues.
By Shreya Aggarwal