Autism is a developmental disorder.
Autism Spectrum Disorder (ASD) refers to a broad range of conditions that is characterized by challenges in social communication and repetitive behavior.
No single factor has been identified as the cause.
Medical research is still confirming the factors that may lead to autism, but it is thought to be caused by abnormalities in brain structure or function.
It is a lifelong condition, but early intervention can help.
Early diagnosis, intervention and supportive therapeutic and educational strategies have been shown to help children with autism thrive.
Autism Spectrum Disorder – known simply as autism – is a developmental disorder that is characterised by difficulties in social interactions and communication; and repetitive patterns of thought and behaviour.
Autism was first described by psychiatrist Leo Kanner in 1943. He observed a disorder in children who had difficulties socializing with others and showed high sensitivity to changes in their environment.
The signs of autism typically appear during early childhood. It is also known as a spectrum condition, because it affects individuals to varying degrees.
Autism affects approximately 1% of the world’s population, and more than 3.5 million Americans live with an autism spectrum disorder.
The prevalence of autism has increased by nearly 120% between 2000 and 2010 – probably due in part to adjustments in the way it is diagnosed and increased awareness of the disorder.
Parents may spot signs of autism within a child’s first two years of life. However, some notice autism as early as 6-12 months depending on how severe their child’s case is. A parent may notice that their baby doesn’t make eye contact, won’t smile at them or make babbling noises in an attempt to communicate.
Children with autism tend to be either oversensitive or under-sensitive to touch, taste, sound and sight. Have you noticed whether a certain sound upsets your little one or are they partial to one color? Do they seek out objects that rattle?
By 3 months
Does your baby follow moving objects with his/her eyes? Try walking around within their visual field and notice whether their eyes follow you around the room. If they seem more interested in something else, you may want to be more vigilant in watching for other signs of autism. Babies like to know their caregiver isn’t far away from them and so they typically like to watch their caregiver’s movements.
Other signs include:
- Lack of response to loud noises
- Inability to grasp and hold objects
- Lack of smiling
- Lack of babbling
- Not paying attention to new faces
By 7 months
Does your baby turn their head to locate where a sound is coming from? Do they show affection for you? By 7 months, babies are starting to display emotions and are developing their innate sense of curiosity. So, if you’re beginning to notice a distinct lack of affection, interest or emotion, you may want to watch for other signs.
Other signs include:
- Not reaching for objects like teddy bears or toys
- Not laughing or making squealing sounds
- No unprompted smile of his/her own
- A lack of attention-seeking gestures or actions
- A lack of interest in games like “peekaboo”
By 12 months
Crawling, or lack of inclination to crawl, is an important step. Although it is true that babies develop at different rates and some even skip crawling altogether in favor of walking straight away, by 12 months there will be signs of them establishing some sort of independent mobility – like pulling themselves up or rolling over.
Other signs include:
- Not saying a single word
- Not using gestures like waving or shaking their head
- Not pointing out objects or pictures
- The inability to stand up when supported
While these signs are good indications that something is amiss, note that only a specialist can confirm a diagnosis.
By 2 years and older
As your child enters their toddler years, the signs of autism become more noticeable because they’re expected to talk, play and interact more with other children. If your child isn’t interested in playing with others or you find they don’t have much vocal range or expression (they talk in a monotone), they could be displaying signs of autism.
Other signs include:
- Not walking
- Frequently wanting to be alone
- Being uncomfortable with physical contact
- Speaking less than 15 words
- Not responding to their name
- Focusing narrowly on activities, such as lining up toys
- Not understanding feelings or emotions
- Not imitating your words or actions
- Repeating words or phrases
- Not following simple instructions
- Being unable to push a wheeled toy
- Playing inappropriately with toys
- Seeming confused by the function of a household object
- Engaging in ritualistic behaviour
- Regressing by losing language skills and physical abilities
Once they get older and start to reach their teen years, you might spot that they have difficulty adjusting to new environments or social situations, particularly in school. Teachers may draw your attention to their inability to stay on task, following instructions, or making and keeping friends.
Genes and environmental factors may both play a contributing role in causing autism. It is important to note that any concerns around the link between vaccines as a possible cause of autism have been disproven. A summary of this evidence is available to review via the CDC’s website.
Over 1,000 genes – like mutations in the ADNP gene – have been reported to have some association with ASD. However, any genetic contribution is thought to only have a small impact.
Advanced parental age; exposure to air pollution or certain pesticides during pregnancy; maternal health; prematurity and birth difficulty that lead to oxygen deprivation can all be contributing factors.
Broadly speaking, some studies show evidence that the brains of children with autism are enlarged earlier in a child’s development; and also show differences in functional brain connectivity.
Risk factors for autism include:
- A sibling with autism
- Older parents
- Certain genetic conditions, such as Down, fragile X and Rett syndrome
- Low birth weight or delivery complications
Some children have other learning difficulties in addition to autism. For example, children with autism may also be diagnosed with ADHD.
In these cases, it is important to select support strategies with an approach that meets all their needs – while recognizing that the needs arising from having autism are unique.
Several conditions may be diagnosed alongside autism. These include:
- Attention deficit hyperactivity disorder (ADHD)
- Hearing impairment
- Down’s syndrome
- Fetal anti-convulsant syndrome
- Fragile X syndrome
- Social communication disorder
- Visual impairment
If you suspect that your child may have autism, consult your pediatrician.
Since the symptoms vary greatly from case to case, it’s best not to expect an immediate result. Diagnosis can be seen as a two-stage process – starting with an appointment (or a developmental screening) that is followed by a comprehensive diagnostic evaluation.
If your child has autism, you may receive a detailed report on where your child is on the autistic spectrum. This will help you to assess what it is you can do as a family to ensure they receive the best support.
Every child should receive a developmental screening once they reach 18 months of age and again at 24 months of age – whether they display signs of autism or not. During the first visit, the healthcare professional will observe and speak with your child. They’ll ask you questions and address your concerns – so feel free to talk openly and frankly with them about your own observations and worries.
They’ll be looking out for clues as to where your child is developmentally, including: whether your child started smiling by 6 months; if they mimicked sounds and facial expressions by 9 months; and whether they were babbling away by 12 months.
The doctor will also ask you if they:
- are exhibiting unusual behavior
- display signs of repetition
- struggle to make eye contact
- are sensitive to any or all of the five senses
- tend to get angry or frustrated easily
Your next appointment may be with a team of autism specialists that could include: a speech and language pathologist, child psychologist and occupational therapist. This evaluation will in part assess your child’s language abilities and cognitive function.
To be formally diagnosed as autistic, your child must meet the standards of the DSM-5 (the Diagnostic and Statistical Manual of Mental Disorders) and face challenges within these two categories:
Challenges with communication and social interaction: children with autism might find it hard to connect with other children or understand their reactions. They’ll find reading social cues difficult and struggle to hold a conversation.
Restricted and repetitive patterns of behaviour: children with autism might rock their bodies, become upset with small changes to their routine and can often only be deeply interest in one subject.
It may be recommended that your child be genetically-tested in order to rule out other conditions with similar symptoms.
There are no medications or medical treatments available for autism, and no way to correct autism’s underlying cause. There are strategies, however, that can be used to significantly improve outcomes in individuals who have autism. These include tailored instruction, early intervention, school support services, counseling and diagnosis.
- Who can help?
- How can they help?
- How do these approaches help?
- What is an IEP or a 504 plan?
- What are examples of other interventions?
Schools are often equipped to provide specialized instruction for children with autism. You may also want to speak to any one of these professionals for more information: special education teachers; residential care providers; psychologists; social workers; and speech and language therapists.
There are specific teaching methods that are used to help children with autism, including TEACCH. TEACCH uses a method called “structural TEACCHING” which is based on the unique requirements of children with ASD.
Approaches, like TEACCH, are designed to cater to the needs of children with autism by applying specific teaching strategies. This particular method prioritizes organization and adjusts the classroom environment to better support children with autism through: physical organisation; individualized schedules; work and activity schedules; and a visual structure or display of materials in tasks and activities.
In the United States, schools have a legal obligation to help children with disabilities. These children are entitled to a 504 plan, or a menu of special accommodations to assist them.
Children diagnosed with autism may receive access to an Individualized Education Plan – or a program of specialized instruction tailored to their needs.
On-going evaluation can help parents and teachers develop a highly-targeted approach for each child. Counseling can help a child manage the emotional difficulties they may face when struggling academically or managing social anxieties as a result of challenging interactions with their peers. Parents of autistic children may also want to access speech and language therapy.
Support Your Child
While there is no single treatment for autism available, parents can do their part in providing children with the academic and emotional support they need to succeed.
- Make sure your language is simple
- Use pictures, symbols and visual supports when speaking
- Allow more time for your child to process instructions
- Repeat instructions and check if your child has understood
- Be sensitive to their responses to sensory input
- Work with them to set a routine
- Take small steps and praise them for progress
- Gradually introduce new foods
- Don’t make a fuss if they leave food
- Accept that using cutlery may be difficult initially
- Gradually increase the choice of play activities
- Make introductions to new places
- Talk to teachers about adapting the curriculum
- Become an advocate for your child at school