Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social interactions and social communication and by restricted, repetitive patterns of behavior.
Social Interaction and Social Communication
Child shows little interest in making friends; initiates social interactions primarily to have immediate needs met (e.g., to get food, preferred toy); and tends not to share Accomplishments and experiences. Other symptoms include lack of eye contact, and absent or limited and atypical gestures (e.g., using someone’s hand as a tool foropening the door). Loss of language occurs in some cases.
Restricted Interests and Repetitive Behaviors
Intensely repetitive motor movements or use of objects; child is consumed with a single item, idea, or person; experiences difficulty with changes in the environmentor transitioning from one situation to another; may have frequent tantrums; and may be aggressive or self-injurious.
ASD typically appears during the early years of life. Early assessment and intervention are crucial to a child's long-term success. Early signs include:
The number of diagnosed cases of autism and related disorders has dramatically increased over the past decade. According to the most recent study conducted by the Centers for Disease Control and Prevention (2018), ASD occurs in approximately one in every 59 births. ASD is one of the most common serious developmental disabilities, and is four times more likely to occur in boys than in girls.
There are no medical tests for diagnosing ASD, but when parents becomeconcerned about developmental delays in children, they should consult a physician. He or she can rule out various potential medical causes, such as hearing problems. Before a child can be diagnosed, that child should be evaluated by an autism specialist. Such a person may be a psychologist, psychiatrist, pediatric neurologist, or developmental pediatrician who specializes in diagnosing and treating children with ASD.
Best practice guidelines identify the following six components of a comprehensive diagnostic evaluation for autism:
ASD diagnostic criteria are described by the American Psychiatric Association (APA) in its Diagnostic & Statistical Manual of Mental Disorders (DSM-V). Qualified professionals provide these diagnoses when symptoms of ASD (social interaction and social communication, and repetitive behaviors) are present in ranges that are inappropriate for the child’s age and developmental level.
ASD is diagnosed when all these symptoms are present to some degree. A diagnosis also includes a specification of severity. Specifically, qualified professionals will use information gathered during the diagnostic assessment to indicate the level of support an individual with ASD requires: Level 1 Requiring Support; Level 2 Requiring Substantial Support; Level 3 Requiring Very Substantial Support.
Although one specific cause of ASD is not known, current research links autism to biological or neurological differences in the brain. Autism is believed to have a genetic basis, although no single gene has been directly linked to the disorder.
Researchers are using advanced brain-imaging technology to examine factors that may contribute to the development of autism. MRI (Magnetic Resonance Imaging) and PET (Positron Emission Tomography) scans can show abnormalities in the structure of the brain, with significant cellular differences in the cerebellum.
Selecting the most appropriate treatment for an individual with an ASD is complicated. The following factors should influence treatment selection: (a) evidence of intervention effectiveness; (b) professional judgment and data-based clinical decision making; (c) values and preferences of families (including the individual on the autism spectrum); and (d) capacity to accurately implement an intervention.
The National Standards Project of the National Autism Center at May Institute has identified interventions that have sufficient evidence to show they are effective for individuals with ASD. We recommend considering these interventions unless they are deemed inappropriate based on one of the other factors influencing treatment selection.
Parents should look for programs that:
National Autism Center (www.nationalautismcenter.org)
Autism Society of America (www.autism-society.org)
Centers for Disease Control and Prevention (www.cdc.gov [key word “autism])
Doug Flutie Jr. Foundation (www.dougflutiejrfoundation.org)
Financial Planning (www.specialneedsplanning.com)