There aren’t many health or developmental concerns related to children that have been more discussed and debated than autism spectrum disorder, often referred to as ASD. The American Academy of Pediatrics defines ASD as a biologically based neurodevelopmental disorder. ASD is characterized by the effect it has on social communication and interaction, and on restricted, repetitive patterns of behavior, interests, and activities. The “spectrum” included in Autism Spectrum Disorder includes disorders that used to be thought of as separate, like autistic disorder, Asperger syndrome, childhood disintegrative disorder, and childhood pervasive developmental disorder. This means that an ASD diagnosis is a term that covers children facing a wide range of challenges and difficulties.
Symptoms of ASD most commonly start to show up in children between 1 and 2 years old, although in other cases, symptoms might not start to show up until later, when greater social demands make limits in social behavior more obvious. Children with less severe forms of ASD (including what was previously called Asperger’s syndrome) may not show obvious symptoms until 4 to 6 years old, or older.
What does ASD look like?
ASD is a neurodevelopmental disorder characterized by impairments in two major areas, social communication and interaction, and restricted, repetitive patterns of behavior, interests, and activities. Essentially, ASD affects a child’s ability to communicate with and understand others. Children and adults with ASD may also display restricted repetitive behaviors, including repeated movements like rocking or spinning; becoming attached to very regular, or even ritualistic schedules; or only eating very limited types of food, feeling uncomfortable in specific types of fabric, hating loud noises like the sound of the vacuum, or other sensory sensitivities.
That begins with and affects a child’s brain as they grow. ASD affects social interaction and communication abilities in children and adults who have been diagnosed with it. People with ASD may sometimes display “restricted repetitive behaviors.” These behaviors include repeated movements like rocking or spinning; Echolalia (repeating words), attachments to repetitive, ritualistic schedules; very restricted interests at the exclusion of others; or sensory sensitivities like an aversion to loud noises like the vacuum cleaner or hairdryer, smells, the texture of certain foods, or sensory seeking behavior (smelling objects, peering at objects through the corner of their eye, etc).
- Social communication and interaction: Impaired social communication is one of the defining features of ASD, and often first starts to show up as a delay in language development. Beyond that, ASD may lead to a lack of social reciprocity. In younger children and toddlers, this may mean a lack of awareness of other children, including siblings, a lack of empathy or awareness when others are hurt, not being interested in imitating others, and not being interested in showing caregivers new or interesting sights and objects. Young children who may be showing signs of ASD may make very little eye-contact, not seek out interactions with adults, not point to things they want, and not look in the direction that someone who is speaking to them is looking or pointing. As children with ASD get older, it often becomes more clear that they have trouble with back-and-forth interactions like conversations, and may have more trouble than other people figuring out the thoughts and feelings of others. Communication problems are also common symptoms of ASD – according to one estimate, about half of people with ASD have some trouble with language. Children with ASD often are late-talkers.
- Restrictive and repetitive behaviors: Children with ASD may also show unusual behaviors like repetitive movements, including rocking, spinning, foot-tapping or hand-flapping. It is also not uncommon for them to use repetitive vocalizations, like immediately repeating a word or phrase (echolalia), or scripting (repeating phrases out of context that were previously heard or seen on TV). Individuals with ASD also tend to have extreme attachment to routines in day-to-day life. Children with ASD generally have trouble with transitions, and may need to follow the same routine every day. Trouble with coordination can go along with ASD, as can fascination with details, or an extremely intense interest in a very specific subject or object (for example, in a young child, this may look like only wanting to play with tracks or line up their cars). Children with ASD may not play make-believe, or other types of “pretend”-heavy games. Sensory processing difficulties are very common in children and adults with ASD, and may manifest as over-responsiveness to touch, taste, sound, sight, or smell or may cause them to seek out these times of sensory input.
Who is at risk for ASD?
While it’s still not totally clear what causes ASD, studies on identical twins suggest that genes play some role. It’s significantly more likely in boys than it is in girls, and in 2010 and 2012, the Autism and Developmental Disabilities Monitoring Network estimated that its prevalence in 8-year-old children was about 1 in 68.
Though in the past ASD often wasn’t diagnosed until around 5 years old, symptoms can be identified in children younger than 3, and many experts feel they can currently successfully diagnose children as young as 12 to 18 months old. Early diagnosis can make a huge difference in the lives of children with ASD, since Early Intervention services can have a huge impact on these children’s lives as they grow.
For information about how Autism Spectrum Disorder is diagnosed and treated, tap here.