What is autism?Autism is neuro-developmental disorder that impacts four main areas of an individual’s life. Individuals with autism are typically challenged with social skill deficits, difficulties with sensory integration, communication and language deficits, and restrictive or repetitive behaviors.
In more mild forms of autism, these deficits may be subtle and not obvious to the general observer. In moderate and more severe cases of autism, these areas of functioning may be severely impaired and the individual may have great difficulty functioning in their home and community environments. Individuals with moderate or severe forms of autism often have great difficulty in their daily living and in their general adaptation to the world around them.
Families of children with autism often face unique and very challenging obstacles in their lives as they attempt to support their child’s development and learning. It is not uncommon for parents and families to feel very frustrated and overwhelmed when faced with these issues. Families facing these challenges need specific information about autism and many will require high levels of support from family, friends, and professionals.
What causes autism?The causes of autism are still unknown. However, there is a considerable amount of research underway in an attempt to discover the causes of this growing neuro-developmental condition. While there are many hypotheses about the causes of autism, research is the only acceptable method to facilitate our understanding of the etiology of autism.
Many parents have heard that childhood vaccinations and/or diet can cause autism. It is important to know that at the current time, there is not sufficient research to support a causative association between childhood vaccinations and autism. There is not sufficient evidence to link diet or vitamin/minerals to autism. More research is needed in these areas.
The most promising research links autism to genetics. There is also research evaluating environmental triggers that are thought to be associated with autism. Given the pace of research in this area, it is anticipated that we will know more clearly the causes of autism in the next five years.
How is autism treated?Early intervention and Applied Behavior Analysis — also known as ABA — are the only treatments for autism that show clear positive results in the literature.
When autism is identified early in young children, the interventions and support provided to these children tend to have stronger and longer lasting effects. When autism is identified later in childhood or adolescence, the interventions and support techniques and strategies tend to have less of an impact on an individual’s functioning. Early intervention is really an important component in the treatment of autism. In addition to early intervention, research indicates that Applied Behavioral Analysis training is effective for individuals with autism. ABA training is based on the principals of behaviorism and includes direct behavioral approaches to increase specific and more adaptive behaviors in a child’s repertoire.
With the application of ABA principals and high levels of support, children with autism have been known to gain a significant amount of adaptive skills to their lives. The increase in adaptive and more functional behaviors has allowed many children with autism to more effectively interact with others, to communicate better with others, and to function in their homes and schools more successfully.
Other common interventions for children with autism include the application of a specific behavioral support and response plan, direct training to expand verbal and nonverbal means of communication, sensory training to assist with better adaptation to touches, sights, smells, tastes, and sounds, and social skills training.
We do know that children with autism that are involved in treatment tend to do better than children with autism that have not had treatment and support. Treatment is very important for these children.
Are there different kinds of autism?We refer to Autistic Disorder as being on a “spectrum.” One form of autism — known as Asperger disorder -- is thought to be a more mild form of autism and would be on one end of the Autism spectrum. Asperger disorder includes all the same symptoms as autistic disorder but the symptoms are milder and usually have less of a severe interference in the child’s life. Most often, children diagnosed with Asperger disorder use verbal language whereas many children with autistic disorder do not have functional verbal language.
There are other forms of autism that fall somewhere on the spectrum based mainly on the severity and type of symptoms or the age at which the symptoms appear. Other disorders on the spectrum include Rett Disorder, Childhood Disintegrative Disorder, and Pervasive Disorder Not Otherwise Specified. Again, all of these are forms of autism with the most common being Autistic Disorder and Asperger Disorder.
What are the signs and symptoms of autism?Typically, the signs of autism can be seen early in a child’s life. Early signs can include the absence of babbling and cooing as an infant and/or the absence of facial expressions and responsiveness to cuddling. In more severe cases, the infant may actually pull away from physical nurturing.
As the child develops, other signs to look for include the lack of emotional expressions, lack of reciprocal social engagement, restrictive interests in pieces and parts of objects, lack of imaginative play, lack of functional play, and lack of an ability to read nonverbal social cues like gestures, tone of voice, facial expressions and others.
As a toddler, children with autism may begin to repeat sounds or words — also known as echolalia — and may seem extremely shy or fearful in social settings. One of the hallmark signs of autism is the absence of language development. Extreme behavioral challenges often emerge in children with autism commonly sparked by tactile or auditory stimulation, change in routine, or requests to engage in simple activities.
Children with autism are often very restrictive in their interests, routines, and behaviors. Almost all children with autism have difficulty learning in traditional classrooms. Thus, the educational setting is an environment where children with autism can be especially challenging. Again, individuals with autism may exhibit some or all of these symptoms to varying degrees.
Can autism be cured?Today, there is no known cure for autism. Early intervention including diagnosis and using the behavioral strategies of applied behavior analysis can lead to improvements in communication, social, life skills and behavioral functioning.
Given the amount of research currently underway in the United States and other countries, advancements in our knowledge and interventions is expected over the next many years. While we have no known cure, we do know that the majority of children diagnosed with autism demonstrate improvement in functioning with appropriate identification, support, and treatment.
How can children with ASDs be taught to communicate?The lack of appropriate language development is one of the hallmark signs of autism. We now know that children who have autism can be taught to communicate through a variety of verbal and nonverbal methods. In some children with autism, verbal language can be successfully taught, obtained, and maintained by the use of behavioral strategies.
In this method, verbal language is built and expanded on over time. Many children with autism can learn basic verbal language to use to meet their basic needs or to express their experiences or desires to others. It is true that children with autism — even those with severe forms of the disorder -- can learn to use verbal language to communicate.
It is also important to know that for many children with autism, alternatives to verbal language can be provided and are often combined with basic verbal expressions. Many children with autism can develop functional communication through picture exchange systems and sign language.
Is medication necessary for autism treatment?Depending on the symptoms and the severity of the symptoms and behaviors of concern, medication can be useful for individuals with autism. Medications have demonstrated some efficacy when focusing on the more severe symptoms of autism such as extreme hyperactivity, sleeplessness, agitation, and aggression.
While medications have shown to help in many cases with symptom reduction, research indicates that behavioral interventions are necessary and essential for longer-term behavioral change and for the development of more adaptive and functional behaviors and skills. Medication can help with symptoms but it cannot teach new behaviors. Typically, children with autism are treated with a variety of interventions and medication is just one component of a treatment plan.
Where do I go for an evaluation?If you have concerns about your child and suspect autism, we suggest that you always consult with your primary care physician or pediatrician first. It is not uncommon for a primary medical condition to produce symptoms that are similar to those seen with autism.
For example, a toddler with a history of severe ear infections may have great difficulty learning to talk. Extreme forms of childhood anxiety may manifest as underdeveloped socialization or the avoidance of people and play.
A thorough medical evaluation is a very good first step. If your physician suspects autism, he or she is likely to refer the child for a specialized evaluation. The referral for evaluation is typically made to a behavioral pediatrician, a child psychologist, or a master’s level licensed behavioral health professional that specializes in child development.
What should an autism evaluation include?When considering an evaluation to rule out autism, it is important to note that there is no specific battery of tests or set of accepted procedures used to diagnose an individual with autism. Areas that must be included in an evaluation for autism include an assessment of cognitive functioning, an assessment of expressive and receptive language, an assessment of behavioral functioning, and in some cases, an assessment of academic achievement/skills.
A diagnosis of autism cannot be made without a complete and thorough developmental and family history interview. Medical conditions must be ruled out. In addition to these procedures, an appropriate evaluation for autism includes behavioral observations of the child in a variety of different settings.
It is also important to get information and input from as many caregivers as possible including parents, teachers, babysitters, etc.
In addition to these procedures, an evaluation for autism should include specific behavioral and developmental checklists specific to autism. Some common diagnostic checklists include:
How early can a diagnosis of autism be made?The diagnosis of autism can be made as early as age 18 months, but is more commonly identified between ages 3 -4.
Many, if not the majority of children with autism, will not be diagnosed until they enter school. This is probably because this is the time that children’s skills and development are more commonly compared to peers, because learning and behavioral delays are more easily identified in the school setting, and because there are more resources available to identify children with developmental challenges when they enter school.
It is important to note that early identification, diagnosis, and treatment is very important. The earlier the identification, the more likely intervention and support strategies will have the greatest impact in the long run.
My child was just diagnosed with autism. Now what?
Is a special diet needed?In children with autism, there is no empirical evidence that supports the use of special diets as a primary intervention strategy. Research has not produced results that indicate that diet has an impact on the primary symptoms of autism.
However, it is important to note that excessive amounts of any particular food — or diets limited to one or two foods — can create problems and symptoms in children. Indeed, excessive sugar or other foods in excess can influence a child’s behavior.
Like other children, a child with autism who eats a nutritious and well balanced diet will behave and function better than a child that eats nothing but French fries and pizza.
What might be some sensory needs of an individual on the autism spectrum?Individuals diagnosed with autism can experience a variety of functional and sensory differences and deficits. Heightened sensitivity and defensiveness when experiencing visual, auditory, olfactory, oral or tactile stimuli is often present with individuals diagnosed with autism.
Sensory and sensory integration challenges for those with autism can present at varying levels in each individual. Some individuals may experience great sensory challenges and needs, while others exhibit very little needs in this regard.
Does autism change with age?While Autism is a pervasive and chronic neuro-developmental condition, individuals with the disorder can certainly demonstrate changes in their functional behavior, their language, and their communication skills.
Depending on the services in place and how early in life that intervention is started, changes can take place over time. Individuals may become more social, communicative, and learn to identify their basic needs and even address those needs independently.
Progress over time also varies from individual to individual. Some make very significant progress and gain the skills necessary to function adequately in the community. Others with autism may not demonstrate as much response to treatment and may need high levels of support and supervision for most of their life time. It is so very important that consistent evaluation of progress be an integral part of any serve plan for an individual with autism.
What is the life expectancy of a person with autism?Individuals with autism are generally expected to live just as long as those who have not been diagnosed with the disorder.
It should be noted, however, that it is not uncommon for individuals with autism to also have other medical and developmental conditions that may affect their life expectancy. Atypical neurological conditions, seizure disorders, and genetic syndromes are not uncommon in individuals with autism. These additional conditions likely have a greater impact on life expectancy than the diagnosis of autism and the related symptoms.