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Autism spectrum disorder (ASD) is a developmental disability that can cause significant social, communication and behavioral challenges. There is often nothing about how people with ASD look that sets them apart from other people, but people with ASD may communicate, interact, behave, and learn in ways that are different from most other people. The learning, thinking, and problem-solving abilities of people with ASD can range from gifted to severely challenged. Some people with ASD need a lot of help in their daily lives; others need less.
A diagnosis of ASD now includes several conditions that used to be diagnosed separately: autistic disorder, pervasive developmental disorder not otherwise specified (PDD-NOS), and Asperger syndrome. These conditions are now all called autism spectrum disorder.
Signs and Symptoms
People with ASD often have problems with social, emotional, and communication skills. They might repeat certain behaviors and might not want change in their daily activities. Many people with ASD also have different ways of learning, paying attention, or reacting to things. Signs of ASD begin during early childhood and typically last throughout a person’s life.
Children or adults with ASD might:
- not point at objects to show interest (for example, not point at an airplane flying over)
- not look at objects when another person points at them
- have trouble relating to others or not have an interest in other people at all
- avoid eye contact and want to be alone
- have trouble understanding other people’s feelings or talking about their own feelings
- prefer not to be held or cuddled, or might cuddle only when they want to
- appear to be unaware when people talk to them, but respond to other sounds
- be very interested in people, but not know how to talk, play, or relate to them
- repeat or echo words or phrases said to them, or repeat words or phrases in place of normal language
- have trouble expressing their needs using typical words or motions
- not play “pretend” games (for example, not pretend to “feed” a doll)
- repeat actions over and over again
- have trouble adapting when a routine changes
- have unusual reactions to the way things smell, taste, look, feel, or sound
- lose skills they once had (for example, stop saying words they were using)
Diagnosing ASD can be difficult since there is no medical test, like a blood test, to diagnose the disorders. Doctors look at the child’s behavior and development to make a diagnosis.
ASD can sometimes be detected at 18 months or younger. By age 2, a diagnosis by an experienced professional can be considered very reliable.1 However, many children do not receive a final diagnosis until much older. This delay means that children with ASD might not get the early help they need.
There is currently no cure for ASD. However, research shows that early intervention treatment services can improve a child’s development.2, 3 Early intervention services help children from birth to 3 years old (36 months) learn important skills. Services can include therapy to help the child talk, walk, and interact with others. Therefore, it is important to talk to your child’s doctor as soon as possible if you think your child has ASD or other developmental problem.
Even if your child has not been diagnosed with an ASD, he or she may be eligible for early intervention treatment services. The Individuals with Disabilities Education Act (IDEA) says that children under the age of 3 years (36 months) who are at risk of having developmental delays may be eligible for services. These services are provided through an early intervention system in your state. Through this system, you can ask for an evaluation.
In addition, treatment for particular symptoms, such as speech therapy for language delays, often does not need to wait for a formal ASD diagnosis.
We do not know all of the causes of ASD. However, we have learned that there are likely many causes for multiple types of ASD. There may be many different factors that make a child more likely to have an ASD, including environmental, biologic and genetic factors.
- Most scientists agree that genes are one of the risk factors that can make a person more likely to develop ASD.4
- Children who have a sibling with ASD are at a higher risk of also having ASD. 5-10
- ASD tends to occur more often in people who have certain genetic or chromosomal conditions, such as fragile X syndrome or tuberous sclerosis.11-14
- When taken during pregnancy, the prescription drugs valproic acid and thalidomide have been linked with a higher risk of ASD.15-16
- There is some evidence that the critical period for developing ASD occurs before, during, and immediately after birth.17
- Children born to older parents are at greater risk for having ASD.18
ASD continues to be an important public health concern. Like the many families living with ASD, CDC wants to find out what causes the disorder. Understanding the factors that make a person more likely to develop ASD will help us learn more about the causes. We are currently working on one of the largest U.S. studies to date, called Study to Explore Early Development (SEED). SEED is looking at many possible risk factors for ASD, including genetic, environmental, pregnancy, and behavioral factors.
Who is Affected
ASD occurs in all racial, ethnic, and socioeconomic groups, but is almost five times more common among boys than among girls. CDC estimates that about 1 in 68 children has been identified with autism spectrum disorder (ASD).
More people than ever before are being diagnosed with ASD. It is unclear exactly how much of this increase is due to a broader definition of ASD and better efforts in diagnosis. However, a true increase in the number of people with an ASD cannot be ruled out. We believe the increase in ASD diagnosis is likely due to a combination of these factors.
For over a decade, CDC’s Autism and Developmental Disabilities Monitoring (ADDM) Network has been estimating the number of children with ASD in the United States. We have learned a lot about how many U. S. children have ASD. It will be important to use the same methods to track how the number of children with ASD is changing over time in order to learn more about the disorder.
If You’re Concerned
If you think your child might have ASD or you think there could be a problem with the way your child plays, learns, speaks, or acts, contact your child’s doctor, and share your concerns.
If you or the doctor is still concerned, ask the doctor for a referral to a specialist who can do a more in-depth evaluation of your child. Specialists who can do a more in-depth evaluation and make a diagnosis include:
- Developmental Pediatricians (doctors who have special training in child development and children with special needs)
- Child Neurologists (doctors who work on the brain, spine, and nerves)
- Child Psychologists or Psychiatrists (doctors who know about the human mind)
At the same time, call your state’s public early childhood system to request a free evaluation to find out if your child qualifies for intervention services. This is sometimes called a Child Find evaluation. You do not need to wait for a doctor’s referral or a medical diagnosis to make this call.
Where to call for a free evaluation from the state depends on your child’s age:
- If your child is not yet 3 years old, contact your local early intervention system.
- You can find the right contact information for your state by calling the Early Childhood Technical Assistance Center (ECTA) at 919-962-2001.
- Or visit the ECTA website.
- If your child is 3 years old or older, contact your local public school system.
- Even if your child is not yet old enough for kindergarten or enrolled in a public school, call your local elementary school or board of education and ask to speak with someone who can help you have your child evaluated.
- If you’re not sure who to contact, call the Early Childhood Technical Assistance Center (ECTA) at 919-962-2001.
- Or visit the ECTA website.
Research shows that early intervention services can greatly improve a child’s development.2, 3 In order to make sure your child reaches his or her full potential, it is very important to get help for an ASD as soon as possible.
– See CDC.gov for more information.
Reactive Attachment Disorder
Reactive attachment disorder is a rare but serious condition in which infants and young children don’t establish healthy bonds with parents or caregivers.
A child with reactive attachment disorder is typically neglected, abused or orphaned. Reactive attachment disorder develops because the child’s basic needs for comfort, affection and nurturing aren’t met and loving, caring attachments with others are never established. This may permanently change the child’s growing brain, hurting the ability to establish future relationships.
Reactive attachment disorder is a lifelong condition, but with treatment children can develop more stable and healthy relationships with caregivers and others. Safe and proven treatments for reactive attachment disorder include psychological counseling and parent or caregiver education.
See the Mayo Clinic for more information.
Sensory Processing Disorder
Sensory processing (sometimes called “sensory integration” or SI) is a term that refers to the way the nervous system receives messages from the senses and turns them into appropriate motor and behavioral responses. Whether you are biting into a hamburger, riding a bicycle, or reading a book, your successful completion of the activity requires processing sensation or “sensory integration.”
Sensory Processing Disorder (SPD, formerly known as “sensory integration dysfunction”) is a condition that exists when sensory signals don’t get organized into appropriate responses. Pioneering occupational therapist and neuroscientist A. Jean Ayres, PhD, likened SPD to a neurological “traffic jam” that prevents certain parts of the brain from receiving the information needed to interpret sensory information correctly. A person with SPD finds it difficult to process and act upon information received through the senses, which creates challenges in performing countless everyday tasks. Motor clumsiness, behavioral problems, anxiety, depression, school failure, and other impacts may result if the disorder is not treated effectively.
One study (Ahn, Miller, Milberger, McIntosh, 2004) shows that at least 1 in 20 children’s daily lives is affected by SPD. Another research study by the Sensory Processing Disorder Scientific Work Group (Ben-Sasson, Carter, Briggs-Gowen, 2009) suggests that 1 in every 6 children experiences sensory symptoms that may be significant enough to affect aspects of everyday life functions. Symptoms of Sensory Processing Disorder, like those of most disorders, occur within a broad spectrum of severity. While most of us have occasional difficulties processing sensory information, for children and adults with SPD, these difficulties are chronic, and they disrupt everyday life.
For more information see the Sensory Processing Disorder Foundation.
Schizoaffective disorder is a condition in which a person experiences a combination of schizophrenia symptoms — such as hallucinations or delusions — and mood disorder symptoms, such as mania or depression.
Schizoaffective disorder is not as well understood or well defined as other mental health conditions. This is largely because schizoaffective disorder is a mix of mental health conditions ― including schizophrenic and mood disorder features ― that may run a unique course in each affected person.
Untreated, people with schizoaffective disorder may lead lonely lives and have trouble holding down a job or attending school. Or, they may rely heavily on family or live in supported living environments, such as group homes. Treatment can help manage symptoms and improve the quality of life for people with schizoaffective disorder.
For more information see the Mayo Clinic
Bipolar disorder — sometimes called manic-depressive disorder — is associated with mood swings that range from the lows of depression to the highs of mania. When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities. When your mood shifts in the other direction, you may feel euphoric and full of energy. Mood shifts may occur only a few times a year, or as often as several times a day. In some cases, bipolar disorder causes symptoms of depression and mania at the same time.
Although bipolar disorder is a disruptive, long-term condition, you can keep your moods in check by following a treatment plan. In most cases, bipolar disorder can be controlled with medications and psychological counseling (psychotherapy).
For more information see the Mayo Clinic.
Antisocial Personality Disorder (aka Sociopath)
Antisocial personality disorder is a type of chronic mental condition in which a person’s ways of thinking, perceiving situations and relating to others are dysfunctional — and destructive. People with antisocial personality disorder typically have no regard for right and wrong and often disregard the rights, wishes and feelings of others.
Those with antisocial personality disorder tend to antagonize, manipulate or treat others either harshly or with callous indifference. They may often violate the law, landing in frequent trouble, yet they show no guilt or remorse. They may lie, behave violently or impulsively, and have problems with drug and alcohol use. These characteristics typically make people with antisocial personality disorder unable to fulfill responsibilities related to family, work or school.
For more information see the Mayo Clinic.
Autism and Wandering PSA
This is a very important video to watch about Autism and wandering…
Remember the 3 S’s, if you ever see a child wandering alone:
Stop and help
Seek assistance from the Police
Stay with the child until the Police arrive