Autism is referred to as a spectrum disorder because there is so much variation in terms of the type of symptoms people experience and the severity of those symptoms.
Symptoms
While symptoms are often highly variable, they usually begin to appear before the age of three. Parents may notice symptoms associated with how children interact socially, their responsiveness to stimulation, and their ability to communicate. Symptoms of autism include repetitive behaviors, limited interests, and problems with interaction. While people with autism spectrum disorder may not show all of these symptoms, they usually show several of the following:
Trouble making eye contactDifficulty following and engaging in conversationsExtreme distress when routines are even slightly disruptedFacial expressions that don’t match verbal communicationIntense interest in certain subjectsLack of enjoyment in activitiesProblems expressing feelings or needs in wordsNot engaging in “pretend” playSlow or absent response to people trying to gain their attentionSensitivity to sensory stimuli including taste, light, and smellStimming behaviors (i.e., self-stimulating, repetitive actions such rocking, walking on toes, or flapping hands)Trouble seeing things from another person’s point of view
It’s important to remember that because autism is a spectrum condition, people can have symptoms that are described as mild, moderate, or severe. Some people may have several or many symptoms, but only experience them to a mild degree. In other cases, people might only have a few symptoms in key areas but experience severe impairments as a result of those symptoms. People who have milder autism symptoms are often able to function in their daily lives, but they may be more likely to have other mental health concerns including excessive stress, obsessive behaviors, sensory issues, anxiety, and depression. Autism is usually diagnosed in childhood and it can occur in people of all economic backgrounds, races, and ethnicities.
Diagnosis
Signs of autism are typically first noticed by parents, but they may also be spotted by other caregivers, teachers, and doctors.
Lack of smiling or happy expressions by six monthsNo babbling by age oneLack of response when a child’s name is calledNot reaching for objects by age oneLack of single-word speech by 16 monthsNo two-word phrases by age 2Loss of any speech or social skills
Early screening and evaluation are important. If you are concerned about your child’s behavior, it is important to talk to your child’s doctor. The sooner a diagnosis is made, the sooner interventions can begin.
Evaluations
During regular developmental checkups during childhood, doctors track a number of developmental milestones and screen for different types of developmental delays. When children don’t meet certain milestones, they may receive further evaluation. During an additional evaluation, a group of specialists that may include a developmental pediatrician, a child psychiatrist, and a speech-language pathologist, will assess a number of things including age-appropriate behaviors, cognitive skills, and language abilities. Some types of tests that may be used in the diagnosis of autism include:
Autism-symptom questionnaires Developmental monitoring Hearing tests IQ tests
Diagnosis in Adulthood
While autism is often diagnosed in early childhood, it can also be diagnosed during adolescence and adulthood. Diagnosis later in life can sometimes be more difficult since some symptoms of autism can be confused with other mental health conditions such as anxiety, OCD, and ADHD. While researchers are still studying what types of treatments work best for adults with autism, getting a diagnosis can be helpful for understanding both current and past difficulties. It can also help you learn how to recognize your strengths and get help in areas where you may struggle. Early diagnosis is usually ideal, but it is never too late to be evaluated, diagnosed, and treated for autism. If you are experiencing symptoms that may be related to autism, talk to your doctor to learn more.
Causes
While the exact causes are not known, research suggests that there is likely a genetic aspect to the condition. However, they found that autism is four times more common in boys than in girls. Prevalence statistics also indicate that autism is more common now than in the past. It also appears to be increasing, growing as much as 10 to 17% over the past few years. Research that points to a genetic connection includes studies showing that children who have a sibling with autism are at a higher risk of having autism. However, research has also found that only around 20% can be directly attributable to genetic causes. Further research is needed to better understand how specific genetic mutations or variations may contribute to the development of autism spectrum disorder. While genes are thought to be a key contributor, studies have also shown that premature birth and advanced paternal age are also linked to the onset of autism. Certain drugs, when taken during pregnancy, have been linked to a higher risk for autism spectrum disorder.
Types
When a person is diagnosed with autism, they will also have their functional level identified. There are three different levels of autism spectrum disorder:
Level 1: High functioningLevel 2: Moderately severeLevel 3: Severe
These levels are used to describe how severely behaviors and social skills are affected.
Level 1
Level 1 is considered a mild form of autism. People who have this type may have problems with social relationships and restrictive behaviors. They usually only need minimal support to function in their normal daily life.
Level 2
Those with Level 2 autism spectrum disorder need more support. Their social difficulties are apparent, they may have problems communicating, and may need assistance to manage problematic behaviors.
Level 3
People with Level 3 autism have symptoms that interfere with their ability to live and function independently. People with this level of autism often do not communicate verbally, struggle with change, have repetitive or restrictive behaviors, and may be sensitive to sensory stimuli.
Previous Types
The 2013 publication of the Diagnostic and Statistical Manual of Mental Disorders (DSM) marked significant changes in how autism was classified and diagnosed. Until the publication of the DSM-5, experts referred to different types of autism. These included:
Asperger’s syndrome was described as a milder form of autism marked by normal intellectual functioning but difficulty with social interaction.Pervasive developmental disorder, not otherwise specified (PDD-NOS) was a moderate form of autism that was more pronounced than Asperger’s.Autistic disorder was a more severe form of autism marked by more serious deficits than Asperger’s and PDD-NOS.
Today, these conditions are simply known as autism spectrum disorder. While the above types are no longer official diagnoses, some people still find them useful as a way to describe how symptoms are experienced and their severity. For example, people often find that Asperger’s is helpful as a self-identity or to connect with peers with similar experiences.
Treatment
While autism is a lifelong condition, there are treatments that can help with many symptoms and improve people’s ability to function in different areas of life. According to the National Institute of Mental Health, treatment should begin as quickly as possible following a diagnosis. There is no single treatment that is best. People with autism have a wide range of symptoms so that means that each person’s needs are different. Some of the treatment options that might be used include medications and therapy.
Medications
While there is no medication approved for the treatment of autism, a doctor may prescribe certain medications to alleviate certain symptoms. Medications such as selective serotonin reuptake inhibitors (SSRIs), anti-psychotics, stimulants, anti-anxiety medications, and anticonvulsants may help with symptoms such as:
AggressionAnxietyAttention problemsDepressionHyperactivityInappropriate speechIrritabilitySocial withdrawal
Behavioral and Developmental Therapy
Treatment for autism often focuses on behavioral, psychological, or skills training interventions. One commonly used approach is applied behavior analysis (ABA), a form of therapy that utilizes reinforcements to teach and reinforce desirable behaviors and skills. Other common therapies used in the treatment of autism include:
Cognitive-behavioral therapy (CBT)Developmental and individual differences relationship therapy (also known as “floortime”)Early intensive behavioral interventionPivotal response therapyRelationship development interventionVerbal behavior therapy
Such treatments are designed to help people with autism spectrum disorder to:
Foster cognitive abilitiesImprove existing strengthsIncrease language and communication skillsImprove social skillsLearn adaptive skills that allow for independent living
Other therapies that may be used include assistive technology, speech therapy, occupational therapy, and social skills training. Treatment also often incorporates aspects of caregiver training in which parents and other caregivers learn skills that will help them reinforce what is being worked on in treatment.
Coping
In addition to seeking professional treatment, there are also a number of self-help strategies that you can use to help cope with some of the symptoms of autism. Some things that can help:
Be Accepting
Rather than focusing on differences, try viewing these unique characteristics as just part of who someone is. Practice acceptance and unconditional love instead of focusing on trying to “fix” the things that make someone different from others.
Create a Relaxing and Comfortable Environment
Pay attention to things that may be a source of stress including sensory stimuli such as loud noises or bright lights.
Follow A Schedule
People with autism do best with routines and structure. Keep things consistent each day including meals, school, appointments, therapy, and bedtime. When there are going to be changes or disruptions, be sure to give the individual plenty of warning and time to prepare.
Join a Support Group
Look for local support groups in your area or join a group online. You can share experience, get support, learn about treatments, and discover resources and programs related to autism spectrum disorder.
Learn to Identify Triggers
If there are certain things that tend to trigger disruptive or challenging behaviors, you can find ways to prevent or modify those difficult situations.
Pay Attention to Nonverbal Communication
Because people with autism often struggle with communication and social behaviors, they may not be able to tell you what’s wrong. Look at things such as facial expressions, body language, and other nonverbal signals.
Use Positive Reinforcement
The goal is to offer a reward when you “catch them being good.” When you notice that they are using a new skill or are doing something good, praise them for it. Verbal encouragement can go a long way, but you can also use other desired rewards such as stickers or preferred activities as a way to reinforce appropriate behaviors.
A Word From Verywell
Autism is a complex condition that can cause various degrees of impairment and affect a person’s life in many different areas. Early intervention is important and there are many types of treatment and resources available to help. Finding the right treatment for yourself or your loved one can help them function more independently and live a fulfilling life.
