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Autism spectrum disorder (ASD), also known as autism, is a general term that describes a variety of neurodevelopmental conditions.
These conditions can cause differences in communication and social interaction. People with ASD often have restricted or repetitive interests or patterns of behavior.
ASD can be found in all races and economic backgrounds.
According to the Centers for Disease Control and Prevention, ASD is more common in boys than it is in girls. A study of 8-year olds from 11 different locations in the United States revealed a 4.3-to-1 boy-to-girl ratio. ASD was found in approximately 1 in 54 participants.
There are some indications that autism cases are increasing. Some attribute this rise to environmental factors. However, experts debate whether there’s an actual increase in cases or just more frequent diagnoses. Compare autism rates in different U.S. states.
ASD symptoms are most noticeable in childhood between 12 and 24 month olds. However, symptoms can appear sooner or later.
Early symptoms include a delayed or severe delay in social development and language.
The DSM-5 categorizes ASD symptoms into two categories:
- Communication and social interaction problems
- Restricted or repetitive patterns in behavior or activities
A person must have symptoms in both these categories to be diagnosed as autistic.
Communication and social interaction problems
ASD can lead to communication issues that range from mild to severe. Many of these issues are present before age 5.
Here’s a general timeline of what this might look like:
- From birth: trouble maintaining eye contact
- Within 9 months: Not responding to their name
- Within 9 months: Not to display facial expressions that are indicative of their emotions (like anger or surprise),
- Within 12 months: Do not engage in basic interactive games such as peek-a-boo and pat-a–cake
- In 12 months Hand gestures such as hand-waving and hand-waving should be avoided.
- Within 15 months: Not sharing their interests with others (e.g., showing someone a favorite item)
- After 18 months Do not point or look at what others are doing
- In 24 months Not being aware of others’ sadness or hurt feelings
- Within 30 months: not engaging in “pretend play,” like caring for a baby doll or playing with figurines
- Aged 60 months: Not playing turn-taking games like duck-duck goose
A 36-month-old autistic child might have difficulty understanding others’ feelings and may not be able to express their own feelings.
As they get older, autistic children might have difficulty speaking or very limited speech skills. Language skills may develop at a slower pace in autistic children. If there’s a particular topic that’s very interesting to them, for example, they might develop a very strong vocabulary for talking about that one topic. However, they might have difficulty communicating about others.
As autistic children begin talking, they might also talk in an unusual tone that can range from high-pitched and “sing-songy” to robotic or flat.
They might also show signs of hyperlexia, which involves reading beyond what’s expected of their age. Children on the autism spectrum may learn to read sooner than their neurotypical peers. In some cases, as young as 2 years old. But they tend to not comprehend what they’re reading.
Research suggests that hyperlexia can be a sign of autism.
Autistic children may have trouble sharing their emotions with others or finding it difficult to maintain a back-and-forth conversation. It might be more difficult to communicate nonverbally, such as by maintaining eye contact or using body language.
These communication problems can last into adulthood.
Repetitive patterns of behavior and activities that are restricted or repetitive
Autism can also include symptoms that are related to body movements and behavior, in addition the communication and social issues previously mentioned.
These could include:
- Repeated movements like rocking, flapping arms, spinning or running back-and-forth
- Line objects, such as toys, up in a strict order, and get upset when that order is disrupted
- Attachment to rigid routines like bedtime or getting to school
- Repeating the same words or phrases that they hear repeatedly
- getting upset over minor changes
- Focusing on specific parts of objects like the wheel of the toy truck or the hair in a doll’s head, is a good way to focus.
- Some people have unusual reactions to sensory inputs such as sounds, smells, tastes, and smells.
- Obsessive interests
- Talented abilities such as musical talent or memory are exceptional.
Some autistic people might experience additional symptoms, including:
- Language delays, cognitive skills, or delayed movement
- Constipation and diarrhea are common gastrointestinal symptoms
- Stress and excessive worry
- Unusual levels of fear (either higher than expected or lower than expected).
- Hyperactive, inattentive or impulsive behavior
- Unexpected emotional reactions
- Behaviours or preferences that are unusual
- Strange sleeping patterns
What is stimming?
“Stimming” is a term used to describe self-stimulating behaviors, often involving repetitive motions or speech.
One example is to clap, rub an object or repeat a phrase. It’s typically associated with autistic people, but nearly everyone does some form of stimming, whether that’s rubbing their hands together or biting their nails.
Stimming can cause physical harm and interfere with daily life for autistic individuals. However, it can also be a helpful coping strategy for dealing with sensory overload or navigating incontinentious situations.
Learn more about stimming.
American Psychiatric Association (APA) publishes the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5). It is used by clinicians to diagnose a variety mental disorders.
In 2013, the fifth edition of DSM-5 was published. Five different ASD subtypes or specifiers are currently recognized by the DSM-5. They are:
- With or without accompanying intellectual impairment
- With or without an accompanying language impairment
- Associated with a medical condition, genetic condition, or environmental factor
- Associated with another neurodevelopmental, psychological, or behavioral disorder
One or more specifiers can be diagnosed.
Autistic people might have been diagnosed before the DSM-5.
It’s important to note that a person who received one of these earlier diagnoses has not lost their diagnosis and will not need to be reevaluated.
According to the DSM-5, the broader diagnosis of ASD encompasses conditions such as Asperger’s syndrome. Learn more about Asperger’s syndrome and the other older classifications for autism.
A diagnosis of ASD includes:
- Multiple screenings
- Genetic tests
The American Academy of Pediatrics (AAP), recommends that all children be screened for ASD at 18 and 24 months of age.
Screening can help to identify ASD in children sooner than later. They may benefit from early diagnosis as well as support.
The Modified Checklist of Autism in Toddlers is a common screening tool that many pediatric offices use. The survey asks parents to complete 23 questions. The survey results can then be used by pediatricians for the identification of children at higher risk of developing ASD.
It’s important to note that screening is not a diagnosis. ASD is not a condition that children who are positive for ASD have to have. Additionally, screenings do not always identify every child who’s autistic.
Other screenings or tests
Your child’s physician may recommend a combination of tests for autism, including:
- DNA testing for genetic diseases
- Evaluation of behavioral characteristics
- visual and audio tests to rule out any issues with vision and hearing that aren’t related to ASD
- Screening for occupational therapy
- Developmental questionnaires such as the Autism Diagnostic and Observation Schedule Second Edition (ADOS-2),
How to determine the diagnosis
A team of specialists usually performs the diagnosis. This team may include:
- Child psychologists
- Occupational therapists
- Speech and language pathologists
Learn more about the diagnostic tests these specialists use to diagnose ASD.
There’s no specific diet designed for autistic people. Some autism advocates are exploring diet changes to help reduce behavioral issues and improve overall quality of living.
Avoidance of artificial ingredients is a key component of the autism diet. These include:
An autism diet might instead be based on whole foods like:
A gluten-free diet is also recommended by some autism advocates. The protein gluten can be found in:
These advocates believe gluten causes inflammation and adverse bodily effects in autistic individuals. However, scientific research on the relationship between autism and gluten, as well as another protein known casein, is not conclusive.
Anecdotal evidence and some studies have shown that diet may help to improve attention deficit hyperactivity disorder (ADHD) symptoms. This condition is similar to autism. Learn more about the ADHD diet.
Autistic children might not reach the same developmental milestones and/or show the loss of previously acquired social or language skills.
For example, a 2-year old without autism may be interested in games of make-believe. Activities with other children can be enjoyed by a 4-year-old who is not autistic. An autistic child might have difficulty interacting with others, or may dislike it altogether.
Autistic children may also exhibit repetitive behaviors, have trouble sleeping, or eat compulsively non-food items. It may be difficult for them to thrive in a structured environment and a consistent routine.
Your child may be autistic and you will need to work closely together with their teachers in order to ensure that they succeed in school.
There are many resources available to assist autistic children and their families. The Autism Society of America is a national nonprofit that provides support groups in local areas.
Exercise and autism
Some exercises may be helpful for autistic children.
Any type or activity that your child enjoys can be a benefit. Walking and playing in the playground are great options.
Swimming and other water-based activities can be used as both an exercise and sensory play activity. Sensory play activities are a great way to help autistic persons who have difficulty processing signals from their senses.
Sometimes, contact sports can prove difficult for autistic children. Instead, encourage challenging and strengthening exercises. These tips will help you get started with arm circles, star jumps and other autism exercises.
Because of its greater rate in boys, ASD is often stereotyped as a “boys’ disease.”
A 2020 study that looked at 11 states in the United States found that ASD was 4.3 times more common among 8-year old boys than it is in 8 year-old girls. This research was based upon data from 2016.
A 2017 literature review found that the male-to female ratio for autistic youths was closer to 3 to 1.
Either way, this does not mean that ASD doesn’t occur in girls. ASD may present differently in girls than in women.
ASD is being tested earlier than in recent decades. This has led to higher reported rates of ASD in both boys, and girls.
Families with autistic loved one may be worried about how life with ASD will look for them as adults.
Some autistic adults live or work alone. Others may need support or assistance throughout their lives. Each autistic person is unique.
Sometimes autistic people don’t receive a diagnosis until much later in life. This is partly due to a lack of awareness by medical professionals.
It’s never too late to receive a diagnosis, though. If you suspect you might have adult autism, you can read this article.
April 2nd is World Autism Awareness Day. In the United States, April is also known as Autism Awareness Month. Many community advocates rightly call for awareness to be raised about ASD throughout the year, not just on 30 specific days.
The Autism Society for America and other advocates suggested that April be designated Autism Acceptance month instead.
Acceptance of autism requires empathy, understanding, and acceptance that ASD is unique for everyone.
While some therapies and approaches work for some people, others may not. Parents and caregivers might have different opinions on how to advocate for an autistic kid.
Understanding autism and autistic people starts with awareness, but it doesn’t end there. Check out one father’s story on his “frustrations” with autism awareness.
Autism and ADHD can sometimes be confused.
ADHD children have trouble concentrating, fidgeting, and keeping eye contact with others. These symptoms are also common in autistic people.
ADHD is not a spectrum disorder despite sharing some similarities. One difference is that ADHD sufferers don’t have a tendency to lack socio-communicative skills.
Talk to your doctor if you suspect that your child might be hyperactive. It is important to get a clear diagnosis in order to ensure your child receives the best support.
It’s also possible for a person to have both autism and ADHD. Learn more about the relationship between ADHD and autism.
Intensive behavioral support is key to the most effective therapies. These programs will improve a child’s outlook if they are started early.
ASD is complex. It takes time for an autistic person — whether a child or adult — to find the support program best suited for them.