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Understanding Autism

Autism is a disorder that can affect the way a child behaves, thinks, communicates, and interacts with others. Kids with autism are affected in different ways. Some have only mild symptoms and grow up to live independently, while others have more severe symptoms and need supported living and working environments throughout their lives.

Autism affects up to one in every 150 school-age children, which translates to about 560,000 kids, according to the U.S. Centers for Disease Control and Prevention (CDC). It's more common in boys than girls, and is usually diagnosed when a child is between 15 and 36 months old, although signs of the disorder can show up earlier.

While there is no cure for autism, and researchers are unsure of its cause, a variety of therapies and resources are available to help kids with autism and their families.

What Is Autism?

Autism is a spectrum disorder, meaning it affects kids in different ways, at different levels of severity, regarding their ability to communicate, process thoughts, and interact socially. Because there's nothing abnormal about the physical appearance of a child with autism, and because kids develop at different rates, the disorder can be difficult to recognize.

Autism is characterized by:

  • communication problems, which may include delays in developing speech, repeating words, and speaking in a monotone that lacks pitch, inflection, or rhythm
  • poor social interaction
  • repetitive behavior and interests
  • unusual behaviors, such as spinning or flapping hands

About one-third of children who are diagnosed with autism develop fairly typically in the first year or two of life, and then begin to regress in the way that they speak and socialize. They may:

  • prefer to play by themselves
  • not acknowledge other kids who play alongside them
  • like to line up objects and sort them into colors
  • have difficulty making eye contact with other people

If a child shows any one of these behaviors on an isolated basis, it's probably not autism. Usually, it's the collection of these behavior patterns that leads to a diagnosis of autism.

Though kids with autism are affected in different ways, in all cases their capacity to communicate and interact with others is impaired. Other behaviors of kids with autism may include:

  • speech that's often limited to a few repeated or "echoed" words or phrases
  • stopping speaking altogether
  • problems with communicating needs
  • withdrawing from physical contact with other people
  • want to be alone
  • seldom playing fantasy or imagination games
  • engaging in repetitive movements like rocking, hand flapping, or spinning objects
  • throwing tantrums that are prolonged and begin with little warning
  • laughing or crying out of nowhere
  • difficulty showing or receiving affection
  • resistance to change in daily routines
  • no fear of danger
  • very physically active or very underactive
  • lack of response to verbal cues (i.e., calling the child's name, questions, etc.)
  • unusual responses to many sensory experiences, especially to sudden, loud noises or high-pitched sounds
  • obsession with predictable rituals and sometimes playing with only one part of a toy

Not every child with autism will have all of these behaviors. Because some children with autism have just a few of these symptoms, they may appear to be developing within typical expectations, although somewhat slowly.

What Causes Autism?

There isn't one specific cause of autism. Research has focused on whether chemical imbalances, differences in the brain, genetics, or problems with the immune system play a role in causing the disorder.

Food allergies, excessive amounts of yeast in the digestive tract, and exposure to environmental toxins have all been mentioned as causes of autism. But there is no scientific evidence to support this.

Some people believe that thimerisol (a vaccine ingredient) and vaccines — particularly the shot for measles-mumps-rubella (MMR) — may be linked to autism because the same age range in which kids are vaccinated with MMR is the same age range in which autism is diagnosed. But there isn't any scientific evidence to support that link and, in fact, the main 1998 study that reported it was widely discredited in 2004.

How Is Autism Diagnosed?

Autism can't be detected at birth or through any prenatal screening. But researchers do know that if you have one child with autism, you have about a 10% chance of having another child with autism or a similar disorder.

Because autism is difficult to recognize and diagnose, it's important that families seek an evaluation by a medical professional who is experienced in diagnosing and treating the disorder as soon as possible. If, for example, you're concerned because your child is nearing 12-15 months old and isn't gesturing, it's important not to wait to express concerns until the 18-month well-child visit. If there is something wrong, early intervention can help you find ways to manage your child's symptoms.

If you have concerns throughout infancy and the early toddler months — particularly about the way your child is learning to communicate — be sure to closely document your observations and talk with your child's doctor promptly.

There is no single diagnostic test for autism, so the doctor will probably order different tests to rule out other medical problems before making a diagnosis, and also may refer you to a developmental pediatrician, a pediatric psychiatrist, or a pediatric neurologist.

What Is an Early Intervention Program?

If your child has been diagnosed with autism, the health team assessing your child's development and providing treatment might include:

  • a developmental pediatrician (a doctor who specializes in child development)
  • a pediatric psychologist
  • a speech/language pathologist (who specializes in human communication, its development, and its disorders)
  • an occupational therapist (who addresses psychological, social, and environmental factors that may hinder an individual's functioning)
  • special education teacher or early childhood educator

Finding a good early intervention program is very important. These programs provide educational and therapeutic services for young children who have been diagnosed with a physical or cognitive disability. Often, these programs are geared toward "breaking through" whatever barriers a child has to social interaction and can help the child learn to communicate with others through speech and other tools, like pointing, pictures, and sign language. These programs also try to pull a child through the repetitive behaviors and guide them toward other activities.

Some kids with autism are given medications to help control their symptoms — such as antidepressants for minimizing repetitive behaviors, stimulants for controlling hyperactivity, and anticonvulsants for treating aggression. Some kids are also given antipsychotic medications to control repetitive and aggressive behavior.

Finding an Early Intervention Program

Your child's doctor or local Association for Retarded Citizens (ARC) can refer you to an early intervention program in your area. Private agencies such as Easter Seals and United Cerebral Palsy Association also provide programs. And check with your school district, which may offer intermediate units or have "child study teams."

Transitioning Your Child Into a School Setting

Staff members at the early intervention program will help you choose the most appropriate setting for your child's education from among:

  • a "regular" classroom in your local neighborhood school
  • an approved private school offering more intense educational and therapeutic services in classes with low student-to-teacher ratios
  • a support classroom in another school for children with autism

Regardless of the setting, educational programs for children with autism should be highly structured, emphasize communication and social skills, and include positive behavior management techniques. The staff will work with you to implement their classroom strategies at home so that your child has predictable physical and social environments.

Educational support services such as speech, occupational, and physical therapy will be part of your child's school day. Life skills, such as cooking, shopping, or crossing the street, will likely be incorporated into your child's individualized education plan (IEP) to help encourage independence.

The physical organization and layout of the classroom can help reduce your child's frustration. Your child's individual needs should be taken into consideration when determining where he or she will be seated in the classroom. There should also be:

  • few doorways
  • a bathroom in the classroom or nearby
  • specific learning stations to provide order
  • organized supply bins to help the students gather their own materials
  • quiet areas designated for individual learning, with group activities taking place on the other side of the room

Some parents of kids with severe autism may find that a child's needs overwhelm the family's ability to live peacefully. That child may also not be able to function in a classroom setting. In those cases, parents may consider a residential placement for the well-being of the child who's disabled and for the well-being of other family members. If this is the case in your family, it's important to remember that there are nationally known and respected programs that can help your child achieve greater independence in a safe environment.

Alternative Treatments

Parents of a child with autism are often desperate to get help. Although the most widely accepted treatment is an early intervention program and ongoing therapy, there are also other alternative treatments that are considered controversial.

In facilitated communication (FC), a "facilitator" supports the hand, arm, or shoulder of the person with a communication disorder and assists him or her in extending a finger to either point to or press the keys of a computer keyboard or a communication picture board. Supporters say that FC communicates the thoughts of a person otherwise unable to "speak." However, critics say that it's the facilitator communicating, not the person with the disability.

The hormone secretin has gotten recent attention as a breakthrough treatment for autism. Its only current FDA-approved use is in the diagnosis of gastrointestinal problems, but researchers and physicians are studying the possible link to improved communication and social interactions in children who have received injections of secretin. The Autism Society of America urges families to conduct thorough research before asking a doctor to prescribe secretin for their child. Large-scale studies have yet to endorse the initial findings, so caution is urged.

Some parents who have been frustrated by conventional therapies have turned to other controversial treatments, such as swimming with dolphins, neurofeedback, music therapy, social-skills therapy, gluten-free and dairy-free diets, vitamins, anti-anxiety pills, steroids, and eliminating toxins from the home. However, there's no scientific evidence that these treatments work. It is important to talk to your child's doctor before trying any treatment.

Helping Your Child

Learning that a child is has autism can be wrenching for parents. Feeling like they've lost the child they once knew, parents often move through the emotional stages of grief: denial, anger, bargaining, depression, and acceptance. Ongoing professional counseling can help your family accept the diagnosis, move forward, and learn how to best help your child develop to his or her greatest potential.

And you play an extremely important role in helping your child develop. Like other children, kids with autism learn primarily through play. So, it's important to join your child in play that you both enjoy.

Here are some of the positive ways that you can interact with your child at home:

  • Be consistent, have routines in home and when out.
  • Have a place where your child feels child comfortable and secure.
  • In addition to verbal praise, find other ways to reinforce good behaviors and promote self-esteem. After your child has successfully completed a task, for example, give him or her extra time to play with a favorite toy.
  • Present information visually as well as verbally. Combine the spoken word with the presentation of photographs and pictures, sign language, symbols, or gestures to help your child make his or her needs, feelings, or ideas known.
  • Try to show your child affection in as many ways as possible. Though some kids with autism have trouble receiving and expressing affection, they can still benefit from nurturing from a parent.

Talk with your child's doctor or members of your child's educational team about support groups and other resources in your area.

Regardless of the degree of the autism, your child needs the nurturing guidance of parents, teachers, doctors, and caregivers to live the most fulfilling life possible.

Date reviewed: October 2005