Autism Spectrum Disorder is a neurodevelopmental condition characterized by impairments in social communication (e.g., they may not respond to their name, initiate interaction with others, or demonstrate age-appropriate language development), as well as atypical repetitive and stereotypical behavior (e.g., hand-flapping, tapping, spinning, rocking their body, or looking at things out of the corner of their eye). The term “spectrum” is used to denote that there is significant heterogeneity across cases. Although there are common signs and symptoms, every individual on the spectrum is unique and manifests a different set of behaviors.
According to the Center for Disease Control and Prevention, one in 59 children are diagnosed with Autism Spectrum Disorder, affecting approximately 1% of the global population. Prevalence studies have consistently indicated more boys are diagnosed with Autism Spectrum Disorder than girls. More specifically, four males to every one female are diagnosed.
Diagnosis of autism involves observation of the child by the doctor. Seeking the counsel of pediatricians or developmental pediatricians is typically the first step in the autism diagnosis process. If routine checkups indicate signs of autism, the pediatrician will recommend further tests. These tests may be with a neurologist, child psychologist, speech-language pathologist, and occupational therapist.
Early detection and the sensitivity of diagnostic tools have enabled individuals to be diagnosed as early at 18 months. Since the hallmark signs of autism usually appear by age 2 to 3, early detection of autism enables individuals to receive autism treatment sooner, which can have a tremendous impact at minimizing or even preventing some of the symptoms of autism.
Early intervention is key with respect to the prognosis of autism; typically, the earlier a child is treated, the better the prognosis will be. Autism Spectrum Disorder impairments have cascading effects over time, as critical skills (i.e., prerequisite skills) that do not develop cause underdevelopment in other skills. Over time, these deficits create large gaps in skills that significantly prohibit the individual from functioning adaptively in his/her environment. For example, joint attention (i.e., when two people share interest in an object or event) is one such critical skill that affects myriad other skills. A deficit in joint attention can compromise opportunities for social learning and subsequent social and communication development. That is, it can affect a person’s ability to communicate and interact with others.
Only a qualified licensed professionals can diagnose a child with autism, though they are most often diagnosed by a psychologist, neurologist or a developmental pediatrician. Early signs of autism may be detected by 6-18 months. There are specific developmental milestones that are common in all children that can help parents detect early signs of autism. These can include:
- Fixating on objects
- Not responding to name
- Avoiding eye contact
- Lack joint attention
- Engage in repetitive movements, such as rocking or arm flapping
- Unusual play with toys, such as lining them up or focusing on parts of toys rather than the whole
Although there has been a substantial amount of progress in understanding the conditions under which autism is likely to occur, there is still much to learn. Research has identified genetic and environmental factors that increase the risk for autism. It is important to emphasize, however, that risk factors simply make Autism Spectrum Disorder more likely; it does not absolutely determine whether the child will be diagnosed with autism.
The clearest evidence indicating that there is a genetic underpinning for autism is the tendency for it to run in families. Parents who have one child with autism are 5% more likely to have another child with autism. Other evidence pointing to a genetic influence stems from twin studies. Research has found that when one identical twin has autism, there is about an 80% chance that the other twin will be diagnosed. The percent chance decreases with fraternal twins (i.e., 40%). However, this also points to the genetic influence of autism.
Environmental factors also play a role in autism. Research has identified some of these factors, which include advanced parental age at time of conception, extreme prematurity and very low birth weight, to name a few. According to the National Institute for Environmental Health Sciences, there are other possible environmental factors that may place a child at risk. However, more research is needed to determine the level of influence.
Since the original definition of autism in 1943 by Kanner, our understanding of autism has grown tremendously. There have been advances in the way of evidence-based treatment, such as Early Intensive Behavioral Intervention, that provides effective autism treatment to mitigate the symptoms of autism. Some other treatments include, but are not limited to, speech therapy, applied behavior analysis, occupational therapy.
It can feel very overwhelming when a child has received a diagnosis of autism. The best course of action parents can take is to gather information.The best course of action parents can take is to take in information.Pediatricians and neurologist can be a source of information for parents. Parents can also obtain valuable information by joining support groups and speaking to parents or professionals that have extensive knowledge on autism and the best treatments to pursue. Above all, the most important step for parents to take is to seek autism treatment early. Early intervention can have a substantial impact on the trajectory of the child’s development, and evidence-based treatments, such as Early Intensive Behavioral Intervention, can be helpful.