Patient and family education is important to us. Here you can learn more about autism spectrum disorders in children, and view trusted insights from KidsHealth.org, the No. 1 most viewed health site for children, created by the experts at Nemours. We've also provided information from the most respected nonprofit organizations.
About Autism in Children
Autism — whether mild or severe — is a lifelong condition and your child may need medication, therapy or support throughout his or her life. Thankfully today, unlike only a few decades ago, autism specialists can offer many interventions and therapies that can remarkably increase your child’s skills and abilities. The next few decades (and even the next few years) show great promise of more to come.
Autism is a neurodevelopmental disorder, which means it’s a condition related to the improper development of the neurons in the brain.
Children with an autism spectrum disorder develop “unevenly” and have difficulties in communication and social interactions and exhibit repetitive or restrictive behaviors. Very often, these children have exceptional strengths in other areas, such as math, visual processing and musical and artistic abilities (to name a few). Autism spectrum disorder is an active area of research — every day we’re uncovering important information about the disorder.
Traditional Types of Autism
Autism has had many names, including:
- autistic disorder (or autism) — refers to the more severe cases in which children have difficulty communicating and interacting with others (or they may be unable to communicate), and also exhibit unique repetitive/restrictive behaviors such as hand flapping, spinning or rocking.
- Asperger syndrome (AS, also called Asperger’s) — a milder form of autism in which children have average or above-average intelligence, impaired language skills only in some areas (like language pragmatics, or understanding the meaning of words in certain situations), impaired social skills (problems with reciprocity, or the natural “give and take” that occurs in a conversation) and repetitive/restrictive behaviors, sometimes related to a special interest.
- pervasive developmental disorder-not otherwise specified (PDD-NOS) — Because there are many variations within the autism spectrum — with no two children experiencing the same symptoms or patterns of behavior — today we refer to all types of autism as “autism spectrum disorder” regardless of how mild or severe symptoms may be.
The Centers for Disease Control (CDC) estimates that 1 in 88 children has an autism spectrum disorder. And while there are many theories about the causes of autism spectrum disorder in children, large research studies show vaccinations do not increase the risk for the disorder. Other studies show that genes may play a role, and possibly prenatal illness or infections, but it is not caused by anything a mother did, or did not do, during pregnancy. What’s more, autism is not a result of a child’s upbringing, amount of nurturing or environment at home. The cause of autism development disorder continues to be a very active area of study.
Children with an autism spectrum disorder exhibit behavioral symptoms in specific areas, with different degrees of severity, and at different ages or life stages. Some symptoms include:
- delayed babbling or speaking
- does not speak, or is “nonverbal” (but may be able to communicate using pictures or assistive technologies)
- problems understanding the meaning of words
- difficulty starting and sustaining (continuing) conversation
- can only talk about a special interest (no “small talk”)
- does not understand tone, body language or facial expressions
- interprets words literally (may not understand statements like “it’s raining cats and dogs”)
- may speak in a different tone (monotone or high-pitched)
Impaired Social Interaction
- does not engage in interactions or imitation (smiling back or responding to name)
- reduced interest in people
- lack of eye contact
- difficulty making and keeping friends
- difficulty playing games or working in groups (has own rules or way of playing)
- responds to things differently (laughs when it’s serious or cries when it’s not)
- hard time understanding how people think or feel (difficulty with or lack of empathy)
- difficulty seeing other people’s perspective
- difficulty regulating emotions (tantrums when overloaded)
- repeats words over and over
- upset when a routine is disrupted or changed
- hand-flapping, rocking or spinning
- uses toys differently (repeatedly lines items up, spins wheels on vehicles, opens and shuts/turns things on and off)
- intense fixation with details, particularly related to a special interest
Sensory Processing Difficulties
Some children may be easily overloaded by too much — or too little — sensory input. For example, children with an autism spectrum disorder may:
- react adversely to itchy clothing (tags or seams)
- dislike loud noises (vacuum cleaner, school bell, etc.)
- avoid bright lights (particularly flickering of fluorescent lighting)
- avoid being touched or hugged (or conversely, need more touch)
From Nemours' KidsHealth
Trusted External Resources
- The Power of Positive Parenting: A Wonderful Way to Raise Children, by Dr. Glenn I. Latham
- Educate Toward Recovery: Turning the Tables on Autism, by MA BCBA Robert Schramm
- Autism’s False Prophets: Bad Science, Risky Medicine, and the Search For A Cure, by Paul A. Offit, MD
An Autism Spectrum Disorder
Asperger syndrome (AS) is a neurobiological disorder that is part of a group of conditions called autism spectrum disorders. The term "autism spectrum" refers to a range of developmental disabilities that includes autism as well as other disorders with similar characteristics.
They are known as spectrum disorders because the symptoms of each can appear in different combinations and in varying degrees of severity: two children with the same diagnosis, though they may share certain patterns of behavior, can exhibit a wide range of skills and abilities.
As a result, general terms such as "low-functioning," "high-functioning," "autistic tendencies," "pervasive developmental disorder," and others are often used to describe children whose behaviors fall within the spectrum. Kids with AS share many of the same symptoms as those with "high-functioning autism."
Boys are more than three to four times more likely than girls to be affected by AS. Because milder cases are being identified more frequently, the incidence appears to be increasing. However, like other autism spectrum disorders, AS is often difficult to diagnose and treat.
About Asperger Syndrome
The disorder is named after Hans Asperger, a Viennese pediatrician who, in 1944, first described a set of behavior patterns apparent in some of his patients, mostly males. Asperger noticed that although these boys had normal intelligence and language development, they had severely impaired social skills, were unable to communicate effectively with others, and had poor coordination.
According to the Asperger Syndrome Coalition of the United States, the onset of AS may be later than what is typical in autism — or at least it is recognized later. Many kids are diagnosed after age 3, with most diagnosed between the ages of 5 and 9.
AS is characterized by poor social interactions, obsessions, odd speech patterns, and other peculiar mannerisms. Kids with AS often have few facial expressions and have difficulty reading the body language of others; they might engage in obsessive routines and display an unusual sensitivity to sensory stimuli (for example, they may be bothered by a light that no one else notices; they may cover their ears to block out sounds in the environment; or they might prefer to wear clothing made only of a certain material).
Overall, people with AS are capable of functioning in everyday life, but tend to be somewhat socially immature, relate better to adults than peers, and may be seen by others as odd or eccentric.
Other characteristics of AS may include motor delays, clumsiness, limited interests, and peculiar preoccupations. Adults with AS have trouble demonstrating empathy for others, and social interactions continue to be difficult.
Experts say that AS follows a continuous course and usually lasts a lifetime. However, symptoms can wax and wane over time, and early intervention services can be helpful.
Signs and Symptoms
Because the symptoms of AS are often hard to differentiate from other behavioral problems, it's best to let a doctor or other health professional evaluate your child's symptoms. It's not uncommon for a child to be diagnosed with attention deficit hyperactivity disorder (ADHD) before a diagnosis of AS is made later.
A child with AS might have these signs and symptoms:
- inappropriate or minimal social interactions
- conversations almost always revolving around self rather than others
- "scripted," "robotic," or repetitive speech
- lack of "common sense"
- problems with reading, math, or writing skills
- obsession with complex topics such as patterns or music
- average to below-average nonverbal cognitive abilities, though verbal cognitive abilities are usually average to above-average
- awkward movements
- odd behaviors or mannerisms
It's important to note that, unlike kids with autism, those with AS might show no delays in language development; they usually have good grammatical skills and an advanced vocabulary at an early age. However, they typically do exhibit a language disorder — they might be very literal and have trouble using language in a social context.
Often there are no obvious delays in cognitive development. Although kids with AS can have problems with attention span and organization, and have skills that seem well developed in some areas and lacking in others, they usually have average and sometimes above-average intelligence.
What Causes Asperger Syndrome?
Researchers and mental health experts are still investigating the causes of autism and AS. Many believe that the pattern of behavior that characterizes AS may have many causes. Research points to the possibility of brain abnormalities as a cause of AS, given that there have been structural and functional differences in specific regions of the brain recognized by using advanced brain imaging.
There seems to be a hereditary component to AS, and research indicates that in some cases AS may be associated with other mental health disorders such as depression and bipolar disorder.
Contrary to the incorrect assumptions some may make about people with the disorder, AS is not caused by emotional deprivation or the way a person has been brought up. Because some of the behaviors exhibited by someone with AS may be seen by others as intentionally rude, many people wrongly assume that AS is the result of bad parenting — it isn't. It's a neurobiological disorder whose causes are not yet fully understood.
Currently, there is no cure for the disorder — kids with AS become adults with AS. But many lead full and happy lives, and the likelihood of achieving this is enhanced with appropriate education, support, and resources.
Diagnosing Asperger Syndrome
Asperger syndrome can be very difficult to diagnose. Children with AS function well in most aspects of life, so it can be easy to attribute their strange behaviors to just being "different."
Experts say that early intervention involving educational and social training, performed while a child's brain is still developing, is very important for kids with AS.
If your child exhibits some of the symptoms and behaviors that are typical of AS, it's critical to seek help from your doctor. He or she can refer you to a mental health professional or other specialist for further evaluation.
When a specialist assesses your child, a thorough "psychosocial" evaluation will be performed. This includes a careful history of when symptoms were first recognized, the development of motor skills and language patterns, and other aspects of personality and behavior (including favorite activities, unusual habits, preoccupations, etc.).
Particular emphasis is placed on social development, including past and present problems in social interaction and development of friendships. A psychological evaluation and assessment of communication skills are usually conducted to determine which strengths and skills might be deficient.
Treating Asperger Syndrome
Because AS can present patterns of behaviors and problems that differ widely from child to child, there isn't a "typical" or prescribed treatment regimen. However, depending on what their strengths and weaknesses are (or depending on what their development history is), kids may benefit from these treatments:
- parent education and training
- specialized educational interventions
- social skills training
- language therapy
- sensory integration training for younger kids, usually performed by an occupational therapist, in which they are desensitized to stimuli to which they're overly sensitive
- psychotherapy or behavioral/cognitive therapy for older kids
It will help if you involve all of your child's caregivers in the treatment. The health professionals who are caring for your child should know what the others are doing, and you will often find yourself acting as the "case manager" in this scenario. Teachers, babysitters, other family members, close friends, and anyone else who cares for your child also should be involved.
It's important to know that many people can provide assistance. Finding the right program for your child is key and getting help early is important. Kids with AS can and do experience great gains with the appropriate treatment and education.
Helping Your Child
Although AS presents challenges for kids and their parents, you can help your child adjust and offer support in many ways:
- Look into educational or training programs for parents. You're your child's first teacher and you'll continue to be the cornerstone in supporting his or her development.
- Teach your child self-help skills. Learning these skills helps kids achieve maximum independence.
- Because it's not always obvious that a child has AS, alert others to the fact that your child has special needs. As a parent, you may have to take on the role of educator when dealing with teachers, medical personnel, and other caregivers.
- Find a program that addresses your child's specific needs or areas of "deficiency." The Autism Society of America (ASA) encourages family members to talk to the program director to determine if the curriculum or program addresses their child's particular issues.
- Choose special programs or treatments that focus on long-term outcomes and that take the developmental level of your child into consideration.
- Remember that your child is part of a family unit and that his or her needs should be balanced with the those of other family members.
- Get support for yourself and other family members. You can't help your child if you are not meeting your own emotional and physical needs. Your community may offer support groups at a local hospital or mental health center. There is considerable state-to-state variation in the types of government-sponsored services and other programs available to children with autism spectrum disorders and their families.
Your Child's Future
Currently, few facilities are specifically dedicated to providing for the needs of kids with AS. Some children are in mainstream schools where their progress depends on the support and encouragement of parents, caregivers, teachers, and classmates. However, some go to special schools for kids with autism or learning disabilities.
Many people with AS can function well in most aspects of life, so the condition does not have to prevent your child from succeeding academically and socially.
You may feel overwhelmed and discouraged if your child is diagnosed with AS. Remember that your child's treatment team can provide enormous support and encouragement for your child — and your family.
Reviewed by: Rhonda Walter, MD
Date reviewed: January 2012