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
Kids with autism (also called autism spectrum disorder) have differences in the way their brains develop and process information. They might have language delays or trouble communicating with others, perform certain unusual or repetitive behaviors, or have difficulties learning in school.
No two cases of autism are exactly alike — depending on a child's condition, symptoms can be severe and interfere with everyday tasks or they can be mild and cause few problems. Doctors and scientists call this range of symptoms a "spectrum." Asperger syndrome and pervasive developmental disorders (PDD) are conditions that fall within the autism spectrum.
In the past, doctors didn't know a lot about autism. But that's changing. New research has made it easier for doctors to diagnose and begin treating kids earlier than ever before. With early and appropriate treatment that usually includes speech and behavioral therapy, kids with autism can have the opportunity to reach their best potential.
Signs and Symptoms
Signs of autism are usually recognizable by 2 or 3 years of age. But because symptoms are sometimes hard to notice, it can take longer to fully identify autism. The American Academy of Pediatrics (AAP) recommends that pediatricians look for signs that suggest the possibility of autism at every visit. Formal autism screening can begin as early as 16 months of age.
Signs of autism can include:
- trouble interacting, playing with, or relating to others
- having little or brief eye contact with others
- not pointing to objects to call attention to them
- unusual or repetitive movements, such as hand flapping, spinning, or tapping
- delays in developmental milestones or loss of milestones already achieved
- playing with a toy in a way that seems odd or repetitive
- not using or understanding language as a child that age typically would
- not exploring surroundings with curiosity or interest (a child seeming to be in his or her "own world")
Kids who show a pattern of these behaviors should be evaluated by a doctor with expertise in developmental disorders, such as a developmental pediatrician, pediatric neurologist, pediatric psychologist, or psychiatrist.
To diagnose autism, doctors might use parent questionnaires or have a child evaluated by a psychologist to test abilities and behaviors when it comes to things like learning, communication, and play. While brain scans are rarely needed, they can be used to help rule out other conditions.
Causes of autism are not yet fully understood, but scientists believe that genes and environmental factors are involved. In fact, new research has found that genes play a major role; there's a 30% chance of a child developing autism if a sibling has it.
But this doesn't necessarily mean that autism is passed down from parent to child. Some studies suggest that kids with a genetic risk or predisposition to autism might develop it when they are exposed to something (yet unknown) in the environment.
Other studies have suggested that autism could be caused by viruses, allergies, or vaccines. But none of these theories have been scientifically proven. In fact, the vast majority of scientific studies on vaccines have found no link between vaccines — or any of their ingredients — and autism. The 1998 study that suggested such a link has since been retracted by the medical journal that originally published the flawed research.
It's also important to remember that autism is not caused by parenting or bad experiences. Earlier theories that suggested this have been disproved.
Although there's no cure for autism, early intervention and therapy can help kids develop skills and achieve their best potential. Therapy is tailored to each child's individual needs and may include behavioral, educational, speech, and occupational therapies.
The goal of therapy is to help kids learn how to:
- be safe and take care of their bodies
- communicate with peers and caregivers
- play with others and cooperate with social rules
- minimize unwanted behaviors, like repetitive or aggressive behaviors
Research suggests that a minimum of 25 hours a week of social, behavioral, play, speech, and other developmental therapies can help maximize a child's potential. Sometimes medications are also used to treat certain symptoms, like aggression toward oneself or others, problems of inattention, obsessive-compulsive behaviors, and mood swings.
While there's little research to support the use of non-traditional or alternative therapies — such as diet modification, supplements, music, art, and animal therapies — some families have reported significant benefits from them.
Before Age 3
Before age 3, children receive therapy through their home state's early intervention program. Families work together with therapists to develop an Individualized Family Service Plan (IFSP), which outlines the types of therapy to be given and their goals. A team of therapists (which may include behavioral and speech therapists and special education teachers) provides in-home therapy.
The goal of treatment is to help kids get to the point where they can learn in a regular classroom and become as independent as possible in daily life.
After Age 3
Kids ages 3-5 are entitled to free preschool services under the Individuals with Disabilities Education Act (IDEA). Educational and therapeutic programs are offered through local school districts or other educational facilities — either at home or in a classroom. Some areas also offer parent education to help parents with the challenges of raising a child with developmental disabilities.
Once kids reach kindergarten, parents can ask to set up an individualized education plan (IEP) through the local school district. An IEP can include educational as well as behavioral, social, and self-care goals.
Helping Your Child
Once you discover your child may have a developmental delay, it's important to get help. Even before a formal diagnosis of autism is made, your child can begin early intervention to address language and other delays.
Unfortunately, treatment can be expensive and often is not reimbursed by insurance companies. But help is out there if you look in the right places — for instance, federally funded grants that cover the costs of autism services or research studies that diagnose, evaluate, and treat kids with autism.
To find out what's available to your child, contact:
- your doctor or health care system
- your township or county department
- health and education departments
- churches and other charitable organizations
- local chapters of autism advocacy groups (like Autism Speaks)
Reviewed by: Michelle New, PhD
Date reviewed: June 2012