Autism

KidsHealth from Nemours

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.

 
What Is Autism Spectrum Disorder?

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.
 
Prevalence and Cause of Autism Spectrum Disorders in Children

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.

 
Symptoms of Autism Spectrum Disorder in Children

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:

Communication Difficulties
  • 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)
Repetitive/Restrictive Behaviors
  • 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)

Asperger Syndrome

Asperger syndrome (AS) is a type of autism. Autism affects how a person interprets language, communicates, and socializes. 

AS used to be considered its own condition, with its own diagnosis, but that changed in 2013. That's when the guidebook that doctors use (The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, commonly called DSM-5) changed the classification of AS. Now, kids who show signs of AS are diagnosed with autism and are considered "on the autism spectrum."

"On the Autism Spectrum"

The term "autism spectrum" refers to a wide range of developmental disabilities. These disabilities can appear in different combinations with varying degrees of severity: two children with the same diagnosis, though they may share certain patterns of behavior, can have 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 on the autism spectrum. 

Kids with AS are generally considered to be on the "high-functioning" end of the autism spectrum. Boys are three to four times more likely than girls to have AS. The incidence seems to be increasing, but this might be because milder cases are being identified more frequently.

Although Asperger syndrome is no longer considered to be a diagnosis all on its own, many parents and people in the medical community still use the term.

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, couldn't communicate well 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 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, few facial expressions, and other peculiar mannerisms. Often, kids with AS have trouble reading the body language of others. They might engage in obsessive routines and show 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, kids and teens with AS can function 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 can include motor delays, clumsiness, limited interests, and peculiar preoccupations. Adults with AS have trouble showing 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 increase and decrease over time, and early intervention services can be helpful.

Signs and Symptoms

Because the signs of AS can be similar to those of other behavioral problems, it's best to let a doctor or other health professional evaluate a child's symptoms. Many kids are 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 that almost always revolve 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 grammar skills and an advanced vocabulary at an early age. However, many do have a language disorder — for instance, a child might be very literal and have trouble using language in a social context.

Often there are no obvious delays in cognitive development. Kids with AS can have problems with attention span and organization, or skills that seem well developed in some areas and lacking in others, but 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. Brain abnormalities are thought to be one possible cause of AS, because structural and functional differences have been seen with advanced brain imaging.

Genetics might play a role, and research indicates that some cases of AS may be associated with other mental health problems such as depression and bipolar disorder.

AS is not caused by emotional deprivation or the way a child was brought up. Because some behaviors seen in AS may be thought of as intentionally rude by others, 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 their chances of doing so are helped by 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, done while a child's brain is still developing, is very important for kids with AS.

If your child shows 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.

A specialist will do a thorough "psychosocial" evaluation of your child. This includes a careful history of when symptoms were first noticed, the development of motor skills and language patterns, and other aspects of personality and behavior (including favorite activities, unusual habits, preoccupations, etc.).

Particular focus 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 usually are done to see which might be lacking.

Treating Asperger Syndrome

AS behaviors and problems can differ widely from child to child, so there isn't a "typical" or prescribed treatment. But, depending on what their strengths and weaknesses are (or what their development history is), kids may benefit from:

  • parent education and training
  • specialized educational interventions
  • social skills training
  • language therapy
  • for younger kids, sensory integration training. This usually involves occupational therapy, in which a child is desensitized to stimuli he or she is overly sensitive to
  • psychotherapy or behavioral/cognitive therapy for older kids
  • medicines

Many people can help your child, so it's important to involve all caregivers. For instance, every health professional caring for your child should know what the others are doing. And teachers, babysitters, other family members, close friends, and anyone else who cares for your child should be involved.

Finding the right program is key, as is getting help for your child early. Kids with AS can and do have great gains with the proper treatment and education.

Helping Your Child

AS brings challenges for kids and their parents, but 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, tell others that your child has special needs. As a parent, you may have to be an educator when dealing with teachers, medical personnel, and other caregivers.
  • Find a treatment or intervention program tailored to your child's specific issues or areas of "deficiency." The Autism Society of America (ASA) recommends talking with the program's director to be sure that it can meet your child's needs.
  • Choose special programs or treatments that focus on long-term goals and are suited to your child's developmental level.
  • Remember that your child is part of a family, and that his or her needs should be balanced with those of other family members.
  • Get support for yourself and other family members. You can't help your child if you're not meeting your own emotional and physical needs. Your community may have support groups at a local hospital or mental health center. Government-sponsored services and other programs vary from state to state.

Your Child's Future

Few facilities are dedicated to providing for the needs of kids with AS. Some children attend mainstream schools where their progress depends on the support and encouragement of parents, caregivers, teachers, and classmates. Others go to special schools for kids with autism or learning disabilities.

Many people with AS manage 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 the treatment team can provide enormous support and encouragement for your child — and your family.

Reviewed by: Rhonda S. Walter, MD
Date reviewed: September 26, 2016