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
- Disciplining Your Child With Special Needs
- Obsessive-Compulsive Disorder
- Occupational Therapy
- Delayed Speech or Language Development
- A to Z: Autism
- Auditory Processing Disorder
- Does My Toddler Have a Language Delay?
- Anxiety, Fears, and Phobias
- Camps for Kids With Special Needs
- Relaxation Techniques for Children With Serious Illness
- Individualized Education Programs (IEPs)
- Sleep Problems in Teens
- Sending Your Child With Special Needs to Camp
- Brain and Nervous System
- Speech-Language Therapy
- What Is ADHD?
- Raising a Child With Autism: Paige and Iain's Story
- Autism Special Needs Factsheet
- Is There a Connection Between Vaccines and Autism?
- Asperger Syndrome
- Giving Teens a Voice in Health Care Decisions
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
In a recent parent-teacher conference, maybe the teacher expressed concern that your child could have a problem with certain speech or language skills. Or perhaps while talking to your child, you noticed an occasional stutter.
Could your child have a problem? And if so, what should you do?
It's wise to intervene quickly. An evaluation by a certified speech-language pathologist can help find out if your child is having problems. Speech-language therapy is the treatment for most kids with speech and/or language disorders.
Speech Disorders, Language Disorders, and Feeding Disorders
A speech disorder refers to a problem with the actual production of sounds. A language disorder refers to a problem understanding or putting words together to communicate ideas.
Speech disorders include:
- Articulation disorders: difficulties producing sounds in syllables or saying words incorrectly to the point that listeners can't understand what's being said.
- Fluency disorders: problems such as stuttering, in which the flow of speech is interrupted by abnormal stoppages, partial-word repetitions ("b-b-boy"), or prolonging sounds and syllables (sssssnake).
- Resonance or voice disorders: problems with the pitch, volume, or quality of the voice that distract listeners from what's being said. These types of disorders may also cause pain or discomfort for a child when speaking.
Language disorders can be either receptive or expressive:
- Receptive disorders: difficulties understanding or processing language.
- Expressive disorders: difficulty putting words together, limited vocabulary, or inability to use language in a socially appropriate way.
- Cognitive-communication disorders: difficulty with communication skills that involve memory, attention, perception, organization, regulation, and problem solving.
Dysphagia/oral feeding disorders are disorders in the way someone eats or drinks, including problems with chewing, swallowing, coughing, gagging, and refusing foods.
Specialists in Speech-Language Therapy
Speech-language pathologists (SLPs), often informally known as speech therapists, are professionals educated in the study of human communication, its development, and its disorders. They hold at least a master's degree and state certification/licensure in the field, and a certificate of clinical competency from the American Speech-Language-Hearing Association (ASHA).
SLPs assess speech, language, cognitive-communication, and oral/feeding/swallowing skills to identify types of communication problems (articulation; fluency; voice; receptive and expressive language disorders, etc.) and the best way to treat them.
In speech-language therapy, an SLP will work with a child one-on-one, in a small group, or directly in a classroom to overcome difficulties involved with a specific disorder.
Therapists use a variety of strategies, including:
- Language intervention activities: The SLP will interact with a child by playing and talking, using pictures, books, objects, or ongoing events to stimulate language development. The therapist may also model correct vocabulary and grammar and use repetition exercises to build language skills.
- Articulation therapy: Articulation, or sound production, exercises involve having the therapist model correct sounds and syllables in words and sentences for a child, often during play activities. The level of play is age-appropriate and related to the child's specific needs. The SLP will physically show the child how to make certain sounds, such as the "r" sound, and may demonstrate how to move the tongue to produce specific sounds.
- Oral-motor/feeding and swallowing therapy: The SLP may use a variety of oral exercises — including facial massage and various tongue, lip, and jaw exercises — to strengthen the muscles of the mouth for eating, drinking, and swallowing. The SLP may also introduce different food textures and temperatures to increase a child's oral awareness during eating and swallowing.
When Is Therapy Needed?
Kids might need speech-language therapy for a variety of reasons, including, but not limited to:
- hearing impairments
- cognitive (intellectual, thinking) or other developmental delays
- weak oral muscles
- chronic hoarseness
- birth defects such as cleft lip or cleft palate
- motor planning problems
- articulation problems
- fluency disorders
- respiratory problems (breathing disorders)
- feeding and swallowing disorders
- traumatic brain injury
Therapy should begin as soon as possible. Children enrolled in therapy early (before they're 5 years old) tend to have better outcomes than those who begin therapy later.
This does not mean that older kids can't make progress in therapy; they may progress at a slower rate because they often have learned patterns that need to be changed.
Finding a Therapist
It's important to make sure that the speech-language therapist is certified by ASHA. That certification means the SLP has at least a master's degree in the field and has passed a national examination and successfully completed an ASHA-accredited supervised clinical fellowship.
Sometimes, speech assistants (who usually have a 2-year associate's or 4-year bachelor's degree) may assist with speech-language services under the supervision of ASHA-certified SLPs. Your child's SLP should be licensed in your state and have experience working with kids and your child's specific disorder.
You might find a specialist by asking your child's doctor or teacher for a referral or by checking local directories online or in your telephone book. State associations for speech-language pathology and audiology also maintain listings of licensed and certified therapists.
Helping Your Child
Speech-language experts agree that parental involvement is crucial to the success of a child's progress in speech or language therapy.
Parents are an extremely important part of their child's therapy program and help determine whether it is a success. Kids who complete the program quickest and with the longest-lasting results are those whose parents have been involved.
Ask the therapist for suggestions on how you can help your child. For instance, it's important to help your child do the at-home stimulation activities that the SLP suggests to ensure continued progress and carry-over of newly learned skills.
The process of overcoming a speech or language disorder can take some time and effort, so it's important that all family members be patient and understanding with the child.
Reviewed by: Brooke Crenshaw, MS, CCC-SLP
Date reviewed: September 26, 2016