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
- Camps for Kids With Special Needs
- Sending Your Child With Special Needs to Camp
- Disciplining Your Child With Special Needs
- Does My Toddler Have a Language Delay?
- Relaxation Techniques for Children With Serious Illness
- Occupational Therapy
- Individualized Education Programs (IEPs)
- Raising a Child With Autism: Paige and Iain's Story
- Is There a Connection Between Vaccines and Autism?
- Giving Teens a Voice in Health Care Decisions
- A to Z: Autism
- Brain and Nervous System
- Auditory Processing Disorder
- Sleep Problems in Teens
- Speech-Language Therapy
- What Is ADHD?
- Autism Special Needs Factsheet
- Asperger Syndrome
- Anxiety, Fears, and Phobias
- Obsessive-Compulsive Disorder
- Delayed Speech or Language Development
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
Anxiety, Fears, and Phobias
Everyone, from the youngest child to the oldest adult, experiences anxieties and fears at one time or another. Feeling anxious in a particularly uncomfortable situation never feels very good. However, with kids, such feelings are not only normal, they're also necessary. Dealing with anxieties can prepare young people to handle the unsettling experiences and challenging situations of life.
Many Anxieties and Fears Are Normal
Anxiety is defined as "apprehension without apparent cause." It usually occurs when there's no immediate threat to a person's safety or well-being, but the threat feels real.
Anxiety makes someone want to escape the situation — fast. The heart beats quickly, the body might begin to perspire, and "butterflies" in the stomach soon follow. However, a little bit of anxiety can actually help people stay alert and focused.
Having fears or anxieties about certain things can also be helpful because it makes kids behave in a safe way. For example, a kid with a fear of fire would avoid playing with matches.
The nature of anxieties and fears change as kids grow and develop:
- Babies experience stranger anxiety, clinging to parents when confronted by people they don't recognize.
- Toddlers around 10 to 18 months old experience separation anxiety, becoming emotionally distressed when one or both parents leave.
- Kids ages 4 through 6 have anxiety about things that aren't based in reality, such as fears of monsters and ghosts.
- Kids ages 7 through 12 often have fears that reflect real circumstances that may happen to them, such as bodily injury and natural disaster.
As kids grow, one fear may disappear or replace another. For example, a child who couldn't sleep with the light off at age 5 may enjoy a ghost story at a slumber party years later. And some fears may extend only to one particular kind of stimulus. In other words, a child may want to pet a lion at the zoo but wouldn't dream of going near the neighbor's dog.
Signs of Anxiety
Typical childhood fears change with age. They include fear of strangers, heights, darkness, animals, blood, insects, and being left alone. Kids often learn to fear a specific object or situation after having an unpleasant experience, such as a dog bite or an accident.
Separation anxiety is common when young children are starting school, whereas adolescents may experience anxiety related to social acceptance and academic achievement.
If anxious feelings persist, they can take a toll on a child's sense of well-being. The anxiety associated with social avoidance can have long-term effects. For example, a child with fear of being rejected can fail to learn important social skills, causing social isolation.
Many adults are tormented by fears that stem from childhood experiences. An adult's fear of public speaking may be the result of embarrassment in front of peers many years before. It's important for parents to recognize and identify the signs and symptoms of kids' anxieties so that fears don't get in the way of everyday life.
Some signs that a child may be anxious about something may include:
- becoming clingy, impulsive, or distracted
- nervous movements, such as temporary twitches
- problems getting to sleep and/or staying asleep longer than usual
- sweaty hands
- accelerated heart rate and breathing
Apart from these signs, parents can usually tell when their child is feeling excessively uneasy about something. Lending a sympathetic ear is always helpful, and sometimes just talking about the fear can help a child move beyond it.
What's a Phobia?
When anxieties and fears persist, problems can arise. As much as a parent hopes the child will grow out of it, sometimes the opposite occurs, and the cause of the anxiety looms larger and becomes more prevalent. The anxiety becomes a phobia, or a fear that's extreme, severe, and persistent.
A phobia can be very difficult to tolerate, both for kids and those around them, especially if the anxiety-producing stimulus (whatever is causing the anxiety) is hard to avoid (e.g., thunderstorms).
"Real" phobias are one of the top reasons kids are referred to mental health professionals. But the good news is that unless the phobia hinders the everyday ability to function, the child sometimes won't need treatment by a professional because, in time, the phobia will be resolved.
Focusing on Anxieties, Fears, or Phobias
Try to answer the following questions honestly:
Is your child's fear and behavior related to it typical for your child's age? If the answer to this question is yes, it's a good bet that your child's fears will resolve before they become a serious cause for concern. This isn't to say that the anxiety should be discounted or ignored; rather, it should be considered as a factor in your child's normal development.
Many kids experience age-appropriate fears, such as being afraid of the dark. Most, with some reassurance and perhaps a nightlight, will overcome or outgrow it. However, if they continue to have trouble or there's anxiety about other things, the intervention may have to be more intensive.
What are the symptoms of the fear and how do they affect your child's personal, social, and academic functioning? If symptoms can be identified and considered in light of your child's everyday activities, adjustments can be made to alleviate some of the stress factors.
Does the fear seem unreasonable in relation to the reality of the situation; could it be a sign of a more serious problem? If your child's fear seems out of proportion to the cause of the stress, this may signal the need to seek outside help, such as a counselor, psychiatrist, or psychologist.
Parents should look for patterns. If an isolated incident is resolved, don't make it more significant than it is. But if a pattern emerges that's persistent or pervasive, you should take action. If you don't, the phobia is likely to continue to affect your child.
Contact your doctor and/or a mental health professional who has expertise in working with kids and adolescents.
Helping Your Child
Parents can help kids develop the skills and confidence to overcome fears so that they don't evolve into phobic reactions.
To help your child deal with fears and anxieties:
- Recognize that the fear is real. As trivial as a fear may seem, it feels real to your child and it's causing him or her to feel anxious and afraid. Being able to talk about fears helps — words often take some of the power out of the negative feeling. If you talk about it, it can become less powerful.
- Never belittle the fear as a way of forcing your child to overcome it. Saying, "Don't be ridiculous! There are no monsters in your closet!" may get your child to go to bed, but it won't make the fear go away.
- Don't cater to fears, though. If your child doesn't like dogs, don't cross the street deliberately to avoid one. This will just reinforce that dogs should be feared and avoided. Provide support and gentle care as you approach the feared object or situation with your child.
- Teach kids how to rate fear. A child who can visualize the intensity of the fear on a scale of 1 to 10, with 10 being the strongest, may be able to "see" the fear as less intense than first imagined. Younger kids can think about how "full of fear" they are, with being full "up to my knees" as not so scared, "up to my stomach" as more frightened, and "up to my head" as truly petrified.
- Teach coping strategies. Try these easy-to-implement techniques. Using you as "home base," your child can venture out toward the feared object, and then return to you for safety before venturing out again. Kids also can learn some positive self-statements (such as "I can do this" and "I will be OK") to say to themselves when feeling anxious. Relaxation techniques are helpful, including visualization (of floating on a cloud or lying on a beach, for example) and deep breathing (imagining that the lungs are balloons and letting them slowly deflate).
The key to resolving fears and anxieties is to overcome them. Using these suggestions, you can help your child better cope with life's situations.
Reviewed by: D'Arcy Lyness, PhD
Date reviewed: April 28, 2017