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
- Giving Teens a Voice in Health Care Decisions
- What Is ADHD?
- A to Z: Autism
- Anxiety, Fears, and Phobias
- Autism Special Needs Factsheet
- Asperger Syndrome
- Disciplining Your Child With Special Needs
- Occupational Therapy
- Does My Toddler Have a Language Delay?
- Camps for Kids With Special Needs
- Relaxation Techniques for Children With Serious Illness
- Individualized Education Programs (IEPs)
- Sending Your Child With Special Needs to Camp
- Raising a Child With Autism: Paige and Iain's Story
- Is There a Connection Between Vaccines and Autism?
- Delayed Speech or Language Development
- Brain and Nervous System
- Auditory Processing Disorder
- Obsessive-Compulsive Disorder
- Speech-Language Therapy
- Sleep Problems in Teens
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
Brain and Nervous System
You're in the middle of a meeting at work, but your mind keeps drifting to the parent–teacher conference you have tonight ... and the dry cleaning you have to pick up on the way home ... and how you wish you hadn't skipped lunch because the rumbling in your stomach is driving you nuts. Then, suddenly, you're back in the moment, hoping nobody noticed your brief "departure."
It may seem as if your brain is always on the go. And it is. The brain not only controls what you think and feel, how you learn and remember, and the way you move and talk, but also many things you're less aware of — such as the beating of your heart, the digestion of your food, and yes, even the amount of stress you feel. Like you, your brain is quite the juggler.
Anatomy of the Nervous System
If you think of the brain as a central computer that controls all bodily functions, then the nervous system is like a network that relays messages back and forth from the brain to different parts of the body. It does this via the spinal cord, which runs from the brain down through the back and contains threadlike nerves that branch out to every organ and body part.
When a message comes into the brain from anywhere in the body, the brain tells the body how to react. For example, if you accidentally touch a hot stove, the nerves in your skin shoot a message of pain to your brain. The brain then sends a message back telling the muscles in your hand to pull away. Luckily, this neurological relay race takes a lot less time than it just took to read about it.
Considering everything it does, the human brain is incredibly compact, weighing just 3 pounds. Its many folds and grooves, though, provide it with the additional surface area necessary for storing all of the body's important information.
The spinal cord, on the other hand, is a long bundle of nerve tissue about 18 inches long and ¾ inch thick. It extends from the lower part of the brain down through spine. Along the way, various nerves branch out to the entire body. These make up the peripheral nervous system.
Both the brain and the spinal cord are protected by bone: the brain by the bones of the skull, and the spinal cord by a set of ring-shaped bones called vertebrae. They're both cushioned by layers of membranes called meninges as well as a special fluid called cerebrospinal fluid. This fluid helps protect the nerve tissue, keep it healthy, and remove waste products.
All About the Brain
The brain is made up of three main sections: the forebrain, the midbrain, and the hindbrain.
1. The Forebrain
The forebrain is the largest and most complex part of the brain. It consists of the cerebrum — the area with all the folds and grooves typically seen in pictures of the brain — as well as some other structures beneath it.
The cerebrum contains the information that essentially makes us who we are: our intelligence, memory, personality, emotion, speech, and ability to feel and move. Specific areas of the cerebrum are in charge of processing these different types of information. These are called lobes, and there are four of them: the frontal, parietal, temporal, and occipital.
The cerebrum has right and left halves, called hemispheres, which are connected in the middle by a band of nerve fibers (the corpus collosum) that enables the two sides to communicate. Though these halves may look like mirror images of each other, many scientists believe they have different functions. The left side is considered the logical, analytical, objective side. The right side is thought to be more intuitive, creative, and subjective. So when you're balancing the checkbook, you're using the left side; when you're listening to music, you're using the right side. It's believed that some people are more "right-brained" or "left-brained" while others are more "whole-brained," meaning they use both halves of their brain to the same degree.
The outer layer of the cerebrum is called the cortex (also known as "gray matter"). Information collected by the five senses comes into the brain from the spinal cord to the cortex. This information is then directed to other parts of the nervous system for further processing. For example, when you touch the hot stove, not only does a message go out to move your hand but one also goes to another part of the brain to help you remember not to do that again.
In the inner part of the forebrain sits the thalamus, hypothalamus, and pituitary gland. The thalamus carries messages from the sensory organs like the eyes, ears, nose, and fingers to the cortex. The hypothalamus controls the pulse, thirst, appetite, sleep patterns, and other processes in our bodies that happen automatically. It also controls the pituitary gland, which makes the hormones that control our growth, metabolism, water and mineral balance, sexual maturity, and response to stress.
2. The Midbrain
The midbrain, located underneath the middle of the forebrain, acts as a master coordinator for all the messages going in and out of the brain to the spinal cord.
3. The Hindbrain
The hindbrain sits underneath the back end of the cerebrum, and it consists of the cerebellum, pons, and medulla. The cerebellum — also called the "little brain" because it looks like a small version of the cerebrum — is responsible for balance, movement, and coordination.
The pons and the medulla, along with the midbrain, are often called the brainstem. The brainstem takes in, sends out, and coordinates all of the brain's messages. It also controls many of the body's automatic functions, like breathing, heart rate, blood pressure, swallowing, digestion, and blinking.
How the Nervous System Works
The basic functioning of the nervous system depends a lot on tiny cells called neurons. The brain has billions of them, and they have many specialized jobs. For example, sensory neurons take information from the eyes, ears, nose, tongue, and skin to the brain. Motor neurons carry messages away from the brain and back to the rest of the body.
All neurons, however, relay information to each other through a complex electrochemical process, making connections that affect the way we think, learn, move, and behave.
Intelligence, learning, and memory. At birth, the nervous system contains all the neurons you will ever have, but many of them are not connected to each other. As you grow and learn, messages travel from one neuron to another over and over, creating connections, or pathways, in the brain. It's why driving seemed to take so much concentration when you first learned but now is second nature: The pathway became established.
In young children, the brain is highly adaptable; in fact, when one part of a young child's brain is injured, another part can often learn to take over some of the lost function. But as we age, the brain has to work harder to make new neural pathways, making it more difficult to master new tasks or change established behavior patterns. That's why many scientists believe it's important to keep challenging your brain to learn new things and make new connections — it helps keeps the brain active over the course of a lifetime.
Memory is another complex function of the brain. The things we've done, learned, and seen are first processed in the cortex. Then, if we sense that this information is important enough to remember permanently, it's passed inward to other regions of the brain (such as the hippocampus and amygdala) for long-term storage and retrieval. As these messages travel through the brain, they too create pathways that serve as the basis of our memory.
Movement. Different parts of the cerebrum are responsible for moving different body parts. The left side of the brain controls the movements of the right side of the body, and the right side of the brain controls the movements of the left side of the body. When you press the accelerator with your right foot, for example, it's the left side of your brain that sends the message allowing you to do it.
Basic body functions. A part of the peripheral nervous system called the autonomic nervous system is responsible for controlling many of the body processes we almost never need to think about, like breathing, digestion, sweating, and shivering. The autonomic nervous system has two parts: the sympathetic and the parasympathetic nervous systems.
The sympathetic nervous system prepares the body for sudden stress, like if you see a robbery taking place. When something frightening happens, the sympathetic nervous system makes the heart beat faster so that it sends blood more quickly to the different body parts that might need it. It also causes the adrenal glands at the top of the kidneys to release adrenaline, a hormone that helps give extra power to the muscles for a quick getaway. This process is known as the body's "fight or flight" response.
The parasympathetic nervous system does the exact opposite: It prepares the body for rest. It also helps the digestive tract move along so our bodies can efficiently take in nutrients from the food we eat.
The senses. Your spouse may be a sight for sore eyes at the end of a long day — but without the brain, you wouldn't even recognize him or her. Pepperoni pizza sure is delicious — but without the brain, your taste buds wouldn't be able to tell if you were eating pizza or the box it came in. None of your senses would be useful without the processing that happens in the brain.
- Sight. Sight probably tells us more about the world than any other sense. Light entering the eye forms an upside-down image on the retina. The retina transforms the light into nerve signals for the brain. The brain then turns the image right-side up and tells us what we are seeing.
- Hearing. Every sound we hear is the result of sound waves entering our ears and causing our eardrums to vibrate. These vibrations are then transferred along the tiny bones of the middle ear and converted into nerve signals. The cortex then processes these signals, telling us what we are hearing.
- Taste. The tongue contains small groups of sensory cells called taste buds that react to chemicals in foods. Taste buds react to sweet, sour, salty, and bitter. Messages are sent from the taste buds to the areas in the cortex responsible for processing taste.
- Smell. Olfactory cells in the mucous membranes lining each nostril react to chemicals we breathe in and send messages along specific nerves to the brain — which, according to experts, can distinguish between more than 10,000 different smells. With that kind of sensitivity, it's no wonder research suggests that smells are very closely linked to our memories.
- Touch. The skin contains more than 4 million sensory receptors — mostly concentrated in the fingers, tongue, and lips — that gather information related to touch, pressure, temperature, and pain and send it to the brain for processing and reaction.
Things That Can Go Wrong With the Brain
Because the brain controls just about everything, when something goes wrong with it, it's often serious and can affect many different parts of the body. Inherited diseases, brain disorders associated with mental illness, and head injuries all can affect the way the brain works and upset the daily activities of the rest of the body.
Problems that can affect the brain include:
Brain tumors. A brain tumor is an abnormal tissue growth in the brain. A tumor in the brain may grow slowly and produce few symptoms until it becomes large, or it can grow and spread rapidly, causing severe and quickly worsening symptoms. Brain tumors in children can be benign or malignant. Benign tumors usually grow in one place and may be curable through surgery if they're located in a place where they can be removed without damaging the normal tissue near the tumor. A malignant tumor is cancerous and more likely to grow rapidly and spread.
Cerebral palsy. Cerebral palsy is the result of a developmental defect or damage to the brain before or during a baby's birth, or during the first few years of a child's life. It affects the motor areas of the brain. A person with cerebral palsy may have average intelligence or can have severe developmental delays or intellectual disability. Cerebral palsy can affect body movement in many different ways. In mild cases of cerebral palsy, there may be minor muscle weakness of the arms and legs. In other cases, there may be more severe motor impairment — a child may have trouble talking and doing basic movements like walking.
Epilepsy. This condition includes a wide variety of seizure disorders. Partial seizures involve specific areas of the brain, and symptoms vary depending on the location of the seizure activity. Other seizures, called generalized seizures, involve a larger portion of the brain and usually cause uncontrolled movements of the entire body and loss of consciousness when they happen. Although the specific cause is unknown in many cases, epilepsy can be related to brain injury, tumors, or infections. The tendency to develop epilepsy may run in families.
Headaches. Of the many different types of headaches, the most common include tension headache (the most common), caused by muscle tension in the head, neck, and shoulders; migraine, an intense, recurring headache with an unclear cause; and cluster headache, considered by some to be a form of migraine. Migraines happen with or without warning and may last for several hours or days. There seems to be an inherited risk for migraines and certain triggers that can lead to them. People with migraines may have dizziness, numbness, sensitivity to light, and nausea, and may see flashing zigzag lines before their eyes.
Meningitis and encephalitis. These infections of the brain and spinal cord are usually caused by bacteria or viruses. Meningitis is an inflammation of the coverings of the brain and spinal cord, and encephalitis is an inflammation of the brain tissue. Both conditions may cause permanent injury to the brain.
Mental illness. Mental illnesses are psychological and behavioral in nature and involve a wide range of problems in thought and function. Certain mental illnesses are now known to be linked to structural abnormalities or chemical dysfunction of the brain. Some are inherited. But often the cause is unknown. Injuries to the brain and chronic drug or alcohol abuse also can trigger some mental illnesses. Signs of chronic mental illnesses such as bipolar disorder or schizophrenia may first show up in childhood. Mental illnesses that can be seen in younger people include depression, eating disorders such as bulimia or anorexia nervosa, obsessive-compulsive disorder (OCD), and phobias.
Head injuries. Head injuries fit into two categories: external (usually scalp) injuries and internal head injuries. Internal injuries may involve the skull, the blood vessels within the skull, or the brain. Fortunately, most childhood falls or blows to the head result in injury to the scalp only, which is usually more frightening than dangerous. An internal head injury could have more serious implications.
Concussions are also a type of internal head injury. A concussion is the temporary loss of normal brain function as a result of an injury. Repeated concussions can result in permanent brain injury. One of the most common reasons kids get concussions is through sports, so it's important to make sure they wear appropriate protective gear and don't continue to play if they've had a head injury.
Reviewed by: Steven Dowshen, MD
Date reviewed: April 28, 2017