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
- Raising a Child With Autism: Paige and Iain's Story
- Is There a Connection Between Vaccines and Autism?
- 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)
- Brain and Nervous System
- Obsessive-Compulsive Disorder
- Delayed Speech or Language Development
- Asperger Syndrome
- What Is ADHD?
- A to Z: Autism
- Autism Special Needs Factsheet
- Auditory Processing Disorder
- Speech-Language Therapy
- Sleep Problems in Teens
- Anxiety, Fears, and Phobias
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
Occupational therapy (OT) treatment focuses on helping people with a physical, sensory, or cognitive disability be as independent as possible in all areas of their lives. OT can help kids with various needs improve their cognitive, physical, sensory, and motor skills and enhance their self-esteem and sense of accomplishment.
Some people may think that occupational therapy is only for adults; kids, after all, do not have occupations. But a child's main job is playing and learning, and occupational therapists can evaluate kids' skills for playing, school performance, and daily activities and compare them with what is developmentally appropriate for that age group.
According to the American Occupational Therapy Association (AOTA), in addition to dealing with an someone's physical well-being, OT practitioners address psychological, social, and environmental factors that can affect functioning in different ways. This approach makes OT a vital part of health care for some kids.
Kids Who Might Need Occupational Therapy
According to the AOTA, kids with these medical problems might benefit from OT:
- birth injuries or birth defects
- sensory processing disorders
- traumatic injuries (brain or spinal cord)
- learning problems
- autism/pervasive developmental disorders
- juvenile rheumatoid arthritis
- mental health or behavioral problems
- broken bones or other orthopedic injuries
- developmental delays
- post-surgical conditions
- spina bifida
- traumatic amputations
- severe hand injuries
- multiple sclerosis, cerebral palsy, and other chronic illnesses
Occupational therapists might:
- help kids work on fine motor skills so they can grasp and release toys and develop good handwriting skills
- address hand–eye coordination to improve kids' play and school skills (hitting a target, batting a ball, copying from a blackboard, etc.)
- help kids with severe developmental delays learn basic tasks (such as bathing, getting dressed, brushing their teeth, and feeding themselves)
- help kids with behavioral disorders maintain positive behaviors in all environments (e.g., instead of hitting others or acting out, using positive ways to deal with anger, such as writing about feelings or participating in a physical activity)
- teach kids with physical disabilities the coordination skills needed to feed themselves, use a computer, or increase the speed and legibility of their handwriting
- evaluate a child's need for specialized equipment, such as wheelchairs, splints, bathing equipment, dressing devices, or communication aids
- work with kids who have sensory and attentional issues to improve focus and social skills
How Physical Therapy and OT Differ
Although both physical and occupational therapy help improve kids' quality of life, there are differences. Physical therapy (PT) deals with pain, strength, joint range of motion, endurance, and gross motor functioning, whereas OT deals more with fine motor skills, visual-perceptual skills, cognitive skills, and sensory-processing deficits.
Occupational Therapy Practitioners
There are two professional levels of occupational practice — occupational therapist (OT) and occupational therapist assistant (OTA).
Since 2007, an OT must complete a master's degree program (previously, only a bachelor's degree was required). An OTA is only required to complete an associate's degree program and can carry out treatment plans developed by the occupational therapist but can't complete evaluations.
All occupational therapy practitioners must complete supervised fieldwork programs and pass a national certification examination. A license to practice is mandatory in most states, as are continuing education classes to maintain that licensure.
Occupational therapists work in a variety of settings, including:
- rehabilitation centers
- mental health facilities
- private practices
- children's clinics
- nursing homes
Finding Care for Your Child
If you think your child might benefit from occupational therapy, ask your doctor to refer you to a specialist. The school nurse or guidance counselor also might be able to recommend someone based on your child's academic or social performance.
You also can check your local yellow pages, search online, or contact your state's occupational therapy association or a nearby hospital or rehabilitation center for referrals.
However you find an occupational therapist for your child, make sure that your health insurance company covers the program you select./p>
Reviewed by: Wendy Harron, BS, OTR/L
Date reviewed: September 26, 2016