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Children and young adults with ASD are most likely to suffer from a TBI.

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The causes of a TBI to someone with ASD are very similar to those of anyone else, however, people with ASD might experience a higher risk. This can be due to accidental injuries, impulsive behaviors, and specific vulnerabilities due to certain brain regions.

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Additionally, family members and caregivers are prone to experiencing effects from the person with the TBI.

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Other TBI causes in people with ASD can include sensory issues, communication challenges, and sometimes be due to physical disabilities the person might experience.

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Autism primarily affects the brain — especially areas like the frontal and temporal lobes, amygdala, hippocampus, and cerebellum. These regions help with emotions, memory, social interaction, and coordination — all areas where individuals with autism may show unique patterns of behavior or processing.

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In autism, the brain may have too many or misorganized connections between neurons. This affects how different brain regions "talk" to each other, especially for complex tasks like understanding social cues or switching attention. Think of it like a web of wires with extra, tangled links!

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People with autism often show differences in brain chemicals like serotonin, dopamine, and GABA. These neurotransmitters help regulate mood, focus, and sensory processing — so changes here can lead to heightened sensitivities, repetitive behaviors, or emotional challenges.

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 Early Brain Development and Synapse Pruning

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 Early Brain Development and Synapse Pruning

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ASD begins very early in development. A key process that’s affected is synapse pruning, which normally clears out extra brain connections in childhood. In autism, this pruning may not happen properly, which can lead to sensory overload or difficulty filtering information.

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Early Brain Development and Synapse Pruning

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Diagnostic Method #1: Standardized Diagnostic Tools

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Diagnostic Method #1: Standardized Diagnostic Tools

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One of the most common tools used to diagnose individuals with ASD are formal assessments that should only be used by trained clinicians. There is ADOS (Autism Diagnostic Observation Schedule), ADI (Autism Diagnostic Interview), CARS (Childhood Autism Rating Scale), GARS (Gilliam Autism Rating Scale), and a few more. These types of tests help ensure that diagnosis are consistent, evidence-based, and align with DSM-5 information.

These tests are created for trained professionals, who often use more than one test for a more accurate diagnosis. They consist of observations, interviews, and questionnaires. The tests check for proper diagnosis, developmental history, symptoms severity, and sometimes are just initial assessments. The time it takes to get these tests done depends on several factors, but some tests may only take 10 minutes while others may take 2.5 hours. These tests vary in age ranges from 1 years old to adult aged. Some tests require you to be a certain age before the test is done.

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Diagnostic Method #2: Developmental Screening and Monitoring

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Diagnostic Method #2: Developmental Screening and Monitoring

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Another way that autism can be diagnosed is through developmental screenings/monitoring. Though these are technically 2 different "methods", I feel that they are very close because the monitoring usually triggers the screening. These diagnostic methods are usually triggered by an monitoring adult who has concerns about a child's development. Could be a child care provider/teacher, mom/dad, guardian, or doctor at a pediatric checkup.

If a doctor or healthcare provider feels that the child is not meeting milestones, they will "screen" the child with things like CHAT (Checklist for Autism in Toddlers), STAT (Screening Tool for Autism in Toddlers), ASQ-3 (Ages and Stages Questionnaire), CSBS-DP (Communication and Symbolic Behavior Scales - Developmental Profile), or PEDS (Parents Evaluation of Developmental Status). The age ranges of these test vary from birth to 8 years old. The goal of these test are to get early intervention for children under 3 and special education services for all school aged children who may need it.

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Those who suffer with ASD are known to have difficulty communicating verbally. Such as an inability to keep eye contact, unable to hold the flow of conversation going back and forth, and understanding facial expressions.

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Long-Term Consequence: Difficulty with Emotional Regulation

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Long-Term Consequence: Difficulty with Emotional Regulation

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For individuals with both Autism Spectrum Disorder (ASD) and a Traumatic Brain Injury (TBI), long-term difficulties with emotional regulation are common. This means they may struggle to manage strong feelings like frustration, anger, or anxiety, which can lead to emotional outbursts or withdrawal.

From ASD: Many autistic individuals already face challenges in understanding and expressing emotions.

From TBI: Brain injury can further impair areas responsible for impulse control and emotional processing.

Together, these challenges can impact relationships, daily functioning, and quality of life. Support often includes therapy focused on emotional regulation (like CBT or DBT), consistent routines, and sensory-friendly environments.

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Long-Term Consequence: Difficulty with Emotional Regulation

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Those with ASD often repeat the same motions and actions. They have trouble sitting still and may rock back and forth or verbally repeat themselves. This behavior is more apparent when they are faced with uncomfortable or overstimulating situations. A change in routine is seen as stressful, as they prefer to keep things the same.

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Long Term Consequence: Independent Living

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Long Term Consequence: Independent Living

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While some are able to live on their own, others are faced with challenges that would not allow them to. These challenges include tasks like cleaning, cooking or dealing with finances. It all depends on the severity of each person, as every single person is different. They are usually living with relatives or group homes that have support of social workers. So although it is possible to have independence, it is not always the case with everyone diagnosed with ASD.

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Many autistic individuals have the skill and desire to work, they will often run into the barrier of getting AND keeping a job. In order to get a job you need to interview for a job. Many autistic individual struggle with small talk,eye contact, tone of voice, and social cues making it difficult to "wow" an interviewer.

If an autistic person receives a job, because of ASD, they may find it hard to multi-task, adapt to changes, manage time effectively, which may result in low work performance.

There may be other things that cause a person with ASD to not want to work at a place such as things that trigger their sensory sensitivities or lack of support from workplace for things that are directly related to ASD, such as a place not allowing a person with a sound sensitivity to wear noise cancelling headphones which may trigger meltdowns or quitting. There could also be a boss who is overly "touchy" and loves to give hugs, but an autistic person may be triggered by touch or the feel of skin. This could cause a person with ASD to be uncomfortable or quit as well.

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Speech Therapy helps with communication difficulties, which can be impacted by both autism (e.g., social communication challenges) and TBI (e.g., word-finding or cognitive-linguistic impairments).

The focus areas can be improving expressive and receptive language,

enhancing pragmatic (social) communication, supporting alternative communication methods (like AAC devices if needed)Improving expressive and receptive language, and enhancing pragmatic (social) communication.

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The purpose of OT is Aims to improve daily living skills, sensory regulation, and motor coordination, all of which may be affected in individuals with ASD and/or TBI.

Occupational Therapies focus areas are sensory integration techniques (for overstimulation or under-responsiveness), cognitive rehabilitation strategies (for memory, attention, and executive function), and developing routines and adaptive strategies for independence.

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Another symptom of autism is sensory issues. This means their senses - like hearing, taste, smell, touch, or sight- can be a lot more sensitive (or sometimes less sensitive) that other people. For example, sounds that seem normal to most could sound painfully loud to them. Crowded or loud spaces along with bright lights could also be overwhelming

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Many autistic people struggle with motor skills which can either be gross motor skills, like running or jumping, or fine motor skills like writing or tying their shoes. These difficulties are due to the brain processing movement differently. For example, they make struggle with tasks that require hand coordination, or be more clumsy.

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A program that helps searching for a job, as well as getting prepared to behave in a workplace.

Targets to aid in independence and self esteem.

Professional - Job coach or rehabilitation counselors.

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Treatment: Physical therapy

Physical therapy helps individuals with autism to improve their gross motor skills, such as balance or coordination. This treatment is done through exercises, movement play or sport activities. This supports long term motor functions and is provided by a licensed physical therapist.

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A program that helps in learning social behaviors such as eye contact and social cues.

Targets aid in group settings and conversation skills.

Professional - Psychologist

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Speech, Hearing, or Cognitive Rehabilitation

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Speech, Hearing, or Cognitive Rehabilitation

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Cognitive-communication therapy is designed to help individuals with challenges in memory, attention, problem-solving, and communication caused by TBI, while also addressing existing social communication deficits associated with autism.

This treatment supports recovery from TBI-related cognitive impairments (like memory loss, disorganized thinking, and attention difficulties) while also improving pragmatic language skills affected by autism (like turn-taking, topic maintenance, and interpreting social cues).

A Speech Language Therapist specially trained in cognitive-communication rehabilitation would be the professional to go to.

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Speech, Hearing, or Cognitive Rehabilitation

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Individuals with TBI are at increased risk of developing post-traumatic epilepsy or seizures. Anti-seizure medications such as Levetiracetam (Keppra) are commonly prescribed to manage or prevent seizures, especially if the injury affects the temporal or frontal lobes.

Generic Levetiracetam costs approximately $20–$60/month with insurance and $100–$300/month without insurance, depending on the pharmacy and dosage.

The likely hood of insurance covering this would be about a 4 out of 5. Most private insurance plans and Medicare Part D typically cover anti-seizure medications, though some may require prior authorization or a generic substitution.

If untreated, post-traumatic seizures can lead to severe complications, including recurrent seizures, worsening brain injury, cognitive decline, increased fall risk, and even death. Seizures also worsen behavioral and sensory regulation in individuals with autism, further impairing quality of life and independence.

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Long Term Medical Treatment: Risperidone

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Long Term Medical Treatment: Risperidone

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Risperidone is an antipsychotic that alters dopamine and serotonin activity in the brain. It treats severe irritability, aggression, and self-harm behavior. Costs can range up to $800 per month. luckily, it is usually covered by insurance when prescribed for autism-related irritability so I'd give it a 4 on our scale.

If a person were to avoid this medication, it could cause worsening aggressive outbursts, unchecked self-harming behaviors, increased family stress or caregiver burnout, difficulty in school, therapy, or social settings due to disruptive behavior. It may even lead to hospitalization or residential placement in severe cases.

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SSRIs are antidepressants that increase serotonin levels in the brain. They are used for anxiety, obsessive or repetitive behaviors, depression, or mood instability that can be caused by having autism or many other disorders. This medication can cost up to $300 per month. Insurance typically covers the cost if it's prescribed for a diagnosis like anxiety or depression.

If a person avoids this medication it may cause ongoing high anxiety may cause withdrawal or rigid behavior, obsessive behaviors, risk of depression, emotional shutdown, or suicidal thoughts, social isolation or refusal to attend school or therapy, and/or reduced participation in daily activities or learning due to emotional distress.

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Treatment: Occupational Therapy

Occupational therapy helps people with autism improve their fine motor skills, in daily activities such as writing or feeding/ dressing themselves. This treatment is usually done through hands-on exercises and is provided by a licensed occupational therapist.

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Low income families will face a large amount of challenges. Including being unable to afford the proper health care, parents lack of time to take care of children, and the education on the matter. Children with ASD may be unable to get diagnosed properly or at all.

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There are many adults who grew up without the awareness of ASD and without the assistance of health care professionals. They may have or could still currently struggle with employment issues and relationships. Those with minor symptoms could absolutely fly under the radar and not be diagnosed properly. There are also a lack of health providers for adults compared to the help that children have on a daily basis.

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Lifestyle Change: Consistent Daily Routine

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Lifestyle Change: Consistent Daily Routine

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This lifestyle change is rated 7 out of 10 in difficulty because it requires consistent effort and adaptation, especially when cognitive or sensory challenges interfere with motivation or memory. Occupational therapists are key in helping create structured, manageable routines.

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Lifestyle Change: Improved Sleep Hygiene 

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Lifestyle Change: Improved Sleep Hygiene 

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Sleep hygiene is rated 6 out of 10 in difficulty due to the behavioral changes and environmental adjustments it requires. A behavioral therapist or sleep specialist can provide personalized guidance and support to make these changes sustainable.

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Public Health Interventions: Early Screening and Helmet Safety

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Public Health Interventions: Early Screening and Helmet Safety

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Interventions:

1. Early Developmental Screening Programs – Promotes early detection of autism and developmental delays.

2. Helmet Safety Campaigns – Reduces TBI risk by encouraging protective gear during physical activities.

Target Areas:

Early Screening: Individual

Helmet Campaigns: Environment

Challenges:

Screening: Access to trained professionals, stigma

Helmet Use: Compliance, cost, inconsistent laws

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Public Health Intervention: Inclusive Education and Domestic Violence Screening

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Public Health Intervention: Inclusive Education and Domestic Violence Screening

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Interventions:

1. Inclusive Education Policies – Ensures access to tailored education for students with autism.

2. TBI Prevention in Domestic Violence Programs – Adds brain injury screening to DV support services.

Target Areas:

Inclusive Education: Policy

DV + TBI Programs: Policy & Environment

Challenges:

Education: Funding, training gaps

DV Screening: Low awareness, resource limitations

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1. Early screening apps/tools help to diagnose autism early. These are different screenings that parents and providers can do on their technology devices to detect early signs of autism. Some track behavior while others are questionnaires. These apps/tools always run a risk of misdiagnosis or false diagnosis. There could also be risks of data and privacy issues.

2. Eye-Tracking technology is used to track where a child looks when presented with photos, videos, etc... Children with autism often have a different gaze pattern which this machine can help pick up on. There is always the chance that people may over-rely on this technology. This testing is also costly and not easily accessible.

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1. AAC devices are treatment/support for autism. These devices help non-verbal or minimally verbal individuals communicate. This help improve independence and enhances interactions for nonverbal autistic children. Some negatives to this may be children over relying on the device instead of learning to speak, some AACs can be expensive and require training, and some people with autism just may not enjoy the devices.

2. Teletherapy is becoming more prevalent in todays world. Autistic individuals use teletherapy for speech, ABA, and occupational therapy sessions. This is great for individuals in remote areas. The down side is hand-on therapy is less effective, possibly less engaged children, and theres always those pesky little tech difficulties.

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Currently, there is no evidence showing that autism is a condition that can be prevented.