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CDC activities and resources on autism spectrum disorder (ASD).

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For parents

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Special Ed Curriculum, Visual Supports & More: National Autism Resources

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Shop our online store for the visual supports, sensory tools, social skills curriculum you need for your students with autism.

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Information on Autism Spectrum Disorder for Families

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Directory of CDC resources for families of children with autism spectrum disorder (ASD).

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National Institute of Mental Health (NIMH)

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Overview

Autism spectrum disorder (ASD) is a neurological and developmental disorder that affects how people interact with others, communicate, learn, and behave. Although autism can be diagnosed at any age, it is described as a "developmental disorder" because symptoms generally appear in the first two years of life.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a guide created by the American Psychiatric Association that health care providers use to diagnose mental disorders, people with ASD often have:

Difficulty with communication and interaction with other people

Restricted interests and repetitive behaviors

Symptoms that affect their ability to function in school, work, and other areas of life

Autism is known as a "spectrum" disorder because there is wide variation in the type and severity of symptoms people experience.

People of all genders, races, ethnicities, and economic backgrounds can be diagnosed with ASD. Although ASD can be a lifelong disorder, treatments and services can improve a person's symptoms and daily functioning. The American Academy of Pediatrics recommends that all children receive screening for autism. Caregivers should talk to their child's health care provider about ASD screening or evaluation.

Signs and Symptoms of ASD

People with ASD have difficulty with social communication and interaction, restricted interests, and repetitive behaviors. The list below gives some examples of common types of behaviors in people diagnosed with ASD. Not all people with ASD will have all behaviors, but most will have several of the behaviors listed below.

Social communication / interaction behaviors may include:

Making little or inconsistent eye contact

Appearing not to look at or listen to people who are talking

Infrequently sharing interest, emotion, or enjoyment of objects or activities (including by infrequently pointing at or showing things to others)

Not responding or being slow to respond to one's name or to other verbal bids for attention

Having difficulties with the back and forth of conversation

Often talking at length about a favorite subject without noticing that others are not interested or without giving others a chance to respond

Displaying facial expressions, movements, and gestures that do not match what is being said

Having an unusual tone of voice that may sound sing-song or flat and robot-like

Having trouble understanding another person's point of view or being unable to predict or understand other people's actions

Difficulties adjusting behaviors to social situations

Difficulties sharing in imaginative play or in making friends

Restrictive / repetitive behaviors may include:

Repeating certain behaviors or having unusual behaviors, such as repeating words or phrases (a behavior called echolalia)

Having a lasting intense interest in specific topics, such as numbers, details, or facts

Showing overly focused interests, such as with moving objects or parts of objects

Becoming upset by slight changes in a routine and having difficulty with transitions

Being more sensitive or less sensitive than other people to sensory input, such as light, sound, clothing, or temperature

People with ASD may also experience sleep problems and irritability.

People on the autism spectrum also may have many strengths, including:

Being able to learn things in detail and remember information for long periods of time

Being strong visual and auditory learners

Excelling in math, science, music, or art

Causes and Risk Factors

Researchers don't know the primary causes of ASD, but studies suggest that a person's genes can act together with aspects of their environment to affect development in ways that lead to ASD. Some factors that are associated with an increased likelihood of developing ASD include:

Having a sibling with ASD

Having older parents

Having certain genetic conditions (such as Down syndrome or Fragile X syndrome)

Having a very low birth weight

Diagnosing ASD

Health care providers diagnose ASD by evaluating a person's behavior and development. ASD can usually be reliably diagnosed by the age of two. It is important to seek an evaluation as soon as possible. The earlier ASD is diagnosed, the sooner treatments and services can begin.

Diagnosis in Young Children

Diagnosis in young children is often a two-stage process.

Stage 1: General Developmental Screening During Well-Child Checkups

Every child should receive well-child check-ups with a pediatrician or an early childhood health care provider. The American Academy of Pediatrics recommends that all children receive screening for developmental delays at their 9-, 18-, and 24- or 30-month well-child visits, with specific autism screenings at their 18- and 24-month well-child visits. A child may receive additional screening if they are at high risk for ASD or developmental problems. Children at high risk include those who have a family member with ASD, show some behaviors that are typical of ASD, have older parents, have certain genetic conditions, or who had a very low birth weight.

Considering caregivers' experiences and concerns is an important part of the screening process for young children. The health care provider may ask questions about the child's behaviors and evaluate those answers in combination with information from ASD screening tools and clinical observations of the child. Read more about screening instruments on the Centers for Disease Control and Prevention (CDC) website.

If a child shows developmental differences in behavior or functioning during this screening process, the health care provider may refer the child for additional evaluation.

Stage 2: Additional Diagnostic Evaluation

It is important to accurately detect and diagnose children with ASD as early as possible, as this will shed light on their unique strengths and challenges. Early detection also can help caregivers determine which services, educational programs, and behavioral therapies are most likely to be helpful for their child.

A team of health care providers who have experience diagnosing ASD will conduct the diagnostic evaluation. This team may include child neurologists, developmental pediatricians, speech-language pathologists, child psychologists and psychiatrists, educational specialists, and occupational therapists.

The diagnostic evaluation is likely to include:

Medical and neurological examinations

Assessment of the child's cognitive abilities

Assessment of the child's language abilities

Observation of the child's behavior

An in-depth conversation with the child's caregivers about the child's behavior and development

Assessment of age-appropriate skills needed to complete daily activities independently, such as eating, dressing, and toileting

Because ASD is a complex disorder that sometimes occurs with other illnesses or learning disorders, the comprehensive evaluation may include:

The outcome of the evaluation may result in a formal diagnosis and recommendations for treatment.

Diagnosis in older children and adolescents

Caregivers and teachers are often the first to recognize ASD symptoms in older children and adolescents who attend school. The school's special education team may perform an initial evaluation and then recommend that a child undergo additional evaluation with their primary health care provider or a health care provider who specialize in ASD.

A child's caregivers may talk with these health care providers about their child's social difficulties, including problems with subtle communication. These subtle communication differences may include problems understanding tone of voice, facial expressions, or body language. Older children and adolescents may have trouble understanding figures of speech, humor, or sarcasm. They also may have trouble forming friendships with peers.

Diagnosis in adults

Diagnosing ASD in adults is often more difficult than diagnosing ASD in children. In adults, some ASD symptoms can overlap with symptoms of other mental health disorders, such as anxiety disorder or attention-deficit/hyperactivity disorder (ADHD).

Adults who notice the signs and symptoms of ASD should talk with a health care provider and ask for a referral for an ASD evaluation. Although evaluation for ASD in adults is still being refined, adults can be referred to a neuropsychologist, psychologist, or psychiatrist who has experience with ASD. The expert will ask about:

Social interaction and communication challenges

Sensory issues

Repetitive behaviors

Restricted interests

The evaluation also may include a conversation with caregivers or other family members to learn about the person's early developmental history, which can help ensure an accurate diagnosis.

Obtaining a correct diagnosis of ASD as an adult can help a person understand past challenges, identify personal strengths, and find the right kind of help. Studies are underway to determine the types of services and supports that are most helpful for improving the functioning and community integration of autistic transition-age youth and adults.

Treatments and Therapies

Treatment for ASD should begin as soon as possible after diagnosis. Early treatment for ASD is important as proper care and services can reduce individuals' difficulties while helping them learn new skills and build on their strengths.

People with ASD may face a wide range of issues, which means that there is no single best treatment for ASD. Working closely with a health care provider is an important part of finding the right combination of treatment and services.

Medication

A health care provider may prescribe medication to treat specific symptoms. With medication, a person with ASD may have fewer problems with:

Irritability

Aggression

Repetitive behavior

Hyperactivity

Attention problems

Anxiety and depression

Read more about the latest medication warnings, patient medication guides, and information on newly approved medications at the Food and Drug Administration (FDA) website.
Behavioral, psychological, and educational interventions

People with ASD may be referred to a health care provider who specializes in providing behavioral, psychological, educational, or skill-building interventions. These programs are typically highly structured and intensive, and they may involve caregivers, siblings, and other family members. These programs may help people with ASD:

Learn social, communication, and language skills

Reduce behaviors that interfere with daily functioning

Increase or build upon strengths

Learn life skills necessary for living independently

Other resources

Many services, programs, and other resources are available to help people with ASD. Here are some tips for finding these additional services:

Contact your health care provider, local health department, school, or autism advocacy group to learn about special programs or local resources.

Find an autism support group. Sharing information and experiences can help people with ASD and their caregivers learn about treatment options and ASD-related programs.

Record conversations and meetings with health care providers and teachers. This information helps when it's time to decide which programs and services are appropriate.

Keep copies of health care reports and evaluations. This information may help people with ASD qualify for special programs.

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Last Reviewed: March 2022
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Autism spectrum disorder (ASD) is a neurological and developmental disorder that affects how people interact with others, communicate, learn, and behave. Although autism can be diagnosed at any age, it is described as a "developmental disorder" because symptoms generally appear in the first two years of life.

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Types of Treatments

There are many types of treatments available. These treatments generally can be broken down into the following categories, although some treatments involve more than one approach:

Behavioral approaches

Behavioral approaches focus on changing behaviors by understanding what happens before and after the behavior. Behavioral approaches have the most evidence for treating symptoms of ASD. They have become widely accepted among educators and healthcare professionals and are used in many schools and treatment clinics. A notable behavioral treatment for people with ASD is called applied behavior analysis (ABA). ABA encourages desired behaviors and discourages undesired behaviors to improve a variety of skills. Progress is tracked and measured.

Two ABA teaching styles are discrete trial training (DTT) and pivotal response training (PRT).

DTT uses step-by-step instructions to teach a desired behavior or response. Lessons are broken down into their simplest parts, and desired answers and behaviors are rewarded. Undesired answers and behaviors are ignored.

PRT takes place in a natural setting rather than clinic setting. The goal of PRT is to improve a few "pivotal skills" that will help the person learn many other skills. One example of a pivotal skill is being able to initiate communication with others.

Developmental approaches

Developmental approaches focus on improving specific developmental skills, such as language skills or physical skills, or a broader range of interconnected developmental abilities. Developmental approaches are often combined with behavioral approaches.

The most common developmental therapy for people with ASD is speech and language therapy. Speech and language therapy helps to improve the person's understanding and use of speech and language. Some people with ASD communicate verbally. Others may communicate through the use of signs, gestures, pictures, or an electronic communication device.

Occupational therapy teaches skills that help the person live as independently as possible. Skills may include dressing, eating, bathing, and relating to people. Occupational therapy can also include

Sensory integration therapy to help improve responses to sensory input that may be restrictive or overwhelming.

Physical therapy can help improve physical skills, such as fine movements of the fingers or larger movements of the trunk and body.

The Early Start Denver Model (ESDM) is a broad developmental approach based on the principles of ABA. It is used with children 12-48 months of age. Parents and therapists use play, social exchanges, and shared attention in natural settings to improve language, social, and learning skills.

Educational approaches

Educational treatments are given in a classroom setting. One type of educational approach is the Treatment and Education of Autistic and Related Communication-Handicapped Children (TEACCH) approach. TEACCH is based on the idea that people with autism thrive on consistency and visual learning. It provides teachers with ways to adjust the classroom structure and improve academic and other outcomes. For example, daily routines can be written or drawn and placed in clear sight. Boundaries can be set around learning stations. Verbal instructions can be complemented with visual instructions or physical demonstrations.

Social-relational approaches

Social-relational treatments focus on improving social skills and building emotional bonds. Some social-relational approaches involve parents or peer mentors.

The Developmental, Individual Differences, Relationship-Based model (also called DIR or "Floor Time") encourages parents and therapists to follow the interests of the individual to expand opportunities for communication.

The Relationship Development Intervention (RDI) model involves activities that increase motivation, interest, and abilities to participate in shared social interactions.

Social Stories provide simple descriptions of what to expect in a social situation.

Social skills groups provide opportunities for people with ASD to practice social skills in a structured environment.

Pharmacological approaches

Important to know‎

Some medications treat co-occurring symptoms (those that happen along with ASD) and can help people with ASD function better. For example, medication might help manage high energy levels, inability to focus, or self-harming behavior, such as head banging or hand biting. Medication can also help manage co-occurring psychological conditions, such as anxiety or depression, in addition to medical conditions such as seizures, sleep problems, or stomach or other gastrointestinal problems.

It is important to work with a doctor who has experience in treating people with ASD when considering the use of medication. This applies to both prescription medication and over-the-counter medication. Individuals, families, and doctors must work together to monitor progress and reactions to be sure any negative side effects of the medication do not outweigh the benefits.

Psychological approaches

Psychological approaches can help people with ASD cope with anxiety, depression, and other mental health issues. Cognitive-behavior therapy (CBT) is one psychological approach that focuses on learning the connections between thoughts, feelings, and behaviors. During CBT, a therapist and the individual work together to identify goals and then change how the person thinks about a situation to change how they react to the situation.

Complementary and alternative treatments

Some people with ASD and their families use treatments that do not fit into any of the other categories. These treatments are known as complementary and alternative treatments. Complementary and alternative treatments are often used to supplement more traditional approaches. They might include special diets, herbal supplements, chiropractic care, animal therapy, arts therapy, mindfulness, or relaxation therapies. Individuals and families should always talk to their doctor before starting a complementary and alternative treatment.

Additional ASD Treatment Options‎

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Treatment and Intervention for Autism Spectrum Disorder

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Treatment and intervention information for people with autism spectrum disorder (ASD).

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Overview

Autism spectrum disorder is a condition related to brain development that impacts how a person perceives and socializes with others, causing problems in social interaction and communication. The disorder also includes limited and repetitive patterns of behavior. The term "spectrum" in autism spectrum disorder refers to the wide range of symptoms and severity.

Autism spectrum disorder includes conditions that were previously considered separate - autism, Asperger's syndrome, childhood disintegrative disorder and an unspecified form of pervasive developmental disorder. Some people still use the term "Asperger's syndrome," which is generally thought to be at the mild end of autism spectrum disorder.

Autism spectrum disorder begins in early childhood and eventually causes problems functioning in society - socially, in school and at work, for example. Often children show symptoms of autism within the first year. A small number of children appear to develop normally in the first year, and then go through a period of regression between 18 and 24 months of age when they develop autism symptoms.

While there is no cure for autism spectrum disorder, intensive, early treatment can make a big difference in the lives of many children.

Symptoms

Some children show signs of autism spectrum disorder in early infancy, such as reduced eye contact, lack of response to their name or indifference to caregivers. Other children may develop normally for the first few months or years of life, but then suddenly become withdrawn or aggressive or lose language skills they've already acquired. Signs usually are seen by age 2 years.

Each child with autism spectrum disorder is likely to have a unique pattern of behavior and level of severity - from low functioning to high functioning.

Some children with autism spectrum disorder have difficulty learning, and some have signs of lower than normal intelligence. Other children with the disorder have normal to high intelligence - they learn quickly, yet have trouble communicating and applying what they know in everyday life and adjusting to social situations.

Because of the unique mixture of symptoms in each child, severity can sometimes be difficult to determine. It's generally based on the level of impairments and how they impact the ability to function.

Below are some common signs shown by people who have autism spectrum disorder.

Social communication and interaction

A child or adult with autism spectrum disorder may have problems with social interaction and communication skills, including any of these signs:

Fails to respond to his or her name or appears not to hear you at times

Resists cuddling and holding, and seems to prefer playing alone, retreating into his or her own world

Has poor eye contact and lacks facial expression

Doesn't speak or has delayed speech, or loses previous ability to say words or sentences

Can't start a conversation or keep one going, or only starts one to make requests or label items

Speaks with an abnormal tone or rhythm and may use a singsong voice or robot-like speech

Repeats words or phrases verbatim, but doesn't understand how to use them

Doesn't appear to understand simple questions or directions

Doesn't express emotions or feelings and appears unaware of others' feelings

Doesn't point at or bring objects to share interest

Inappropriately approaches a social interaction by being passive, aggressive or disruptive

Has difficulty recognizing nonverbal cues, such as interpreting other people's facial expressions, body postures or tone of voice

Patterns of behavior

A child or adult with autism spectrum disorder may have limited, repetitive patterns of behavior, interests or activities, including any of these signs:

Performs repetitive movements, such as rocking, spinning or hand flapping

Performs activities that could cause self-harm, such as biting or head-banging

Develops specific routines or rituals and becomes disturbed at the slightest change

Has problems with coordination or has odd movement patterns, such as clumsiness or walking on toes, and has odd, stiff or exaggerated body language

Is fascinated by details of an object, such as the spinning wheels of a toy car, but doesn't understand the overall purpose or function of the object

Is unusually sensitive to light, sound or touch, yet may be indifferent to pain or temperature

Doesn't engage in imitative or make-believe play

Fixates on an object or activity with abnormal intensity or focus

Has specific food preferences, such as eating only a few foods, or refusing foods with a certain texture

As they mature, some children with autism spectrum disorder become more engaged with others and show fewer disturbances in behavior. Some, usually those with the least severe problems, eventually may lead normal or near-normal lives. Others, however, continue to have difficulty with language or social skills, and the teen years can bring worse behavioral and emotional problems.

When to see a doctor

Babies develop at their own pace, and many don't follow exact timelines found in some parenting books. But children with autism spectrum disorder usually show some signs of delayed development before age 2 years.

If you're concerned about your child's development or you suspect that your child may have autism spectrum disorder, discuss your concerns with your doctor. The symptoms associated with the disorder can also be linked with other developmental disorders.

Signs of autism spectrum disorder often appear early in development when there are obvious delays in language skills and social interactions. Your doctor may recommend developmental tests to identify if your child has delays in cognitive, language and social skills, if your child:

Doesn't respond with a smile or happy expression by 6 months

Doesn't mimic sounds or facial expressions by 9 months

Doesn't babble or coo by 12 months

Doesn't gesture - such as point or wave - by 14 months

Doesn't say single words by 16 months

Doesn't play "make-believe" or pretend by 18 months

Doesn't say two-word phrases by 24 months

Loses language skills or social skills at any age

Causes

Autism spectrum disorder has no single known cause. Given the complexity of the disorder, and the fact that symptoms and severity vary, there are probably many causes. Both genetics and environment may play a role.

Genetics. Several different genes appear to be involved in autism spectrum disorder. For some children, autism spectrum disorder can be associated with a genetic disorder, such as Rett syndrome or fragile X syndrome. For other children, genetic changes (mutations) may increase the risk of autism spectrum disorder. Still other genes may affect brain development or the way that brain cells communicate, or they may determine the severity of symptoms. Some genetic mutations seem to be inherited, while others occur spontaneously.

Environmental factors. Researchers are currently exploring whether factors such as viral infections, medications or complications during pregnancy, or air pollutants play a role in triggering autism spectrum disorder.

No link between vaccines and autism spectrum disorder

One of the greatest controversies in autism spectrum disorder centers on whether a link exists between the disorder and childhood vaccines. Despite extensive research, no reliable study has shown a link between autism spectrum disorder and any vaccines. In fact, the original study that ignited the debate years ago has been retracted due to poor design and questionable research methods.

Avoiding childhood vaccinations can place your child and others in danger of catching and spreading serious diseases, including whooping cough (pertussis), measles or mumps.

Risk factors

The number of children diagnosed with autism spectrum disorder is rising. It's not clear whether this is due to better detection and reporting or a real increase in the number of cases, or both.

Autism spectrum disorder affects children of all races and nationalities, but certain factors increase a child's risk. These may include:

Your child's sex. Boys are about four times more likely to develop autism spectrum disorder than girls are.

Family history. Families who have one child with autism spectrum disorder have an increased risk of having another child with the disorder. It's also not uncommon for parents or relatives of a child with autism spectrum disorder to have minor problems with social or communication skills themselves or to engage in certain behaviors typical of the disorder.

Other disorders. Children with certain medical conditions have a higher than normal risk of autism spectrum disorder or autism-like symptoms. Examples include fragile X syndrome, an inherited disorder that causes intellectual problems; tuberous sclerosis, a condition in which benign tumors develop in the brain; and Rett syndrome, a genetic condition occurring almost exclusively in girls, which causes slowing of head growth, intellectual disability and loss of purposeful hand use.

Extremely preterm babies. Babies born before 26 weeks of gestation may have a greater risk of autism spectrum disorder.

Parents' ages. There may be a connection between children born to older parents and autism spectrum disorder, but more research is necessary to establish this link.

Complications

Problems with social interactions, communication and behavior can lead to:

Problems in school and with successful learning

Employment problems

Inability to live independently

Social isolation

Stress within the family

Victimization and being bullied

Prevention

There's no way to prevent autism spectrum disorder, but there are treatment options. Early diagnosis and intervention is most helpful and can improve behavior, skills and language development. However, intervention is helpful at any age. Though children usually don't outgrow autism spectrum disorder symptoms, they may learn to function well.

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Autism spectrum disorder - Symptoms and causes

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Autism spectrum disorder is a serious condition related to brain development that impairs the ability to communicate and interact with others.

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The latest data on autism spectrum disorder (ASD) from CDC's Autism and Developmental Disabilities Monitoring (ADDM) Network.

Prevalence of ASD

About 1 in 36 children has been identified with autism spectrum disorder (ASD) according to estimates from CDC's Autism and Developmental Disabilities Monitoring (ADDM) Network. [Read Article]

ASD is reported to occur in all racial, ethnic, and socioeconomic groups. [Read Article]

ASD is nearly 4 times more common among boys than among girls. [Read Article]

About 1 in 6 (17%) children aged 3-17 years were diagnosed with a developmental disability, as reported by parents, during a study period of 2009-2017. These included autism, attention-deficit/hyperactivity disorder, blindness, and cerebral palsy, among others. [Read Summary]

What Is Prevalence?‎

Prevalence is the number of people in a population that have a condition, relative to all the people in the population. Prevalence is typically shown as a percentage (such as 1%) or a proportion (such as 1 in 100).

Identified prevalence of ASD

ADDM Network 2000-2020: Combining data from all sites

Surveillance Year

Birth Year

Number of ADDM Sites Reporting

Combined Prevalence per 1,000 Children (Range Across ADDM Sites)

This is about 1 in X children

CDC's 2023 Community Report on Autism

CDC's 2023 Community Report on Autism provides summaries of the latest ADDM data:

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Data and Statistics on Autism Spectrum Disorder

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Summary and table of prevalence of autism spectrum disorder (ASD) in United States children and adol

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There is currently no one standard treatment for autism spectrum disorder (ASD).

Many people with ASD benefit from treatment, no matter how old they are when they are diagnosed. People of all ages, at all levels of ability, can often improve after well-designed interventions.

But there are many ways to help minimize the symptoms and maximize abilities. People who have ASD have the best chance of using all of their abilities and skills if they receive appropriate therapies and interventions.

The most effective therapies and interventions are often different for each person. However, most people with ASD respond best to highly structured and specialized programs. In some cases, treatment can greatly reduce symptoms and help people with autism with daily activities.

Research shows that early diagnosis and interventions, such as during preschool or before, are more likely to have major positive effects on symptoms and later skills. Read more about early interventions for autism.

Because there can be overlap in symptoms between ASD and other disorders, such as attention deficit hyperactivity disorder (ADHD), it's important that treatment focus on a person's specific needs, rather than the diagnostic label.

Select the links for more information on each type of treatment for ASD.

If you have a question about treatment, talk to a health care provider who specializes in caring for people with ASD. These resources have more information about treatments for autism:

Citations

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There is currently no one standard treatment for autism spectrum disorder (ASD).

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Words of wisdom from other parents

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Support for Family Members | Autism Speaks

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Click here for Autism Speaks resources that will help support family and friends of children and adults with autism during the ups, downs and in between.

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Make a picture-based schedule of the day's activities and post it where all of the children can easily check it throughout the day.

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Accreditation Standard 3: Teaching

Teachers who purposefully use multiple instructional approaches optimize children's opportunities for learning. Children arrive in preschool with different backgrounds, interests, experiences, and abilities. By considering these differences, teachers are better able to meet each child's needs and help all children learn. This article supports standard 3 by sharing instructional supports for children with autism spectrum disorder.

Michael is 3 years old and was recently diagnosed with autism spectrum disorder (ASD). His mother became worried when he was 18 months old because he wasn't talking, but the pediatrician told her not to worry-boys talk late. However, the more time she and Michael spent with other families, the more her concerns grew. In particular, when they went to their neighborhood play group for toddlers, Michael's mother noticed that Michael seemed noticeably different from the other children his age.

By age 3, the pediatrician shared Michael's mother's concerns and suggested she contact her local Child Find department. Michael's mother had never heard of Child Find, so she was surprised to learn that this service is available across the country. It's required by federal law that all public school districts have processes for identifying, and then offering services to, children who have disabilities. If only she had known about Child Find when Michael was just a year old!

Through Child Find, Michael was diagnosed and placed in an integrated preschool classroom that had a mix of children with and without disabilities. Although Michael said only a few words to communicte, he could sing entire songs and recite lines from TV shows and movies.

The first few weeks in preschool presented challenges. Michael didn't understand what he was supposed to be doing, where in the classroom he was supposed to be, or how to do the activities the other children were doing. As his teacher saw how much trouble Michael was having, she began to develop a number of visual supports she thought would make it easier for Michael to participate in the life of the classroom.

What are visual supports?

Children with ASD usually have difficulty understanding language that they hear. When they listen to others speaking, they may not be able to keep up: by the time they understand the beginning of the first sentence, the speaker may be on to the fifth sentence. A child with ASD may be trying to listen but still miss most of what is being said.

In contrast, many children with ASD have strengths in processing information visually and in thinking spatially. In the classroom, communicating visually can make a big difference. (This is not to say that verbal communication should stop-children with ASD still need opportunities to develop their language skills.) Visual supports come in many forms: pictures, objects, gestures, and text (once children can read). Images found online, labels from packaging, pictures in catalogs, or software developed specifically for children with ASD are all possible sources of visual supports. Basically, anything informative that children with ASD can see may be considered a visual support.

Autism, or autism spectrum disorder (ASD), is a developmental disability that can generally be diagnosed between 18 months and 3 years of age. Indicators that an evaluation should be done include social interaction and communication differences like little eye contact, lack of shared attention and enjoyment, and an absence of interest in playing with other children. Some children with ASD may be nonverbal, while others may talk in scripted language or echo what they have just heard. Children with ASD may have very strong interests in one particular toy or type of toy (Thomas the Tank Engine, dinosaurs), or they may use toys differently than other children (spinning the wheels on a car with their fingers for long periods of time). Small changes in the environment may make them very upset. ASD has been increasing rapidly, with a current prevalence rate of 1:59. The ratio of boys to girls diagnosed with ASD is 4.5:1.

Using visual supports: Six strategies

1. Tell a child where to sit or stand. Placing markers on the floor to show where to stand when lining up or having a marker on the table or chair showing where to sit lets children with ASD know where they are supposed to be. Carpet squares or classroom rugs with defined seating areas serve the same purpose. You can also tape a line in hallways to help direct children.

2. Show the schedule of classroom activities. Many teachers make a picture-based schedule of the day's activities and post it where all of the children can easily check it throughout the day. For children with ASD, it may be helpful to have their own individual schedules that they can manipulate. Providing one picture for each activity and lining them up vertically make it easier for many children with ASD to know what's happening throughout the day.

Some children do better if they carry the picture representing an activity with them to the activity area and check in. Other children prefer to turn the picture over and then make their way to the appropriate area.

If you have a child who needs even more support, you can make detailed schedules for what will happen within each activity. For circle time, you might make a short schedule showing a song, read aloud, and any other activities you have planned. These schedules may also depict tasks to be accomplished, such as playing hopscotch or walking and crawling like different animals during gross motor time.

3. Support understanding what you are saying. Often, when teachers give verbal directions, children with ASD may not respond. You might feel that a child is being willfully disobedient, but the child might not understand you. Having pictures to accompany your verbal directions can help. If a child with ASD appears distressed, try using a visual guide instead of a verbal one (since hearing even more hard-to-understand words may increase the child's frustration). To support children with ASD in group activities, you may find it helpful to show a large picture of "sit down" or "be quiet," or to have a set of pictures on a lanyard you can show to individual children when necessary.

4. Help a child develop self-regulation. To foster children's social and emotional development, teachers often share-and have children practice-strategies for calming down, like breathing deeply or going to a cozy nook in the room. For children with ASD, visual explanations and reminders of these strategies can help them self-regulate, especially when they are beginning to become upset. Showing a picture of a person taking a deep breath or squeezing his or her hands together provides a model that is easier to understand than a verbal direction.

Self-regulation skills for positive emotions (like being excited) need to be taught too. For example, a five-point scale for voice level can be represented visually so all the children know when they are using an outside voice or an inside one.

5. Foster independence. Visually presenting the steps to complete a task encourages children to be independent. For example, you could list the steps for brushing your teeth, washing your hands, and using the bathroom; select a picture to represent each step; and post these guides in the appropriate areas of the bathroom. Functional routines, like hanging up coats, can also be represented with pictures.

Another use of visual supports is to put photos of toys and other classroom materials on the shelves where they belong so children can clean up without assistance, enabling children to be independent in this classroom task. Sometimes, taking the adult who is providing verbal directions out of the situation results in the child with ASD being more willing and able to follow directions.

6. Expand the use of expressive language. Children with ASD often have difficulty expressing themselves verbally. Providing pictures that support communication-such as single pictures for children who are beginning to communicate either verbally or nonverbally and language expansion boards for more skilled children-will encourage them to use words expressively, either with or without speech. Handing a picture to a conversational partner or pointing to a picture to show something to a teacher or peer serves as intentional communication for a child who is nonverbal. This boosts understanding between the teacher and the child. In addition, increasing the child's ability to communicate often decreases challenging behavior.

Similarly, giving children choices often reduces inappropriate behavior-and giving children with ASD visuals for making choices can be very helpful. For children who are not able to understand two-dimensional pictures, the actual objects can be presented. (While this is not always feasible, it can be done at key times, like when helping a child decide whether to go to the block center or to the light table.)

Revisiting Michael's classroom

The first thing Michael's teacher did to help him adjust to the classroom was to create an individual schedule for him by velcroing a picture of each activity to a long, vertical piece of felt. His schedule ended with a photo of his mother, which was comforting to him and also reassured him that she would pick him up at the end of the day.

The schedule made it easier for Michael to navigate the classroom throughout the day's activities. As part of his transition between activities, he carried the appropriate picture and checked in to the area he was assigned to. Since Michael could see when the end of the day was coming, he stopped asking for his mother throughout the day. Michael's teacher also created visuals to show the tasks within each activity and to show the steps for functional routines, like washing hands before snack time.

After working with Michael for a couple of weeks to understand his current communication skills and to get to know his interests, Michael's teacher developed a communication board for him to ask for preferred items and to express "no" when he didn't want something. She labeled his cubby, his chair at the group table, his work area, and his spot on the carpet so that he could rely on visual instead of verbal reminders. All of these visual supports helped Michael adjust to his new classroom and enabled him to participate in each day's activities without feeling stressed or overwhelmed by his teacher's verbal directions.

Selected Accreditation Assessment Items Related to Teaching Children with Autism

3A.3 Show or describe two ways in which teaching staff, program staff, and/or consultants work as a team to implement individualized plans for children. Such plans may include any Individualized Family Service Plans (IFSPs) and Individualized Education Programs (IEPs).

3B.2 When a child's ongoing challenging behavior must be addressed, show a written policy including these steps:

Assess the function of the behavior

Work with families and professionals to develop an individualized plan to address the behavior

Include positive behavior support strategies as part of the plan

3E.7 Teachers sometimes customize learning experiences, based on their knowledge of the children's social relationships.

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Support You Can See (and Feel): Teaching Children with Autism

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Accreditation Standard 3: Teaching Teachers who purposefully use multiple instructional approaches optimize children's opportunities for learning. Children arrive in preschool with different backgrounds, interests, experiences, and abilities. By considering these differences, teachers are better able to meet each child's needs and help all children learn.

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"What is ASD?" This is one of the most controversial topics at hand and with due rights. ASD is constantly changing and evolving to include more and more "disorders" in what seems like a daily basis. The ASD umbrella has been jam packed with more and more clinical disorders that health professionals see fits best under this category that it has sent the total numbers of individuals with an Autism Spectrum Disorder sky rocketing to astronomical highs. By doing so it has sent many into a state of fear of sorts of the individuals on the spectrum and in many cases caused undo criticisms towards these individuals. Even with all of the opinions and expertise going around, the underlying question still exists. "What is ASD?" We will give you the clinical definition set forth by the CDC, but the real purpose for this blog is to let the people be heard. This site is about letting all speak on the matter so we can as a community create an answer to this question that seems to go in so many directions. To try to minimalize any fears surrounding this question or the individuals it involves. So please, we invite everyone to get involved so we can all read the opinions that surround this question. We look forward to reading every persons response on this topic.

CDC definition: Autism spectrum disorder (ASD) is a developmental disability that can cause significant social, communication and behavioral challenges. There is often nothing about how people with ASD look that sets them apart from other people, but people with ASD may communicate, interact, behave, and learn in ways that are different from most other people. The learning, thinking, and problem-solving abilities of people with ASD can range from gifted to severely challenged. Some people with ASD need a lot of help in their daily lives; others need less.

A diagnosis of ASD now includes several conditions that used to be diagnosed separately: autistic disorder, pervasive developmental disorder not otherwise specified (PDD-NOS), and Asperger syndrome. These conditions are now all called autism spectrum disorder.

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What is ASD? - ASK: Advocates for Spectrum Knowledge

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"What is ASD?" This is one of the most controversial topics at hand and with due rights. ASD is constantly changing and evolving to include more and more "disorders" in what seems like a daily basis.

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Academic supports are never one-size-fits all. Teachers can best support autistic students when they have a range of strategies to choose from. As a general principle, interventions that provide predictability, support, and empowerment, while also reducing anxiety and building on strengths, are effective. When applied in the classroom, such interventions enable autistic students to best demonstrate what they know. These eight strategies put this principle into practice. For teachers who will be working with autistic students this fall, read on to learn more about these approaches and find a handy infographic to use as a guide!

1. Priming

Priming is a method of preparing autistic students for an activity that they will be expected to complete by allowing them to preview the activity beforehand. Priming sets the student up for success by providing them predictability, which also reduces anxiety. During priming, the student previews the materials that will be used in an upcoming activity, such as a worksheet, outline for a project, or schedule of events that will occur. Priming is not a time for teaching or reviewing the content of an activity or having the student actually complete the activity. Priming should occur in short, concise time periods in an environment that is relaxing for the autistic student, and it should be led by a person who is patient and supportive. When priming is effective, it reduces barriers for the student and enables them to fully engage in the activity when the time comes.

2. Making accommodations and modifications

Many autistic students require assignment accommodations and modifications in order to be successful at school. Modifying assignments can be accomplished easily without drawing undue attention to the student. The particular modifications may differ based on individual students' strengths and needs, but some examples of modifications include:

Reformatting assignments to distinguish relevant details from irrelevant details

Grouping like questions together on quizzes and tests

Allowing additional time for the student to complete tasks

Allowing the student to use alternative methods to demonstrate understanding (oral vs. written report, creating a pamphlet or PowerPoint presentation, etc.)

Shortening tasks or reducing the number of tasks the student is expected to complete

Outlining precisely what information the student is expected to learn from reading

Providing graphic organizers and concrete strategies for assignments

Giving the student a model to follow of what is expected on assignments

Providing pre-highlighted texts and/or study guides

Identifying the information that the student will be responsible for on upcoming tests

Sharing a model of what is expected on assignments or a list of grading criteria

Modifications and accommodations like these do not excuse the autistic student from completing their work or diminish the academic rigor. Rather, they are designed to give the student access to the content and/or skill at the center of the assignments.

3. Visual supports

Visual supports help autistic students focus on the task at hand by providing clarity, supporting focus, and providing predictability. Some visual supports include image-based information. Other visual supports provide written versions of information that is otherwise either implied or conveyed through speech only. Depending on the type of support, visual supports can help autistic students understand "hidden" school rules and expectations as well as supporting those who experience challenges with auditory processing or executive function. Using additional visual strategies, such as color-coding, can help make the information even more clear. Some examples of visual supports include:

Map of school outlining the student's classes

List of classes, room numbers, books, and other supplies needed

List of teacher's expectations and routines for each class

Schedule of activities within the class

Sample models of assignments, with important requirements demarcated

List of test reminders

List of schedule changes

List of homework assignments

4. Home base

A home base is a place where an autistic student can go to plan or review daily events, regain control and calm after a meltdown, and/or escape the stress of the current environment. It can be located at home or at school. It is important that the student perceives home base as a positive and reassuring environment. For some students, it may be necessary to schedule the use of home base as a regular part of the day. For example, at the beginning of the day, home base can serve to preview the day's schedule, introduce and get familiar with changes in the typical routine, ensure that materials are organized, or prime the student for specific subjects. Home base is also effective when scheduled after a particularly stressful activity or task. Home base may contain items determined to help facilitate self-calming, such as a bean bag chair, weighted blanket or vest, or mini-trampoline. Home base is never to be used as a punishment, a timeout, or an escape from tasks and activities.

5. Handwriting modifications

Fine motor skills, such as handwriting, are a challenge for many autistic people. Teachers must take this into consideration and make appropriate accommodations for autistic students. Examples of accommodations include:

Asking a student to only write key words in response to a question, rather than complete sentences. (Some autistic students may not respond well to this accommodation, as it breaks grammatical rules.)

Modifying assignments and tests to incorporate multiple-choice, fill-in-the-blank, matching, and/or short-answer questions, rather than essay questions

Letting the student underline or highlight answers to questions within a reading passage, rather than having to write out the answers

Allowing the student to use a computer or smart device to type information, rather than writing it by hand

Permitting the student to verbally express information and tape record it, rather than writing it by hand

Allowing the student to state information to a scribe, such as a peer, aide, etc.

Supplying the student with a teacher-made outline of main ideas and key points from readings and/or presentations

6. Choice-making

Choice-making is a strategy in which small choices and decisions are embedded into daily routines and activities. This strategy allows autistic students to have some control over events in their life. While this is important for everyone, it can be particularly beneficial for autistic students because it provides predictability and agency. Many opportunities are available throughout the day to give autistic students choices. Choice-making does not mean that a student gets to decide if they want to complete an assignment. Rather, it gives student control over other aspects of the learning process. For example, the student could choose what color pen or pencil to use when completing the assignment. However, when providing choices, it is important to keep the individual student in mind. Sometimes, students who usually have the ability to make choices cannot do so under stressful situations or if the choices are not appealing to them. In these cases, offering choices could inadvertently increase stress instead of benefiting the student.

7. Incorporation of special interests

Many autistic individuals have specific topics or subject areas that they are particularly interested in. Autistic students tend to enjoy learning more about their special interests and are motivated by them. Incorporating these special interests into the autistic student's curriculum is one way of making tasks interesting when they may initially seem overwhelming or meaningless. Of course, based on the curriculum, it is not always possible for teachers to incorporate a student's special interest in this way. But when it is possible and when it can facilitate a student's ability to learn a new concept, teachers can consider opportunities to incorporate this strategy into a lesson or activity.

8. Homework considerations

Homework may present major concerns to autistic students. For example:

Homework often requires handwriting, which can be cognitively and physically challenging for autistic students.

Many autistic students have to work hard to remain emotionally composed throughout the school day and, therefore, arrive home exhausted. These students may need their afternoons and evenings to relax and recharge without additional demands.

Autistic students may have additional activities in the afternoons or evenings, such as attending social skills groups.

As a result, homework should be considered on an individual basis for each student, and any decision should incorporate the student, school team and additional service providers, and parents. Teachers can consider whether homework should be assigned, completed during a designated time during the school day, waived, and/or modified. Teachers should also consider how they can make assignments more accessible for the autistic student.
These strategies are adapted from An Educator's Guide to ASD (Level 1 Supports) . This guide and other guides for educators may be downloaded for free from our Resources page. Educators may also order up to two physical copies of each guidebook for free from our Store.

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8 Academic Supports for Autistic Students | OAR

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Academic supports are never one-size-fits all. Teachers can best support autistic students when they have a range of strategies to choose from. As a general principle, interventions that provide predictability, support, and empowerment, while also reducing anxiety and building on strengths, are effective.

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In this episode, we talk about common adjustments teachers can make in the classroom to support autistic students. Autism is a lifelong developmental condition that can affect a student's ability to learn and the rate at which they develop new skills. Autistic students may have repetitive behaviours and experience challenges with sensory issues or social communicationwith possible accompanying intellectual and/or language impairment. Since the condition occurs on a spectrum, students will vary vastly in their strengths and talents.

Year 3 student Christopher discusses how he sometimes has trouble focusing and talks about a supervised 'time out' arrangement that helps him. His mum Claire talks about how anxiety can be one of the biggest factors holding him back. Teacher Helen McLennan says that structure and routine are important to all students, but especially autistic students. Dr Suzanne Carrington explains why it is important to get to know a student's learning strengths and to provide both scaffolding and personalised support.

Consider that some autistic students may not be able to cope in a noisy classroom environment or may have other sensory sensitivities therefore require the implementation of strategies to counteract this such as the use of headphones or by providing a quiet room. When setting classroom activities, think about what you are trying to achieve , and whether the task can be completed in an alternate way.

Discussion starters?

Search "Classroom adjustments" in Apple podcasts This link will open in a new window , Spotify This link will open in a new window , Google podcasts This link will open in a new window or wherever you get your podcasts to listen via your mobile device.

28 minute run time.
Credits Interviewees
Helen McLennan, Inclusion Support Teacher, Fig Tree Pocket State School

Dr Suzanne Carrington, Program Director, Autism Cooperative Research Centre and Assistant Dean (Research), Faculty of Education, Queensland University of Technology

Christopher, Year 3 student

Claire, Christopher's mum
Host/Producer Producer/Audio Engineer Further resources
Find further resources on the website. Download a Autism Spectrum Australia website and the the podcast episode. Autism Aspergers Advocacy Australia transcript This link will open in a new window of

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In this episode, we talk about common adjustments teachers can make in the classroom to support autistic students. Autism is a lifelong developmental condition that can affect a student's ability to learn and the rate at which they develop new skills.

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Setting up your autism classroom correctly can increase skill acquisition and independence and lower stress and anxiety. According to Dr. Lori Ernsperger, an autism specialist with over twenty years of experience, "the best way to make sure your students learn well is to ensure that the physical layout of your classroom is maximized and workstations are clearly delineated."

Creating a well-designed classroom that has clearly defined work stations and visual cues can greatly increase the independence of your students. Make sure you have plenty of visual cues, reduce clutter, and as much as possible remove distracting visuals and auditory stimulation. Here are a few tips to help you set up your classroom from Dr. Ernsperger's book Keys to Success for Teaching Students with Autism.

Pay Special Attention to the Physical Layout
Before you start this process, begin by thinking about the "flow" of your classroom day. Think about the flow of students and staff as they transition around the classroom. Try to decrease waiting times. Furniture arrangement should support both small group and large group instruction and can create physical walkways that can facilitate smooth transitions.

Make sure to:
- Label each workstation, shelves, and cabinets with a picture and the corresponding word.
- Use furniture to partition off specific areas.
- Remove any furniture or materials that are not useful.
- Use colored tape to establish boundaries.

Try to design your class layout according to your class schedule. As you are setting up your classroom, make sure it supports your schedule. For example, an area with a tile floor is more appropriate for snack time rather than language arts.

Keep in Mind Sensory Stimulation
Sensory challenges are common with autistic students; try to minimize sensory stimuli as much as possible. Pay attention to lighting, windows, floor coverings and ceilings. Even small changes like lowering shades and turning down overhead lights can be helpful. Use carpets to reduce noise levels. Face desks away from windows or doors.

Get Rid of the Clutter
Many teachers are collectors once something comes into your classroom it never leaves! Does your classroom have unused furniture, old posters or items that don't serve a specific teaching purpose? If so now is the time to get rid of the clutter. Many students with autism pay attention to details and can miss the big picture. It would be a shame for them to focus on a nonteaching item instead of you. Take a minute, stand in the middle of your classroom and check to see if there are any posters, or items sitting out that don't serve a teaching purpose - if you see something that you will not use get rid of it.

Use Visuals to Increase Independence and Define Spaces
A picture is worth a thousand words - so use them. Label cabinets with words or pictures to visually show students how to put things away. Use a visual schedule to help your student understand the flow of the day. Many students with autism don't understand personal space. Define personal space by drawing masking tape outlines on the floor.

Have a Calm Down Area
Misunderstandings, over stimulation, or communication break downs can easily lead to frustration and even a meltdown. Prepare ahead of time for this by creating a calming area. This could be a desk with dividers by it or a small area in the corner of the classroom with a bean bag chair and some headphones. Ideally this area should have a few calming items your student enjoys and should never be used as a form of punishment. Make sure this area is free of distractions. Once the student is calm, use the break area to teach stress reduction techniques.

Organize Your Desk, Teaching Resources and Data Collection Materials
You must also provide an area for the staff to store their personal belongings, store resource materials, and provide for data collection. Try to reduce the number of teacher desks in the classroom. They often take up a large amount of valuable space; therefore, it is not always feasible for every staff member to have a desk. You may also want to keep personal belongings and unused teaching items in a locked cabinet. Also make sure it is as easy as possible for your staff to collect data. You may consider hanging clipboards on the wall or placing file folders in each of your centers.

For more tips on how to help your autistic students check out Dr. Ernsperger's book for practical guidance on effective classroom environments, curriculum development, instructional strategies, managing problem behaviors, data collection and building effective teams.

For more ideas check out our Teaching Supplies section.

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Set up your classroom to increase understanding, build skills, and support independence.