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1. What is Autism Spectrum Disorder?

Autism Spectrum Disorder (ASD) is a group of complex neurodevelopment disorders caused by differences in the brain that affect communication and behavior.

2. What does the Autism Spectrum mean?

The term “spectrum” refers to the wide range of symptoms, skills, and levels of ability in functioning that can occur in people with ASD. ASD affects every person differently. Individuals can have a few symptoms and characteristics while others have many. Some children and adults with ASD are fully able to perform all activities of daily living and may have gifted learning and cognitive abilities while others require substantial support to perform basic activities.

3. How does an individual obtain a ASD diagnosis?

The DSM-5 lists criterion for an individual to get an Autism diagnosis. Some of the behavioral criteria include: deficits in social communication and social interaction across multiple contexts, restricted, repetitive patterns of behavior, interests, or activities, symptoms must be present in the early developmental period, symptoms must cause clinically significant impairment in social, occupational, or other important areas of current functioning, these disturbances are not better explained by intellectual disability or global developmental. For more specific criterion, a link to the DSM-5 for Autism will be linked below.

4. What are common characteristics of Autism Spectrum Disorder?

Characteristics of individuals with Autism vary greatly. The two main categories of signs and symptoms are social communication/interaction skills and restricted or repetitive behaviors/interests. A few common characteristics of relating to social behavior are:

Avoids or does not keep eye contact.

Does not respond to name by 9 months of age.

Does not show facial expressions like happy, sad, angry, and surprised by 9 months of age.

Does not play simple interactive games by 12 months of age. Ex. Pat-a-cake.

Uses few or no gestures by 12 months of age. Ex. Waving hello or goodbye.

Does not share interests with others by 15 months of age.

Etc.

Some common characteristics of relating to repetitive behaviors are:

Lines up toys or other objects and gets upset when order is changed.

Repeats words or phrases over and over (echolalia).

Plays with toys the same way every time.

Gets upset by minor changes.

Has obsessive interests.

Must follow certain routines.

Flaps hands, rocks body, or spins self in circles.

Has unusual reactions to the way things sound, smell, taste, look, or feel.

Etc.

Other characteristics include:

Delayed language skills.

Delayed movement skills.

Delayed cognitive or learning skills.

Hyperactive, impulsive, and/or inattentive behavior.

Unusual eating and sleeping habits.

Unusual mood or emotional reactions.

Anxiety, stress, or excessive worry.

Etc.

5. At what age is Autism usually diagnosed?

Autism can be diagnosed at any age but characteristics usually begin in early childhood. The American Academy of Pediatrics recommends that all children get screened for developmental delays and behaviors often associated with ASD at 18-24 months.

6. What is the cause of Autism Spectrum Disorder?

Autism can be caused by a genetic disorder, but not always. The cause of Autism is generally unknown.

7. What are possible risk factors of Autism?

There are multiple possible risk factors for Autism including:

Having a sibling with ASD.

Having certain genetic or chromosomal conditions, such as fragile X syndrome or tuberous sclerosis.

Experiencing complications at birth.

Being born to older parents.

8. What is the prevalence of Autism Spectrum Disorder?

~ 1 in 36 children.

4 times more likely to occur in males.

Occurs in all racial, ethnic, and socioeconomic groups.

9. What types of treatment are available for Autism Spectrum Disorder?

Behavioral approaches

Applied Behavior Analysis (ABA)

Developmental approaches

Speech language therapy

Occupational therapy

Physical therapy

Sensory integration therapy

Educational approaches

Special education(TEACCH)

Social-relational approaches

Social skills groups, social stories, etc.

Pharmacological approaches

Psychological approaches

Cognitive-Behavior Therapy (CBT)

10. Types of services available for individuals diagnosed with ASD

From ages 0-3 years old, early intervention services are available. Can be a referred from a physician or parent referral.

From ages 3-22 years old, special education services are available. This is usually through the local public school system.

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Applied Behavior Analysis (ABA)

Based on the science of learning and behavior.

The goal is to increase good behaviors that are helpful decrease behaviors that are harmful or affect learning.

Can be adapted to fit the needs of a specific individual.

Can be done in a variety of environments such as a clinic, school, home, etc.

Focuses on positive reinforcement.

Based off the framework of antecedent, behavior, and consequence.

Can include Discrete Trial Training (DTT) and Pivotal Response Training (PRT).

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Focuses on improving specific developmental skills, such as language skills or physical skills, or a broader range of interconnected developmental abilities. Developmental approaches and behavioral approaches are usually used together.

Speech language therapy

Improves understanding of speech and language.

Improves ability to communicate. This could be verbal communication, gestures, pictures, written, assisted technology devices, etc.

Improves social communication.

Occupational therapy

Teaches physical life skills such as bathing, putting on clothing, eating, making a meal, etc.

Goal is to increase independence.

Sensory Integration therapy

Improves overstimulating sensory input.

Physical therapy

Improves motor skills.

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Special education services

Sensory breaks

Following a schedule

Having a visual schedule available

Breaking down information

Use of a communication device

Use of visuals/multiple modes of exposure to content

Noise cancelling headphones

Fidget toys

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Leifler, E., Carpelan, G., Zakrevska, A., Bölte, S., & Jonsson, U. (2021). Does the learning environment ‘make the grade’? A systematic review of accommodations for children on the autism spectrum in mainstream school. Scandinavian Journal of Occupational Therapy, 28(8), 582–597. https://doi.org/10.1080/11038128.2020.1832145 , https://www.crossrivertherapy.com/autism/accommodations-for-students

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Family involvement is really important when providing intervention for an individual with Autism. Treatment should be child and family focused.

A family with a child diagnosed with Autism can be experiencing many challenges. This is important to keep in mind when working with the family and identifying supports. Parents of children with Autism experience higher divorce rates, higher stress levels, and higher signs of fatigue.

Can recommend family supports such as support groups, online communities, etc.

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Educators should be aware of strategies that increase the likelihood of child success.

Get to know the individual as each diagnosis presents differently.

Create structured environments.

Create social opportunities.

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https://iris.peabody.vanderbilt.edu/module/asd1/#content

https://iris.peabody.vanderbilt.edu/module/asd2/#content

https://www.ninds.nih.gov/health-information/disorders/autism-spectrum-disorder

https://iris.peabody.vanderbilt.edu/wp-content/uploads/pdf_info_briefs/ASD_Comparison_information_brief.pdf

https://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd

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Centers for Disease Control and Prevention

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Autism spectrum disorder (ASD) is a developmental disability caused by differences in the brain. Some people with ASD have a known difference, such as a genetic condition. Other causes are not yet known. Scientists believe there are multiple causes of ASD that act together to change the most common ways people develop. We still have much to learn about these causes and how they impact people with ASD.

People with ASD may behave, communicate, interact, and learn in ways that are different from most other people. There is often nothing about how they look that sets them apart from other people. The abilities of people with ASD can vary significantly. For example, some people with ASD may have advanced conversation skills whereas others may be nonverbal. Some people with ASD need a lot of help in their daily lives; others can work and live with little to no support.

ASD begins before the age of 3 years and can last throughout a person's life, although symptoms may improve over time. Some children show ASD symptoms within the first 12 months of life. In others, symptoms may not show up until 24 months of age or later. Some children with ASD gain new skills and meet developmental milestones until around 18 to 24 months of age, and then they stop gaining new skills or lose the skills they once had.

As children with ASD become adolescents and young adults, they may have difficulties developing and maintaining friendships, communicating with peers and adults, or understanding what behaviors are expected in school or on the job. They may come to the attention of healthcare providers because they also have conditions such as anxiety, depression, or attention-deficit/hyperactivity disorder, which occur more often in people with ASD than in people without ASD.

Signs and Symptoms

People with ASD often have problems with social communication and interaction, and restricted or repetitive behaviors or interests. People with ASD may also have different ways of learning, moving, or paying attention. These characteristics can make life very challenging. It is important to note that some people without ASD might also have some of these symptoms.
Learn more about signs and symptoms of ASD "
Diagnosis

Diagnosing ASD can be difficult since there is no medical test, like a blood test, to diagnose the disorder. Doctors look at the child's behavior and development to make a diagnosis. ASD can sometimes be detected at 18 months of age or younger. By age 2, a diagnosis by an experienced professional can be considered reliable. However, many children do not receive a final diagnosis until they are much older. Some people are not diagnosed until they are adolescents or adults. This delay means that people with ASD might not get the early help they need.
Learn more about screening and diagnosis of ASD "
Treatment

Current treatments for ASD seek to reduce symptoms that interfere with daily functioning and quality of life. ASD affects each person differently, meaning that people with ASD have unique strengths and challenges and different treatment needs. 2 Treatment plans usually involve multiple professionals and are catered to the individual.
Learn about treating the symptoms of ASD "
Risk Factors

There is not just one cause of ASD. There are many different factors that have been identified that may make a child more likely to have ASD, including environmental, biologic, and genetic factors.

Although we know little about specific causes, the available evidence suggests that the following may put children at greater risk for developing ASD:

Having a sibling with ASD

Having certain genetic or chromosomal conditions, such as fragile X syndrome or tuberous sclerosis

Experiencing complications at birth

Being born to older parents

CDC is currently working on one of the largest U.S. studies to date on ASD. This study called the Study to Explore Early Development (SEED), was designed to look at the risk factors and behaviors related with ASD. CDC is now conducting a follow-up study of older children who were enrolled in SEED to determine the health, functioning, and needs of people with ASD and other developmental disabilities as they mature.

How Often ASD Occurs

CDC's Autism and Developmental Disabilities Monitoring (ADDM) Network has been estimating the number of 8-year-old children with ASD in the United States since 2000.

ASD occurs in all racial, ethnic, and socioeconomic groups. It is more than 4 times more common among boys than among girls.
Learn more about how CDC estimates the number of children with ASD "
If You're Concerned

As a parent, you already have what it takes to help your young child learn and grow. CDC has developed materials to help you track your child's developmental milestones and share that progress, or any concerns, with your child's doctor at every check-up.
Learn more about CDC milestone checklists and other parent materials "
Contact your child's doctor if you think your child might have ASD or if you have any other concerns about the way your child plays, learns, speaks, or acts.

If you are still concerned, ask the doctor for a referral to a specialist who can do a more in-depth evaluation of your child. Specialists who can do a more in-depth evaluation and make a diagnosis include

Developmental pediatricians (doctors who have special training in child development and children with special needs)

Child neurologists (doctors who work on the brain, spine, and nerves)

Child psychologists or psychiatrists (doctors who know about the human mind)

At the same time, call your state's public early childhood system to request a free evaluation, sometimes called a Child Find evaluation, to find out if your child qualifies for intervention services. You do not need to wait for a doctor's referral or a medical diagnosis to make this call.

Where to call for a free evaluation from the state depends on your child's age:

If your child is not yet 3 years old, contact your local early intervention system.
You can find the right contact information for your state by calling the Early Childhood Technical Assistance Center (ECTA) at 919-962-2001.

If your child is 3 years old or older, contact your local public school system.

Even if your child is not yet old enough for kindergarten or enrolled in a public school, call your local elementary school or board of education and ask to speak with someone who can help you have your child evaluated.

If you're not sure who to contact, call the ECTA at 919-962-2001.

Research shows that early intervention services can greatly improve a child's development. In order to make sure your child reaches their full potential, it is very important to receive services as soon as possible.

References

1. Lord C, Risi S, DiLavore PS, Shulman C, Thurm A, Pickles A. Autism from 2 to 9 years of age. Arch Gen Psychiatry. 2006 Jun;63(6):694-701.

2. Hyman, S.L., Levy, S.E., Myers, S.M., & AAP Council on Children with Disabilities, Section on developmental and behavioral pediatrics. (2020). Identification, evaluation, and management of children with autism spectrum disorder. Pediatrics, 145(1), e20193447.

3. Handleman, J.S., Harris, S., eds. Preschool Education Programs for Children with Autism (2nd ed). Austin, TX: Pro-Ed. 2000.

4. National Research Council. Educating Children with Autism. Washington, DC: National Academy Press, 2001.

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Basics About Autism Spectrum Disorder (ASD) | NCBDDD | CDC

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Autism Spectrum Disorders (ASDs) are a group of developmental disabilities that can cause significant social, communication and behavioral challenges. CDC is working to find out how many children have ASDs, discover the risk factors, and raise awareness of the signs.

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Anderson, K. A., Cooper, B. P., Orsmond, G. L., Shattuck, P. T., & Sterzing, P. R. (2014). Social participation among young adults with autism spectrum disorder. Journal of Autism and Developmental Disorders, 43(11), 2710-2719. doi: 10.1007/s10803-013-1833-8.

1. The results showed that young adults with ASD were more likely to never see friends, never get phone calls from friends, never be invited to activities, and to be more socially isolated.

2. The rate of being socially isolated in the ASD group was 3-14 times higher than the other three groups .

3. 1/2 to 1/3 of the population having no close friendships, and when friendships do exist, they appear to be less close and supportive than TD young adults.

Clinical Implications:

Creating opportunities for social engagement in the population in adulthood could be beneficial. I could see this being an area that SLP’s can work on with clients.