Autism Spectrum Disorders
No. 11; Updated October 2023
Most infants and young children need and want contact with others to thrive and grow. They smile, cuddle, laugh, and respond eagerly to games like "peek-a-boo" or hide-and-seek. Occasionally, however, a child does not interact in this expected way. Instead, the child seems to exist in his or her own world, a place characterized by needing to repeat routines constantly, odd and peculiar behaviors, problems in communication (both giving and receiving), and a lack of social awareness or interest in other human beings. These are characteristics of a developmental disorder called autism.
Autism can be identified by the time a child is 30 months old. It is often discovered when parents become concerned that their child may be deaf, is not yet talking, talks in an unusual way, stopped talking, resists cuddling, and avoids interaction with others.
Some of the early signs and symptoms which suggest a young child may need further evaluation for autism include:
- no smiling by six months of age
- no back and forth sharing of sounds, smiles or facial expressions by nine months
- not responding when their name is called
- no babbling, pointing, reaching or waving by 12 months of age
- no single words by 16 months of age
- no two word phrases by 24 months of age
- regression in development, loss of developmental milestones
- any loss of speech, babbling or social skills
A preschool age child with "classic" autism is generally withdrawn, aloof, and fails to respond to other people. Some of these children will not even make eye contact. They may also engage in odd or ritualistic behaviors like rocking, hand flapping, or an obsessive need to maintain order.
Many children with autism do not speak at all. Those who do may speak in rhyme, have echolalia (repeating a person's words like an echo), refer to themselves as a "he" or "she," or use peculiar language.
The severity of autism varies widely, from mild to severe. Some children are very bright and do well in school, although they may have problems with school adjustment and making friends. They may be able to live independently when they grow up. Other children with autism function at a much lower level. Intellectual disability may be associated with autism.
Occasionally, a child with autism may display an extraordinary talent in art, music, or another specific area.
The cause of autism remains unknown, although current theories indicate a problem with the function or structure of the central nervous system. What we do know, however, is that parents do not cause autism, and childhood vaccines do not cause autism.
Children with autism need a thorough and complete evaluation and specialized language services, behavioral, and educational programs. Some children with autism may also benefit from treatment with medication. Early identification/diagnosis and proper treatments can help youth with autism tremendously. Child and adolescent psychiatrists are trained to diagnose autism, and to help families design and implement an appropriate treatment plan. They can also help families cope with the stress which may be associated with having a child with autism.
Although there is no cure for autism, appropriate specialized treatment provided early in life can have a positive impact on the child's development and produce an overall reduction in disruptive behaviors and symptoms.
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