About autism

Autism is a brain disorder that is associated with a range of developmental problems, mainly in communication and social interaction. The first signs of this disorder typically appear before age 3. Although treatment has improved greatly in the past few decades, autism cannot be cured. It persists throughout life.

It’s estimated that three to six of every 1,000 children have autism. A recent increase in the number of autism cases in the United States may be the result of improved diagnosis and changes in diagnostic criteria.

The disorder occurs three to four times more often in boys than in girls. The severity of symptoms is variable. Some children with autism will grow up able to live independently, while others may always need supportive living and working environments.

The cause of autism isn’t clear, and there’s no cure. But intensive, early treatment can make a difference.

Symptoms

In general, children with autism have problems in three crucial areas of development — social skills, language and behavior. The most severe autism is marked by a complete inability to communicate or interact with other people.

Because the symptoms of autism vary widely, two children with the same diagnosis may act quite differently and have strikingly different skills.

If your child has autism, he or she may develop normally for the first few months — or years — of life and then later become less responsive to other people, including you. You may recognize the following signs in the areas of social skills, language and behavior:

Social skills

  • Fails to respond to his or her name
  • Has poor eye contact
  • Appears not to hear you at times
  • Resists cuddling and holding
  • Appears unaware of others’ feelings
  • Seems to prefer playing alone — retreats into his or her “own world”

Language

  • Starts talking later than other children
  • Loses previously acquired ability to say words or sentences
  • Does not make eye contact when making requests
  • Speaks with an abnormal tone or rhythm — may use a singsong voice or robot-like speech
  • Can’t start a conversation or keep one going
  • May repeat words or phrases verbatim, but doesn’t understand how to use them

Behavior

  • Performs repetitive movements, such as rocking, spinning or hand-flapping
  • Develops specific routines or rituals
  • Becomes disturbed at the slightest change in routines or rituals
  • Moves constantly
  • May be fascinated by parts of an object, such as the spinning wheels of a toy car
  • May be unusually sensitive to light, sound and touch

Young children with autism also have a hard time sharing experiences with others. When someone reads to them, for example, they’re unlikely to point at pictures in the book. This early-developing social skill is crucial to later language and social development.

As they mature, some children with autism become more engaged with others and show less marked disturbances in behavior. Some, usually those with the least severe impairments, eventually may lead normal or near-normal lives. Others, however, continue to have severe impairments in language or social skills, and the adolescent years can mean a worsening of behavior problems.

The majority of children with autism are slow to acquire new knowledge or skills. However, some children with autism have normal to high intelligence. These children learn quickly yet have trouble communicating, applying what they know in everyday life and adjusting in social situations. An extremely small number of children with autism are “autistic savants” and have exceptional skills in a specific area, such as art or math.

Causes

Autism has no single, identifiable cause. The disorder seems to be related to abnormalities in several regions of the brain. Researchers have identified a number of gene defects associated with autism.

Families with one autistic child have a one in 20 chance of having a second child with the disorder. In some cases, relatives of autistic children show mild impairments in social and communication skills or engage in repetitive behaviors.

Children with symptoms of autism have a higher than normal risk of also having:

  • Fragile X syndrome, which causes mental retardation
  • Tuberous sclerosis, in which tumors grow in the brain
  • Tourette’s syndrome
  • Epilepsy

Some people believe autism is caused by vaccines — particularly the measles-mumps-rubella vaccine (MMR), as well as vaccines containing thimerosal, a preservative that contains a very small amount of mercury. But extensive studies have shown no link between vaccines and autism.

Diagnosis

Your child’s doctor will look for signs of developmental delays at regular checkups. If your child shows some signs of autism, you may be referred to a specialist in treating children with autism. This specialist, working with a team of professionals, can perform a formal evaluation for the disorder.

Because autism varies widely in severity and manifestations, making a diagnosis may be difficult. There isn’t a medical test to pinpoint the disorder. Instead, a formal evaluation consists of observing your child and talking to you about how your child’s social skills, language skills and behavior have developed and changed over time. To help reach a diagnosis, your child may undergo a number of developmental tests covering speech, language and psychological issues.

Although the signs of autism often appear by 18 months, the diagnosis sometimes isn’t made until age 2 or 3, when there may be more obvious delays in language development. Early diagnosis is important because early intervention — preferably before age 3 — seems to be associated with the best chance for significant improvement.

Treatment

There’s no cure for autism, and there’s no “one-size-fits-all” treatment. In fact, the range of home-based and school-based treatments and interventions for autism can be overwhelming. Your doctor can help identify resources in your area that may work for your child. Treatment options may include:

  • Behavioral and communication therapies. Many programs have been developed to address the range of social, language and behavioral difficulties associated with autism. Some programs focus on reducing problem behaviors and teaching new skills. Other programs focus on teaching children how to act in social situations or how to communicate better with other people.
  • Drug therapies. Right now, there are no medications that directly improve the core signs of autism. But some medications can help control symptoms. Stimulants can help with hyperactivity, while antipsychotic drugs sometimes will control repetitive and aggressive behaviors.
  • Complementary approaches. Some parents choose to supplement educational and medical intervention with complementary therapies, such as art therapy, music therapy, special diets, vitamin and mineral supplements, and sensory integration — which focuses on reducing a child’s hypersensitivity to touch or sound. However, there is no scientific proof that these therapies work. It’s important to talk with your child’s doctor before trying any treatment.

Children with autism often respond well to highly structured education programs. Successful programs often include a team of specialists and a variety of activities to improve social skills, communication and behavior.

A child won’t “outgrow” autism. But he or she can learn to function within the confines of the disorder, especially if treatment begins early. Preschool children who receive intensive, individualized behavioral interventions show good progress.

Raising a child with autism can be physically exhausting and emotionally draining. These ideas may help:

  • Find a team of trusted professionals. You’ll need to make important decisions about your child’s education and treatment. Find a team of teachers and therapists who can help evaluate the options in your area and explain the federal regulations regarding children with disabilities. Make sure this team includes a case manager or service coordinator, who can help access financial services and government programs.
  • Take time for yourself and other family members. Caring for a child with autism can be a round-the-clock job that puts stress on your marriage and your whole family. To avoid burnout, take time out to relax, exercise or enjoy your favorite activities. Try to schedule one-on-one time with your other children and plan date nights with your spouse — even if it’s just watching a movie together after the children go to bed.
  • Seek out other families of autistic children. Other families struggling with the challenges of autism can be a source of useful advice. Many communities have support groups for parents and siblings of children with autism.
  • Learn about the disorder. There are many myths and misconceptions about autism. Learning the truth can help you better understand your child and his or her attempts to communicate. With time, you’ll likely be rewarded by seeing your child grow and learn and even show affection — in his or her own way.