Fact Sheet for Autism Spectrum Disorder
According to the National Institute of Health, Autism Spectrum Disorder (ASD) is a range of complex neurodevelopment disorders, characterized by social impairments, communication difficulties, and restricted, repetitive, and stereotyped patterns of behavior. Autistic Disorder, sometimes called Autism or classic ASD, is the most severe form of ASD, while other conditions along the spectrum include a milder form known as Asperger's Syndrome, Childhood Disintegrative Disorder and Pervasive Developmental Disorder - Not Otherwise Specified (usually referred to as PDD-NOS). In May 2013, the American Psychiatric Association published new guidelines for diagnosing ASD's with the greatest change being all of the diagnostic categories mentioned above have been merged into one diagnosis of Autism Spectrum Disorder. While there has been some controversy regarding the new diagnosis, the transition toward using the new diagnosis has begun and the North Carolina Psychology board has decreed that all psychologists practicing in this state shall use the new diagnostic criteria by June 2014 (see blog page for more information). Although ASD varies significantly in character and severity, it occurs in all ethnic and socioeconomic groups and affects every age group. Experts estimate that 1 out of 68 children age 8 have an ASD (Centers for Disease Control and Prevention: March 2014). Males are about four times more likely to have an ASD than females.
What are some common signs of Autism?
The hallmark feature of ASD is impaired social interaction. As early as infancy, a baby with ASD may be unresponsive to people or focus intently on one item to the exclusion of other items or people for long periods of time. A child with ASD may appear to develop normally and then withdraw and become indifferent to social engagement. Some children and adults with ASD may have interest in interacting with others, but not have the ability to effectively connect with them. Children with an ASD may fail to respond to their names and often avoid eye contact with other people. They have difficulty interpreting what others are thinking or feeling because they can’t understand social cues, such as tone of voice or facial expressions, and don’t watch other people’s faces for clues about appropriate behavior. People with ASD may seem to lack empathy or not know how to respond to others' feelings. Children with an ASD also don’t know how to play interactively with other children.
Many children with an ASD engage in repetitive movements such as rocking and twirling, or in self-abusive behavior such as biting or head-banging. They may also have unusual or overly intense interests, have great difficulty adjusting to change, insist on very specific routines or rituals, and have unusual responses to light, smell, touch, hearing, and movement. People with an ASD also have deficits in communication including delayed speech, difficulty maintaining a conversation, misuse of pronouns, and odd tone of voice. Even those individuals with well developed language may have difficulty with the social aspects of communication including turn taking in conversation, regulating the content of their speech, and understanding jokes or sarcasm.
Children with characteristics of an ASD may have co-occurring conditions, including Fragile X syndrome (which causes Intellectual Disability), Tuberous Sclerosis, epileptic seizures, Tourette Syndrome, learning disabilities, and Attention Deficit/Hyperactivity Disorder. About 20 to 30 percent of children with an ASD develop seizures by the time they reach adulthood. In addition, many teens and adults suffer from depression and anxiety as they become more aware of their differences and challenges.
What causes Autism?
Scientists aren’t certain about what causes ASD, but it’s likely that both genetics and environment play a role. Researchers have identified a number of genes associated with the disorder. Studies of people with ASD have found irregularities in several regions of the brain. Other studies suggest that people with ASD have abnormal levels of serotonin or other neurotransmitters in the brain. These abnormalities suggest that ASD could result from the disruption of normal brain development early in fetal development caused by defects in genes that control brain growth and regulate how brain cells communicate with each other. It has also been speculated that environmental factors such as chemical or substance exposure may be influencing gene function prenatally. While these findings are intriguing, they are preliminary and require further study. The theory that parental practices are responsible for ASD has long been disproved.
Do symptoms of Autism change over time?
For many children, symptoms improve with treatment and with age. Frequently, those who begin treatment at earlier ages show the greatest improvement over time, but people can learn new skills and better manage their behavior at any age. During adolescence, some children with an ASD may become depressed or experience behavioral problems, and their treatment may need some modification as they transition to adulthood. People with an ASD usually continue to need services and supports as they get older, but many are able to work successfully and live independently or within a supportive environment.
How is Autism treated?
There is no cure for ASD's. Therapies and behavioral interventions are designed to remedy specific symptoms and can bring about substantial improvement. The ideal treatment plan coordinates therapies and interventions that meet the specific needs of individual children. Most health care professionals agree that the earlier the intervention, the better.
Educational/behavioral interventions: Therapists use highly structured and intensive skill-oriented training sessions to help children develop social and language skills, such as Applied Behavioral Analysis. Family counseling for the parents and siblings of children with an ASD often helps families cope with the particular challenges of living with a child with an ASD. Older children, teens, and adults may benefit from highly structured psychotherapy approaches that teach specific emotion regulation skills such as Cognitive Behavior Therapy. In addition, many teens and adults may benefit from training in independent and and job readiness skills.
Medications: There is medication specifically used to treat ASD, although doctors may prescribe medications for treatment of specific autism-related symptoms, such as anxiety, depression, or Obsessive-Compulsive Disorder. Antipsychotic medications are used to treat severe behavioral problems. Seizures can be treated with one or more anticonvulsant drugs. Medication used to treat people with Attention Deficit/Hyperactivity Disorder can be used effectively to help decrease impulsivity and hyperactivity.
Other therapies: There are a number of alternative therapies, dietary supplements, or interventions available, but few are supported by scientific studies and some have proven to be dangerous to children. Parents should use caution before adopting any alternative treatments, carefully researching the benefits, risks, and costs. Dietary interventions have been helpful in some children with ASD, although the benefits tend to vary greatly among individuals. Parents should be careful that their child’s nutritional status is carefully monitored by a qualified health professional to avoid potential health risks.
Please refer to www.autismspeaks.org/ or www.nih.gov/ for more information.
