Click the question to learn the answer to these frequently asked questions about Autism:
Autism is a complex developmental disability that typically appears during the first three years of life and is the result of a neurological disorder that affects the normal functioning of the brain, impacting development in the areas of social interaction and communication skills. Both children and adults with autism typically show difficulties in verbal and non-verbal communication, social interactions, and leisure or play activities. Autism is a spectrum disorder and it affects each individual differently and at varying degrees.40
Every person with autism is an individual, and like all individuals, has a unique personality and combination of characteristics. Some individuals mildly affected may exhibit only slight delays in language and greater challenges with social interactions. They may have difficulty initiating and/or maintaining a conversation. Their communication is often described as talking at others instead of to them. (For example, a monologue on a favorite subject that continues despite attempts by others to interject comments).41
People with autism also process and respond to information in unique ways. In some cases, aggressive and/or self-injurious behavior may be present. Persons with autism may also exhibit some of the following traits:
- Insistence on sameness; resistance to change
- Difficulty in expressing needs, using gestures or pointing instead of words
- Repeating words or phrases in place of normal, responsive language
- Laughing (and/or crying) for no apparent reason; showing distress for reasons not apparent to other
- Preference to being alone; aloof manner
- Difficulty in mixing with others
- Not wanting to cuddle or be cuddled
- Little or no eye contact
- Unresponsive to normal teaching methods
- Sustained odd play
- Spinning objects
- Obsessive attachment to objects
- Apparent over-sensitivity or under-sensitivity to pain
- No real fears of danger
- Noticeable physical over-activity or extreme under-activity
- Uneven gross/fine motor skills
- Non-responsive to verbal cues; acts as if deaf, although hearing tests in normal range
The term "PDD" is widely used by professionals to refer to children with autism and related disorders; however, there is a great deal of disagreement and confusion among professionals concerning the PDD label. Diagnosis of PDD, including autism or any other developmental disability, is based upon the Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV) (American Psychiatric Association, Washington DC, 1994), and is the main diagnostic reference of mental health professionals in the United States.
According to the DSM-IV, the term "PDD" is not a specific diagnosis, but an umbrella term under which the specific diagnoses are defined.42
Autism is a spectrum disorder, which means it manifests itself in many different forms. A diagnosis can range from mild to severe, and though children who have it (i.e. are on the spectrum) are likely to exhibit similar traits, they're also as individual as the colors of a rainbow, each one managing a grab bag of symptoms. While one child may rarely speak and have difficulty learning how to read and write, another can be so high-functioning he's able to attend classes in a mainstream school. Yet another child may be so sensitive to the feel of fabric that all tags must be cut off before he wears a piece of clothing, while his friend who's also autistic may not have any sensory issues at all.43
According to the Centers for Disease Control, autism affects as many as 1 in every 150 children in the United States. Therefore, it is estimated that 1.5 million Americans may be affected with autism. Also, government statistics suggest the rate of autism is rising 10-17 percent annually. Unfortunately, the numbers appear to be continuing their upward climb. In fact, it is the most prevalent developmental disorder to date; according to the Centers for Disease Control, of the approximately 4 million babies born every year, 24,000 of them will eventually be identified as autistic. Also, recent studies suggest boys are more susceptible than girls to developing autism. In the United States alone, 1 out of 94 boys are suspected of being on the spectrum, with perhaps more going undiagnosed to this day. That said, girls appear to manifest a more severe form of the disorder than their male counterparts.44
No one knows for sure. Though it's understandable to expect that a disorder as common as autism would have a known cause, in many ways it's still quite mysterious. Recent studies suggest a strong genetic basis for autism -- up to 20 sets of genes may play a part in its development. Genetics alone, however, can't account for all the cases, and so scientists are also looking into possible environmental origins, as well as other triggers.45
The simple answer is we don’t know. The vast majority of cases of autism are idiopathic, which means the cause is unknown.
The more complex answer is that just as there are different levels of severity and combinations of symptoms in autism, there are probably multiple causes. The best scientific evidence available to us today points toward a potential for various combinations of factors causing autism – multiple genetic components that may cause autism on their own or possibly when combined with exposure to as yet undetermined environmental factors. Timing of exposure during the child’s development (before, during or after birth) may also play a role in the development or final presentation of the disorder.
A small number of cases can be linked to genetic disorders such as Fragile X, Tuberous Sclerosis, and Angelman’s Syndrome, as well as exposure to environmental agents such as infectious ones ( maternal rubella or cytomegalovirus) or chemical ones ( thalidomide or valproate) during pregnancy.
There is a growing interest among researchers about the role of the functions and regulation of the immune system, both within the body and the brain, in autism. Piecemeal evidence over the past 30 years suggests that people with autism may involve inflammation in the central nervous system. There is also emerging evidence from animal studies that illustrates how the immune system can influence behaviors related to autism.46
Though the debate over the role that vaccines play in causing autism grows more heated every day, researchers have still not found a definitive link between the two. According to organizations such as the Centers for Disease Control and Prevention, the American Academy of Pediatrics and the World Health Organization, there's just not enough evidence to support the contention that vaccines – specifically thimerosal-containing vaccines – cause children to develop autism. One study published in the medical journal Lancet faulting the measles-mumps-rubella (MMR) shot has since been questioned by its own authors, and many others have also failed to pass scientific muster. Still, the accusations continue, largely from parents of children on the spectrum, and it's easy to understand why: There are still no answers to this day about what's causing a disorder that appears to steadily be expanding its reach.47
Unfortunately, experts have been unable thus far to come up with a cure for autism. Many treatments and therapies have surfaced since the disorder has grown more visible in the mainstream press, but reputable doctors have yet to agree on any that will reverse the diagnosis. But there's hope: Scientists are hard at work every day finding a solution for this growing problem. While advocacy groups have said for years that lack of funding for research is to blame for the dearth of definitive answers, a bill known as the Combating Autism Act, which would funnel millions of dollars to developing a cure, was passed through Congress and signed by the President ensuring that $162 million has been appropriated to fund autism research, services and treatment. Until such cure is discovered, parents have been relying on early intervention programs such as applied behavior analysis, or ABA, and play therapy to mitigate the behaviors associated with autism. For some, these treatments have proven to be very successful, helping kids on the spectrum lead a full and active life.48
No two children with autism are alike, but here are some signs that many of them share and that experts agree may be as recognizable as early as the toddler years, or even sooner. Children on the spectrum generally have difficulty relating to others; they may hardly speak, and if they do, they may not communicate in ways that other people can easily understand (they may screech loudly when they're upset, for example, instead of crying). They don't usually sustain eye contact – it's too intense -- and have trouble reading social cues. They're also prone to repetitive behaviors, flapping their hands constantly or uttering the same phrase over and over again. They may also be more sensitive than typically developing children, or dramatically less so, to sights, sounds and touch.49
You can start by making sure he has a reputable healthcare team by his side. That means finding doctors, therapists, psychologists and teachers who understand and have experience with autism and can respond to his shifting needs appropriately. Ask your child's pediatrician to recommend a developmental pediatrician with whom you can consult about the next step. She, in turn, can guide you toward various intervention programs and suggest complementary therapies. It also helps to plug into an already existing network of parents facing the same challenges as you.51
First, be kind to yourself. It's not easy to recover from the shock of learning your child has a developmental disorder that has no known cause or cure. Accept any and all feelings the diagnosis may elicit, and try not to blame yourself: It would've been impossible for you to figure out a way to shield your child from autism completely. The next step is to arm yourself with all the facts about the disorder. Knowledge is power, and the more you know, the more capable you'll feel about navigating the daunting autism gauntlet. That said, it's also important to give yourself a “break” from autism when it becomes too overwhelming. And if you find that the diagnosis has been so crippling that you've been unable to get past it, consider talking to a counselor or therapist. You can't — and aren't expected to — weather this storm alone.52
Most likely yes. Much depends on where your child falls on the spectrum, but with your support, as well as that of doctors, therapists and teachers, your child should be able to attend school. In fact, it's his right: According to the Individuals with Disabilities Act of 1990, which mentions autistic children specifically, your child deserves access to a “free and appropriate” education funded by the government, whether it be in a mainstream or special education classroom.53
What distinguishes Asperger's Syndrome from autism is the severity of the symptoms and the absence of language delays. Children with Asperger's may be only mildly affected and frequently have good language and cognitive skills. To the untrained observer, a child with Asperger's may seem just like a normal child behaving differently. They may be socially awkward, not understanding of conventional social rules, or show a lack of empathy. They may make limited eye contact, seem to be unengaged in a conversation, and not understand the use of gestures.
One of the major differences between Asperger's Syndrome and autism is that, by definition, there is no speech delay in Asperger's. In fact, children with Asperger's frequently have good language skills; they simply use language in different ways. Speech patterns may be unusual, lack inflection, or have a rhythmic nature or it may be formal, but too loud or high pitched. Children with Asperger's may not understand the subtleties of language, such as irony and humor, or they may not recognize the give-and-take nature of a conversation.
Another distinction between Asperger's Syndrome and autism concerns cognitive ability. While some individuals with autism experience mental retardation, by definition a person with Asperger's cannot possess a "clinically significant" cognitive delay, and most possess average to above-average intelligence.54
Early intervention is defined as services delivered to children from birth to age 3, and research shows that it has a dramatic impact on reducing the symptoms of autism spectrum disorders. Studies in early childhood development have shown that the youngest brains are the most flexible. In autism, we see that intensive early intervention yields a tremendous amount of progress in children by the time they enter kindergarten, often reducing the need for intensive supports.55
Although autism is believed to have a strong environmental component, there is little doubt that autism is a disorder with a strong genetic basis. If you are expecting another child, or have plans to expand your family in the future, you may be concerned about the development of any younger siblings of your child with autism.
Studies have estimated that families affected with one child with autism have roughly a 5-10% percent chance of having a second child with autism. This risk increases if two or more children in the family are already affected.
More recent evidence suggests that early signs of autism may be seen in some children as young as 8-10 months of age. For example, infants who later develop autism may be more passive, are more difficult to soothe, or fail to orient when their name is called. Some of these early signs may be noticed by parents, others may only be observed with the help of a trained clinician.56