What is Autism?

Autism Spectrum Disorder (ASD) and autism are both general terms for a group of complex disorders of brain development. These disorders are characterized, in varying degrees, by difficulties in social interaction, verbal and nonverbal communication and repetitive behaviors. With the May 2013 publication of the DSM-5 diagnostic manual, all autism disorders were merged into one umbrella diagnosis of ASD. Previously, they were recognized as distinct subtypes, including autistic disorder, childhood disintegrative disorder, pervasive developmental disorder-not otherwise specified (PDD-NOS) and Asperger Syndrome. ASD can be associated with intellectual disability, difficulties in motor coordination and attention and physical health issues such as sleep and gastrointestinal disturbances.

Some persons with ASD excel in visual skills, music, math and art. Autism appears to have its roots in very early brain development. However, the most obvious signs of autism and symptoms of autism tend to emerge between 2 and 3 years of age.

How Common Is Autism?

Autism statistics from the U.S. Centers for Disease Control and Prevention (CDC) identify around 1 in 68 American children are on the autism spectrum–a ten-fold increase in prevalence in 40 years. Careful research shows that this increase is only partly explained by improved diagnosis and awareness. Studies also show that autism is four to five times more common among boys than girls. An estimated 1 out of 42 boys and 1 in 189 girls are diagnosed with autism in the United States.
ASD affects over 2 million individuals in the U.S. and tens of millions worldwide. Moreover, government autism statistics suggest that prevalence rates have increased 10 to 17 percent annually in recent years. There is no established explanation for this continuing increase, although improved diagnosis and environmental influences are two reasons often considered.

What Causes Autism?

Not long ago, the answer to this question would have been “we have no idea.” Research is now delivering the answers. First and foremost, we now know that there is no one cause of autism just as there is no one type of autism. Over the last five years, scientists have identified a number of rare gene changes, or mutations, associated with autism. A small number of these are sufficient to cause autism by them. Most cases of autism, however, appear to be caused by a combination of autism risk genes and environmental factors influencing early brain development.

In the presence of a genetic predisposition to autism, a number of nongenetic, or “environmental,” stresses appear to further increase a child’s risk. The clearest evidence of these autism risk factors involves events before and during birth.

They include advanced parental age at time of conception (both mom and dad), maternal illness during pregnancy and certain difficulties during birth, particularly those involving periods of oxygen deprivation to the baby’s brain. It is important to keep in mind that these factors, by themselves, do not cause autism. Rather, in combination with genetic risk factors, they appear to modestly increase risk.

A growing body of research suggests that a woman can reduce her risk of having a child with autism by taking prenatal vitamins containing folic acid and/or eating a diet rich in folic acid (at least 600 mcg a day) during the months before and after conception. Increasingly, researchers are looking at the role of the immune system in autism.

How is Autism Treated?

The ideal treatment plan coordinates medications, therapies and interventions that meet the specific needs of an individual. Symptoms related to autism can be greatly improved and in some cases completely overcome. Most health care professionals agree that the earlier the interventions, the better.

Medications: Currently there is no cure for autism nor do children “outgrow” autism, however, there are medications that can sometimes help individuals with ASD function better. 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 disorder can be used effectively to help decrease impulsivity and hyperactivity. Similarly medications are used to manage, depression, seizures. Control self-injurious behaviors, anxiety, and obsessive compulsive disorder. Medications might not affect all children in the same way.

It is important to work with a health care professional who has experience in treating children with ASD. Parents and health care professionals must closely

monitor a child’s progress and reactions while he or she is taking a medication to be sure that any negative side effects of the treatment do not outweigh the benefits. Studies show that early diagnosis and intervention lead to significantly improved outcomes.

Therapy and Behavioral Interventions: Therapies and behavioral interventions are designed to remedy specific symptoms and can bring about substantial improvement. Therapists use highly structured and intensive skill-oriented training using Applied Behavior Analysis to help children develop social and language skills. 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.

Other Therapies: There are a number of controversial therapies or interventions available, but few, if any, are supported by scientific studies. Parents should use caution before adopting any unproven treatments. Although dietary interventions have been helpful in some children, parents should be careful that their child’s nutritional status is carefully followed.

“Red Flags of Autism”

The following “red flags” may indicate your child is at risk for an autism spectrum disorder. If your child exhibits any of the following, please don’t delay in asking your pediatrician or family doctor for an evaluation.
  • No big smiles or other warm, joyful expressions by six months or thereafter
  • No back-and-forth sharing of sounds, smiles or other facial expressions by nine months
  • No babbling by 12 months.
  • No back-and-forth gestures such as pointing, showing, reaching or waving by 12 months
  • No words by 16 months
  • No meaningful, two-word phrases (not including imitating or repeating) by 24 months
  • Any loss of speech, babbling or social skills at any age
(*Thanks to Autism Speaks for providing the most up-to-date data on these topics. Watch this page for periodic updates from Autism Speaks. Go to www.autismspeaks.org for the latest news in autism research and other subjects of related interest.)

When To See A Doctor

The most important thing you can do as a parent or caregiver is to learn the early signs of autism and understand the typical developmental milestones your child should be reaching at different ages. Children with autism usually show some signs of delayed development within the first year. If you suspect that your child may have autism, discuss your concerns with your doctor. The earlier that treatment begins the more effective it will be. Your primary care doctor may refer
you to a Physician who specializes in assessment and treatment of autism. If the doctor sees any signs of a problem, a comprehensive diagnostic evaluation is needed. This thorough review may include looking at the child’s behavior and development and interviewing the parents. It may also include a hearing and vision screening, genetic testing, neurological testing, and other medical testing.