What is Autism

If someone told you your child might have autism, or if your child received a diagnosis of autism, you likely have questions—starting with the basics: what is autism, and how will it affect my child and family’s life?

Autism is a lifelong neurodevelopmental disability, known formally as autism spectrum disorder (ASD). It usually appears during early childhood and can affect children’s language and communication skills, social skills, and self-regulation skills, which help us manage our emotions and behaviors in tough situations.

No one knows exactly what causes ASD, but research suggests a genetic connection, although a single gene has not been identified. In addition to genetics, brain structures and environmental variables have been linked to the development of autism. Once considered more predominant in white males, autism does not discriminate—and can affect children of all genders, races, ethnicities, nationalities, and socio-economic backgrounds.

Symptoms of Autism

Autism exists on a spectrum, causing individuals to experience the signs and symptoms in various ways and to varying degrees. This means, for example, that one child on the spectrum may not be able to speak, while another talks profusely; one child may over-react to general background noise, while another under-reacts to a loud clang.

While this range of symptoms can make autism tricky to diagnose, the Diagnostics and Statistical Manual of Mental Disorders (DSM-5) defines ASD as a mix of certain characteristics that include:

1 Persistent deficits in communication and social interaction across multiple contexts

These deficits can involve challenges with the back and forth nature of conversations; with sharing interests and emotions with others; and with initiating or responding to social interaction. Some children exhibit little or no interest in making friends with peers, and have difficulty making eye contact and using non-verbal cues (like facial expressions) to communicate. Likewise, a child might have trouble understanding relationships or developing and navigating friendships.

2 Restricted and repetitive patterns of behavior, interests, and activities

These patterns of behavior refer to what the DSM-5 calls “stereotypies,” or repeated movements and sounds that can include head-nodding, rocking, pacing, hand-flapping, and lining up toys. Insisting on the same routine, with limited or no tolerance for change; getting stuck in a rigid thinking pattern; and fixating or obsessing on a single interest are other signs. In addition, children may respond strongly to sensory input like lights, noises, or smells. On the flip side, they may not respond adequately (or under-react) to things like strong smells, painful injuries, or loud noises.

Assessing and Diagnosing Autism

Currently, no medical or blood test can diagnose autism. Instead, pediatricians and other healthcare professionals evaluate your child’s developmental history and behavior—and may need to rule out medical conditions like hearing or speech problems.

If your pediatrician suspects ASD, your child will need to be evaluated by a provider who specializes in autism. This can include clinical psychologists, psychiatrists, developmental pediatricians, or pediatric neurologists.

Whatever the case, a thorough evaluation involves an interview with parents or caregivers; a complete medical exam; a review of all related medical, psychological, and school records; an assessment of your child’s cognitive, developmental, and adaptive functioning skills; and an observation of your child playing.

Act Early—Don’t Delay

If you suspect your child has autism, don’t delay. Research shows that getting a diagnosis and starting treatment early can improve treatment outcomes. Why?

Children’s brains have the most “plasticity” in the first years of life, meaning they’re more adaptable to change through learning and experience. Your child’s brain, during this time period, forms thousands of synaptic connections between neurons—far more than needed.

Then, as your child grows older, the brain eliminates connections used infrequently (a process known as “pruning”) and strengthens those connections activated most frequently.

For these reasons, the American Academy of Pediatrics recommends screening for autism at all 18- and 24-month well-visits—and recommend starting treatment as soon as a developmental delay or autism is suspected.