ASD covers a range of symptoms, abilities, and behaviors, all of which relate to emotional and social development and to communication skills. Some people without ASDs may have some of the symptoms, but those who do have ASD will exhibit enough symptoms, in a severe enough form, that their daily life is very challenging.

No one tool is used to diagnose an ASD, and there is no medical test to rule out an ASD. Again, because autism is a syndrome, it is the confluence of several symptoms together that result in a diagnosis.

Some symptoms of ASD are:

Not playing “pretend” or “make believe” games;

Not pointing at objects of interest or looking at objects when pointed out;

Having no interest in others;

Avoiding eye contact with others;

Appearing unaware when spoken to but responding to other sounds;

Having trouble expressing needs using typical motions or words;

Preferring not to be held or cuddled;

Repeating actions over and over;

Having unusual reactions to tastes, smells, and sounds;

Losing skills once mastered (e. g. not using words previously used).

Parents and caregivers are often the first to notice one or more of the symptoms of an ASD. Following that observation, health care providers can observe the child and use diagnostic tools to assess them.

There are many tools available to assist in diagnosis of autism. Because autism is a syndrome, no one tool should be used for diagnosis. Some diagnostic tools include the Autism Diagnosis Interview–Revised (ADI–R), the Autism Diagnostic Observation Schedule – Generic (ADOS–G), the Childhood Autism Rating Scale (CARS), and the Gilliam Autism Rating Scale (GARS).

Making parents aware of normal development and development milestones, making health care providers aware of early diagnosis and treatment, and encouraging parents to discuss milestones with health care providers can help facilitate an awareness of when such milestones are not being reached. The earlier the diagnosis is suspected and confirmed, the earlier treatment and intervention can begin.

Autistic Disorder

What most people think of when they think of autism is termed autistic disorder.  This disorder is characterized by social and communication challenges, unusual behaviors and interests, and significant delays in language acquisition and usage. Many people who have autistic disorder also have an intellectual disability.

Asperger Syndrome

Asperger syndrome is usually thought of as mild autism. People with Asperger syndrome usually do not have language problems or an intellectual disability.  They may, however, have social challenges, unusual interests, or unusual behaviors.

Rett Syndrome

Rett Syndrome is a neurodevelopmental disorder caused by mutations in a gene, causing genes not to produce proteins.  Children with Rett Syndrome have problems with speech, hand use, and normal movement.  Symptoms of autism such social and language impairments, as well as regression of behavioral milestones are often seen in girls with Rett Syndrome.

Childhood disintegrative disorder

Childhood disintegrative disorder is often confused with late-onset autism because children with this condition develop normally until age 3 or 4, then exhibit a dramatic loss of communication, social, play, and motor skills.

Autism, however, typically occurs earlier than childhood disintegrative disorder. The loss of skills in those affected by childhood disintegrative disorder is also more dramatic.  This condition is far less common than “classic” autism.

The severity of symptoms for any one individual with an ASD can range from mild to severe, but all disorders share the common symptom of social and communication difficulties.

Causes

Autism is complex, and no one single cause has been identified.  Genetics may play a role, and siblings of autistic children are at a higher risk for developing autism than those with no family history.  Research indicates that some variations in gene development may play a role in the development of autism, as may environmental exposure to certain chemicals and toxins.  Routine vaccinations have been ruled out as a cause for autism. Even  researchers who study autism exclusively can not, as of  yet, point to a specific cause of this disorder.

Symptoms

Because children with autism can be very withdrawn and non-communicative, autism can be bewildering for parents and families of those affected. Children affected by autism share many similar symptoms, such as problems with communication, social interaction, and language use. However, since the range of symptoms is great, one child with autism may function in a way that is more “normal” than another with the same diagnosis.

Diagnosis

Parents are often the first to recognize that something is not right with the development of a child who is ultimately diagnosed with autism.  Diagnosis of autism is based on observation, followed by screening and evaluation. Parents may be relieved to receive a diagnosis since that can then lead to treatment and intervention.  Unlike other disorders or diseases, no one medical test can effectively diagnose or rule out autism.  The process of diagnosis can be a difficult time for parents who are anxious for answers.

Treatment

Autism, based on what is known today, cannot be cured, but treatments and interventions – particularly when they are early and intense – can significantly affect the development of a child with autism. With no “one size fits most” treatment proven effective, parents must remain keenly aware of the symptoms their child exhibits in order to determine what may be effective in their child’s specific case.  Behavioral and speech therapies are being studied and found to be effective at lessening autism symptoms.  Medications and diet are also being studied as potential ways to decrease symptoms, but all of these interventions depend on the child affected, adding to the mysterious nature of autism and its treatment.

Autism is complex, but research has made great strides in determining causes and treatments.  The disorder remains vexing, but continuing research will eventually lead to an increased knowledge of causes and prevention, treatments and interventions.

Childhood autism

Behaviors indicative of childhood autism present themselves before age 3. Children affected by this disorder have poor eye contact, language delay, ignore others, and often seem to be “in their own world.” Children with autism have severe speech, communication, and social delays. The Diagnostic and Statistical Manual of Mental Disorders IV (DSM – IV) criteria for an autism diagnosis are quite specific, but all center on a delay in – or total lack of – development in the areas of communication, social interaction, and emotion. Repetitive gestures are also a hallmark of autism.

Asperger’s syndrome

Children affected by Asperger’s syndrome do have difficulties with appropriate speech and communication, but their language use is less affected than those with childhood autism. Children with Asperger’s may have very high IQ’s, but may lack skills needed to care for themselves or to live independently. These children may lack the ability to understand how they are perceived by others.

Children with Asperger’s may talk repetitively about a topic with no understanding that it is boring to others. Children with Asperger’s may be thought of as simply “odd” or lacking social skills, and they may remain un-diagnosed because of their abilities to compensate with their memory skills or academic abilities.

No clinically significant delays in language or cognitive development are present in these children; the DSM-IV criteria for diagnosis focus on impairment in social interaction and repetitive, restrictive, and stereotyped behavior patterns.

Childhood disintegrative disorder

Children with childhood disintegrative disorder develop normally during the first 3 years of their lives then they seem to develop autistic features and to demonstrate a severe functional impairment, including loss of speech.

Seizures that affect the speech centers of the brain may be a factor in this disorder, so children who exhibit symptoms should be thoroughly evaluated for such seizure activity. Motor skills and social interaction may also be affected in children with this impairment; the DSM-IV offers specific criteria for diagnosis of this condition.

Rett’s disease

Rett’s disease affects only girls; they develop normally until the age of 6 months and then regress. The regression is associated with a small head; the head stops growing from 6 months and on. Girls with this disorder have normal head circumference at birth, however.

Recently there has been a specific chromosomal marker associated with this disorder. The DSM-IV specifies also a loss of purposeful movement of hands as diagnostic criteria.

Pervasive developmental disorder not otherwise specified (PDD NOS)

The term PDD NOS is used to describe children with a severe impairment but who do not fully qualify for other autistic diagnoses. Age of onset or the combination of autistic features differentiates this diagnosis from an autism diagnosis. Children with PPD NOS exhibit behaviors similar to those with autism, but have a lesser degree of impairment.

Resources & References

Read the DSM-IV criteria for these disorders here.