Autism Spectrum Disorder in Children
Overview
Autism spectrum disorder (ASD) is a
problem that affects a child’s nervous system and growth and development. It often
shows
up during a child’s first 3 years of life.
Some children with ASD seem to live
in their own world. They are not interested in other children and lack social awareness.
A child with ASD focuses on following a routine that may include normal behaviors.
A
child with the disorder also often has problems communicating with others. They may
not
start speaking as soon as other children. They may not want to make eye contact with
other people.
ASD can keep a child from developing social skills. This is in part because a child
with ASD may not be able to understand facial expressions or emotions in other people.
A child with ASD may:
- Not want to be touched
- Want to play alone
- Not want to change routines
A child with ASD may also repeat
movements. This might be flapping their hands or rocking. They may also have abnormal
attachments to objects. But a child with ASD may also do certain mental tasks very
well.
For example, the child may be able to count or measure better than other children.
Children with ASD may do well in art or music, or be able to remember certain things
very well.
Causes
Experts don’t know what causes ASD.
It may be caused by certain genes. A child with ASD may also have problems with their
brain structure or with certain chemicals in the brain. Researchers do know that ASD
is
not caused by what a parent does to raise a child. It is also not linked to any
vaccines given to children.
Much less often, other things that
may cause ASD include:
Risk Factors
ASD occurs in all racial, ethnic,
and socioeconomic groups. The disorder happens much more often in boys than girls.
Four
to 5 times as many boys as girls have ASD.
Certain gene disorders that run in families can raise a child’s risk for ASD. These
include:
- Fragile-X
- Phenylketonuria (PKU)
- Neurofibromatosis
- Tuberous sclerosis
- Chromosome problems
Your child may need genetic testing
to help find out if another problem has contributed. The testing is done by a medical
geneticist. This is a healthcare provider with special training in genetics and
inherited problems. They can let you know the chances of having another child with
the
gene problem. For example, PKU carries a 1 in 4 chance of happening in another
pregnancy. For tuberous sclerosis, the chances are 1 in 2.
Even when no gene problem is found,
you are at a slightly higher chance of having another child with ASD. Experts think
this
is because several genes from both parents may act together to cause ASD.
Symptoms
Each child may have different
symptoms. Below are the most common symptoms of ASD.
Social symptoms
- Has problems making eye contact with others
- Has problems making friends or
interacting well with other children
Communication symptoms
- Does not communicate well with others
- Starts speaking at a later age than other children or doesn’t speak at all
- When the child is able to speak,
doesn’t use speech in social settings
- Repeats words or phrases (echolalia) or repeats parts of dialogue from TV or movies
Behavior symptoms
- Does repeated movements, such as rocking or flapping fingers or hands
- May be too sensitive or less
sensitive to certain things around them, such as lights, sounds, touch, or
taste
- Has rituals
- Needs routines
The symptoms of ASD may look
like other health conditions. Make sure your child sees their healthcare provider
for
a diagnosis.
Diagnosis
No single medical test can diagnose ASD. Healthcare providers use certain guidelines
to help diagnose ASD in children before age 2. The guidelines can help diagnose the
disorder early. Children diagnosed with ASD early can be treated right away.
The guidelines say that all children should be screened for ASD and other development
disorders before age 2. The screening is done at well-child checkups. Children who
have symptoms of development or behavior disorders will need to get more testing for
ASD.
Healthcare providers look for the following problems during well-child visits before
age 2:
- No babbling, pointing, or gesturing by age 12 months
- No single words spoken by age 16 months
- No two-word phrases by age 24 months,
just repeating words or sounds of others
- Loss of any language or social skills at any age
- No eye contact at 3 to 4 months
If a child has any of the above
problems, the healthcare provider will do more screening. This will help show if your
child has ASD or another developmental disorder. Your child may need to see a healthcare
provider with special training to diagnose and treat ASD. Your child may also need
these
screening tests:
- Nervous system exam
- Imaging tests such as CT scan, MRI, or PET scan
- Mental health tests
- Genetic tests to look for gene problems that cause ASD or other developmental disorders
Treatment
Each child with ASD needs their own
special treatment program. This is because children with ASD can vary a lot in how
much
help they need. Programs that work best are those that are started as early as possible
and include the parents.
Treatment for ASD includes:
-
Behavior change programs. These programs teach social
skills, movement skills, and thinking (cognitive) skills. They can help a child
change problem behaviors.
-
Special education programs. These focus on social skills,
speech, language, self-care, and job skills.
-
Medicine. Some children need medicine to help treat some
of the symptoms of ASD.
Your child and your family may also
need to see a mental health provider. This provider can give you parent counseling,
social skills training, and one-on-one therapy. This healthcare provider can also
help
you find the treatment programs that are best for your child.
Prevention
Experts don’t know how to prevent
ASD in children. They do know that it is
not caused by what a parent does to raise a child, nor is it linked to
childhood vaccines. Spotting and treating ASD early can reduce symptoms and enhance
your
child’s normal development. It can also improve your child’s quality of life.
Living with
ASD is a lifelong condition that
can put great stress on both the person with ASD and their family. Your child’s primary
care provider will play a key role in supporting you and your child. They will help
you
understand treatment and how to care for your child. You play a critical part in your
child’s treatment and well-being. Here are things you can do to help your child:
Key Points
- Autism spectrum disorder (ASD) is a
problem that affects a child’s nervous system and growth and development.
- A child with ASD often has problems
communicating. They may have trouble developing social skills.
- Genes may play a role in ASD.
- All children should be screened for
ASD before age 2.
- Diagnosis may include imaging and
genetic tests.
- Children with ASD need a special,
long-term treatment plan. It may include programs that change behavior and teach
social skills.
- Each child with ASD is unique and has unique experiences.
Families can get help from community-based resources.
Next Steps
Tips to help you get the most from a visit to your child’s healthcare provider:
- Know the reason for the visit and what you want to happen.
- Before your visit, write down questions you want answered.
- At the visit, write down the name of a
new diagnosis and any new medicines, treatments, or tests. Also write down any new
instructions your healthcare provider gives you for your child.
- Know why a new medicine or treatment is prescribed and how it will help your child.
Also know what the side effects are.
- Ask if your child’s condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if your child does not take the medicine or have the test or procedure.
- If your child has a follow-up appointment, write down the date, time, and purpose
for that visit.
- Know how you can contact your child’s
healthcare provider after office hours. This is important if your child becomes ill
and you have questions or need advice.