Autism Spectrum Disorder Symptoms, Causes, Diagnosis, Treatment, Communication, Children - MedicineNet

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Autism Spectrum Disorder (In Children and Adults)

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Autism Symptoms and Screening

Medical Author: David Perlstein, MD FAAP
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR

It is commonplace to have a family member or close friend with a child diagnosed with one of the autism spectrum disorders (ASDs, including autistic disorder, Asperger disorder, pervasive developmental disorder). These are a set of neurodevelopmental disabilities affecting young children and adults, which are currently not considered "curable". The goals of management include minimizing the symptoms and maximizing both independent function and quality of life. These are not uncommon disorders. Their prevalence has been estimated as approximately 6.5 per 1000 children, or 1 in every 150 children. Many believe that there is an "Autism Epidemic." However, as with many diseases and disorders, there are many reasons for this high prevalence.

Fortunately, significant media coverage and increased research have resulted in a better educated public and more vigilant healthcare practitioners. It is clear that early diagnosis and intervention are associated with better outcomes.

The American Academy of Pediatrics (AAP) published an updated guide for the "Management of Children with Autism Spectrum Disorders." In this publication, both background information and management choices are reviewed. In addition the AAP's approved "Surveillance and Screening Algorithm: Autism Spectrum Disorders (ASDs)" is introduced. Currently this translates into the following: All children should be screened for autism at 18 months and again at 2 years of age, and at any time a parent raises a concern about autism spectrum disorders (even if they have no signs of developmental delay). Although many health care practitioners were already screening, the process has been formalized and I expect that even more children will be referred, resulting in earlier diagnosis and intervention.

Autism facts

  • Autism is characterized by impaired development in social interaction, communication, and behavior.

  • The degree of autism varies from mild to severe.

  • Severely afflicted patients can appear to have a profound intellectual disability. Research tends to continue to refute the idea that immunizations cause autism.

  • The cause of autism is unknown.

  • The optimal treatment of autism involves an educational or vocational program that is suited to the developmental level of the child or adult, respectively.

  • It is important for the unique medical and mental-health needs of people with autism to be addressed in order to optimized both their life expectancy and quality of life.

What is autism?

Autism is a developmental disorder that is characterized by impaired development in communication, social interaction, and behavior. Autism afflicts one out of every 100 to 166 children and it affects the lives of many children and their families. It tends to affect about five boys to every one girl. Autism is classified as a pervasive developmental disorder (PDD), a category of disorders that is often described interchangeably with the broad spectrum of developmental disorders affecting young children and adults called the autistic spectrum disorders (ASD). The range of these disorders varies from severely impaired individuals with autism to other individuals who have abnormalities of social interaction but normal intelligence--Asperger's syndrome. The ways in which autism is exhibited can differ greatly. Additionally, autism can be found in association with other disorders such as mental retardation and certain medical conditions. The degree of autism can range from mild to severe. Mildly affected individuals may appear very close to normal. Severely afflicted individuals may have an extreme intellectual disability and unable to function in almost any setting.

In the past, autism has been confused with childhood schizophrenia or childhood psychosis, and may have been misunderstood as schizotypal personality disorder in some adults. As additional research information about autism becomes available, the scope and definition of the condition continues to become more refined. Some of the past confusion about the disorder has been resolved.

What are the symptoms and signs of autism?

The current Diagnosis and Statistical Manual of Mental Disorders-Fourth Edition, Treatment Revision (DSM-IV-TR) identifies three features that are associated with autism:

Impairment in social interaction

Individuals with autism fail to develop normal personal interactions in virtually every setting. This means that affected persons fail to form the normal social contacts that are such an important part of human development. This impairment may be so severe that it even affects the bonding between a mother and an infant. It is important to note that, contrary to popular belief, many, if not most, persons with this disorder are capable of showing affection, demonstrating affection bonding with their mothers or other caregivers. However, the ways in which individuals with autism demonstrate affection and bonding may differ greatly from the ways in which others do so. Their limited socialization may erroneously lead parents and pediatricians away from considering the diagnosis of autism.

As the child develops, interaction with others continues to be abnormal. Affected behaviors can include eye contact, facial expressions, and body postures. There is usually an inability to develop normal peer and sibling relationships and the child often seems isolated. There may be little or no joy or interest in normal age-appropriate activities. Affected children or adults do not seek out peers for play or other social interactions. In severe cases, they may not even be aware of the presence of other individuals.



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