What are the symptoms of autism?
The following are the most common symptoms of autism:
– Lack of responding to name by 12 months of age
– Lack of pointing and use of other gestures, such as waving hi and bye-bye
– Delayed language development (infrequently, some children will “regress” in language skills)
– Immediate or delayed echolalia (repeating words while learning to speak)
– Poor eye contact during interactions
– Trouble understanding the perspective of others
– Challenges with reciprocity during play, social interactions and conversations
– Lack of peer interest
- Repetitive behaviors and restricted interests:
– Has repetitive motor movements (such as rocking and hand or finger flapping)
- Is preoccupied by certain objects or topics
- Sensory interests (e.g., interest in the objects with lights, that move or make sounds)
- Sensitive to sounds, textures or tastes
- Has rituals
- Requires routines.
How is autism diagnosed?
Standard guidelines have been developed to help identify autism in children before the age of 24 months. In the past, diagnosis of autism was often not made until late preschool-age or later. The guidelines can help identify children with autism early, which means earlier, more effective treatment for the disorder.
The American Academy of Pediatrics recommends that all children should be screened for autism spectrum disorders at 18 months and 24 months, regardless of whether any signs are apparent or any concerns have surfaced about a child’s developmental progress. By screening children early for autism, those diagnosed with the disorder can be treated immediately and aggressively.
At this initial screening, a child’s doctor should check for the following developmental deficits:
- No babbling, pointing or gesturing by age 12 months
- No single words spoken by age 16 months
- No two-word spontaneous expressions by age 24 months (not merely repeating the sounds of others)
- Loss of any language or social skills at any age
- No eye contact at 3 to 4 months.
If a child is identified as developmentally delayed, a second screening will give a more in-depth evaluation that can differentiate autism from other developmental disorders. This screening may include more formal diagnostic procedures by clinicians skilled in diagnosing autism, including medical history; psychological assessment and when appropriate; neurological evaluation; genetic testing; metabolic testing; electrophysiologic testing, such as CT scan, MRI or PET scan.
Genetic testing involves an evaluation by a medical geneticist, a doctor who has specialized training and certification in clinical genetics. This is because symptoms of autism may be caused by several genetic syndromes, including Fragile-X, untreated phenylketonuria (PKU), neurofibromatosis, tuberous sclerosis and a variety of chromosome abnormalities. A geneticist can determine whether the symptoms of autism are caused by a genetic disorder, or whether the symptoms have no known genetic cause. If a genetic disorder is diagnosed, other health problems may be involved. The chance for recurrence in a future pregnancy would depend on the syndrome found. For example, PKU is an autosomal recessive disorder with a reoccurrence risk of one in four, or 25 percent, chance, while tuberous sclerosis is an autosomal dominant disorder, with a reoccurrence risk of 50 percent.
In cases where no genetic cause for the autism is identified, the couple has a slightly increased chance for having another child with autism. The reason for this increase over the general population is thought to be because autism may result from several genes inherited from both parents acting in combination, in addition to unknown environmental factors. There is no action or inaction known that parents could have done, or did not do, to cause autism to occur in a child.
At the Center for Autism & Neurodevelopmental Disorders, CHOC has a full-time child psychologist who specializes in early detection and diagnosis of autism spectrum disorders and other developmental disorders in children ages 1 year to 5 years old. Contact the Center for Autism & Neurodevelopmental Disorders.
How is autism treated?
There is no known cure for autism; however, many therapies have been found to be effective in treating the core symptoms of autism. These therapies include behavioral therapy/applied behavior analysis, speech therapy and occupational therapy. Behavioral therapy is used to teach a range of developmental skills including cognitive (thinking), social and play, language and adaptive skills while also reducing behaviors that may interfere with learning and development. Individualized treatment for behavioral therapy is important as children with autism vary greatly in their needs. Intensive behavior therapy during early childhood and home-based approaches that involve parents are considered to produce the best results.
Highly structured special education programs focus on developing cognitive and social, speech, language, self-care and job skills. Medication can be helpful in treating some symptoms associated with autism. Mental health professionals provide parent counseling, social skills training and individual therapy. They also help families identify and participate in treatment programs based on an individual child’s treatment needs.
At CHOC, we are part of the Center for Autism & Neurodevelopmental Disorders, which offers services for children from birth to 22 years of age with autism, attention deficit/hyperactivity disorder (ADHD) and other conditions. The center offers treatment recommendations, parent training, behavior intervention, speech and language therapy, psychology services and referrals to community resources. Contact the Center for Autism & Neurodevelopmental Disorders.
References: Autism Speaks. (2008). First 100 days kit.