Autistic Spectrum Disorder

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KEY POINTS

• A child with autistic spectrum disorder has problems communicating and getting along with others.
• Usually children are placed in public schools and the school district provides needed services. These will include working with a speech therapist, occupational therapist, school psychologist, social worker, school nurse, or aide.
• Treatment will also include doing activities at home.

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What is autistic spectrum disorder?

A child with autistic spectrum disorder (ASD) does not develop normally in several ways, such as having problems communicating and getting along with others. ASD used to be called by different names:

• Autism, a disorder in which a child has problems with communicating and getting along with others. They have unusual or repetitive actions and narrowly focused interests.
• Asperger syndrome, a mild form of autism. A child may have good language skills, but have trouble being around others, and have unusual interests and behaviors.
• Childhood disintegrative disorder, a rare disorder in which a child develops normally until about age 3 or 4 and then suddenly starts to show symptoms of autism

Childhood vaccines do not cause ASD.

What is the cause?

The exact cause of ASD is not known.

• The brain makes chemicals that affect thoughts, emotions, and actions. Without the right balance of these chemicals, there may be problems with the way your child thinks, feels, or acts. A child with this disorder may have too little or too much of some of these chemicals.
• If a woman is infected with a virus, has diabetes, or does not eat a healthy diet while she is pregnant, it increases the risk that the child will develop an autistic spectrum disorder. Exposure to certain chemicals and medicines during pregnancy may also increase the risk. Low oxygen levels from long labor or premature birth may also increase the risk.
• ASDs sometimes run in families. There may be certain genes linked to autism. If the father is older than age 40 when the mother gets pregnant, it may increase a child’s risk.
• Children with one of these disorders may have physical changes in their brain. These changes may mean that some parts of the brain are more active or less active than in other children.
• Children with other brain problems and genetic syndromes such as fragile X syndrome, are sometimes also autistic.

What are the symptoms?

The symptoms of ASD vary. No two children with ASD are exactly alike.

Social Skills

Most children with ASD seem to have a lot of trouble learning the give-and-take of dealing with people. They may also have trouble controlling their emotions. This can take the form of crying or verbal outbursts.

Communication Problems

Children with ASD may have many kinds of communication problems. Some children never talk. Some talk or make noises early in life and then stop. Others are just slow to start and don't start to talk until age 5 to 9. Those who do speak often use language in unusual ways. They also don't always understand tone of voice or nonverbal communication, such as a smile, a wink, or a frown.

Repetitive Behaviors

Children with ASD sometimes repeat movements. Some flap their arms or walk on their toes a lot. They also develop strong habits and routines. They may get very upset at the slightest change in routine.

Other problems

Children with ASD may also have problems with their senses. Many are very sensitive to certain sounds, textures, tastes, and smells.

How is an ASD diagnosed?

Your healthcare provider will ask about your child's development at each well child visit. Tell your provider about any concerns you have and any behavior that seems unusual. As a parent or caregiver, you are usually the first to notice unusual behaviors in your child. Do not ignore problems, thinking that your child is just a little slow and will "catch up." Early treatment helps reduce symptoms. It increases your child's ability to grow and learn new skills.

Your child's healthcare provider will ask about the child's symptoms, medical and family history, and any medicines your child is taking. Your provider will check for a medical illness or drug or alcohol problem that could cause the symptoms. Your child may have tests or scans to check for other possible causes of the symptoms. Because it can be inherited, your healthcare provider may want to screen your other children for symptoms.

If your healthcare provider thinks your child may have autistic spectrum disorder, he or she will refer you to specialists such as a psychologist, psychiatrist, speech therapist, or neurologist. They can do more testing and advise you about treatment. Your school district may also provide testing services for your child.

What is the treatment?

There is no one best treatment for all children with ASD. Before you decide on your child's treatment, find out what your options are. Learn as much as you can and make your choice for your child's treatment based on your child's needs.

Usually children are placed in public schools and the school district provides all needed services. These will include working with a speech therapist, occupational therapist, school psychologist, social worker, school nurse, or aide. You may want to visit public schools in your area to see the type of program they offer to special needs children.

A team of professionals will help evaluate your child and put a plan together. You may also ask your healthcare provider to review the plan. Ask and find out all the services that may be available for your child.

The treatment of ASD may involve:

• Social skills training to increase mental awareness, self-esteem, and confidence, and help your child make more friends.
• Behavior therapy to help your child recognize that the way he acts affects others. This can help your child change problem behaviors.

Treatment will also include doing activities at home.

How can I help my child?

• Build your child's self-esteem. Give unconditional love and support. You can build up your child's self-esteem if you remind him of his strengths. Do this regularly. Your child may need counseling to help change views and expectations about himself.
• Help your child to understand his problem. Talk about the problem. Help your child focus on coping skills rather than feeling like he is the problem. Sometimes being with other children who also have ASD can help. Children may feel better if they realize they are not alone.
• Help your child organize things. Help your child learn to organize toys and games as well as school notes and assignments. When your child needs to read or concentrate, have him work away from the sounds of television, radio, or others talking.
• Take care of your child’s physical health. A balanced diet, enough rest, play activities, and family outings will strengthen your child's body and mind.
• Communicate with the school. Stay in close touch with your child's teachers, therapists, and other caregivers. Let your child's teacher know that you want to play an active role in your child's education. Ask how you can help your child at home.
• Seek professional counseling for yourself as well as your child. Most parents find advice on handling difficult behavior and feelings very helpful.
• Join support groups. These groups help keep you up to date with the latest information. It will also put you in touch with parents who have children with similar problems.
• Be cautious of alternative treatments. Be sure to check with your healthcare provider before giving supplements, changing to a special diet, or using other kinds of alternative treatments.