Autism Spectrum Disorder (ASD) In-Depth
Autism spectrum disorders (ASD) are a group of developmental brain disorders characterized by difficulties with communication, social interactions, and repetitive behaviors. The term “spectrum” in autism spectrum disorder refers to the wide range of symptoms and severity from person to person: no two people with autism are alike.
Degrees of learning and intelligence quotient can vary in ASD children. Some may experience learning challenges and some have signs of lower than normal intelligence. Other children with the disorder have normal to high intelligence — while they may be quick learners, they may also have difficulty communicating and engaging in social situations.
Because of the unique mixture of symptoms from child-to-child, degree of severity can sometimes be difficult to determine. Overall, it is determined by how much these impairments impact the ability to function.
In the United States, autism affected 2.41% of children and adolescents in 2014-2016, according to a research letter published online in the Journal of the American Medical Association. According to the National Autism Association, Autism now affects one in 68 children in the United States. Autism spectrum disorders are about four times more common in boys than girls.
Diagnosis of ASD
Although autism can be diagnosed at any age, it is said to be a “developmental disorder” because symptoms generally appear in the first two years of life. Although parents are usually the first to observe developmental problems, teachers, pediatricians, daycare providers and others play an important role in identifying and treating autism. Often, signs of autism spectrum disorders may be missed, as the adults in the child’s life may optimistically believe the child is just a little slow and will “catch up.” Early intervention is key to getting the child the help they need to reach their full potential.
The following are some ASD symptoms toddlers between 12-24 months might exhibit:
- Attach to certain odd objects and carry them around constantly
- Play with toys in an unusual manner
- Appear under-active or showing little enthusiasm when learning or exploring new things
- Appear to have unusual sensory sensitivities
- Communicate (babble or talk) in an unusual tone
- Display unusual body or hand movements
- Unable to be soothed, overly fussy
Children with ASD do not follow the typical patterns of child development. In some children, hints of future problems may be apparent from birth. In most cases, the problems in communication and social skills become more noticeable as the child lags further behind other children the same age.
Children and teens with ASD demonstrate deficits in the following areas:
- Social interaction
- Repetitive behaviors
Social interaction challenges may include lack of eye contact, flat facial expressions and body posture, inability to develop friendships with children the same age or understand personal space or boundaries. Children and teens with ASD may exhibit a lack of empathy and inability to share interests or achievements with others; and they might only interact with others to achieve a desired outcome. Conversations may be lacking reciprocity by being one-sided and overbearing. Due to being unable to read social cues, they can often appear to be aloof and distant. Children with ASD are unable to comforted by others in times of distress.
In young children, communication issues include delayed speech or no speech at all, losing previous ability to identify and speak words or speak in sentences, resisting physical contact – including cuddling or holding – and preferring to play alone. They might exhibit poor eye contact and lack of facial expression, fail to respond when addressed by name or appear to not to hear you when spoken to, at times. A young child with ASD might be unable to start a conversation or keep one going, and speak with an abnormal tone or rhythm. Children with ASD may also have difficulty recognizing nonverbal cues, such as interpreting other people’s tone of voice, body postures or facial expressions. They may appear to be unable to understand simple questions and directions.
Certain odd repetitive motions may set children with ASD apart from other children. As with other symptoms of ASD, these behaviors may manifest in varying degrees, from subtle to highly apparent. Some children and teens might exhibit behavior such as freezing in position, flapping their arms, or walking on their toes.
As children, they might spend hours lining up their cars and trains in a certain way, rather than using them for pretend play. Consistency and stability for ASD children is imperative in any environment. Any slight change in any of the child’s routines can be extremely disruptive and upsetting for a child with ASD. It is possible that order and sameness lend some stability in a world of confusion.
Repetitive behavior can also take the form of persistent, intense preoccupation. For example, the child might be obsessed with learning all about vacuum cleaners, train schedules, or lighthouses. Often there is great interest in numbers, symbols, or science topics.
Symptoms in Teens with ASD
Some of the ASD symptoms for younger children apply to teenagers. They might have a tendency to dominate conversations, unable to converse with a “give and take.” A teen with ASD may have difficulty answering questions about themselves.They also may hone in on one particular subject and have difficulty with other topics outside of their particular focus. They may have unusual speech patterns – either sounding robotic or overly formal or “old fashioned” way. They may have difficulty following instructions, especially those with more than one or two steps.
In teens, ASD may evolve in its manifestation. The patterns of behavior may change over time. Many teens have, over time, acquired positive skills and behaviors, but are still behind their peers in their ability to relate to and understand others. Puberty and sexual development may be more difficult for teens who have autism than for others this age. Without the ability to ask for things in a socially acceptable manner – through language or gestures, for example – kids with ASD can find themselves at a loss to let others know what they need. As a result, they may simply take what they want or scream. Until they are taught and able to develop better communication skills, ASD children do whatever they can to get through to others. As people with ASD grow up, they can become increasingly aware of their difficulties in understanding others and in being understood. Teens with ASD are at an increased risk for developing depression, anxiety, and epilepsy.
National Institute of Mental Health. (2018). Autism Spectrum Disorder. Retrieved from https://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd/index.shtml on April 15, 2019.
Mayo Clinic. (2018). Autism Spectrum Disorder. Retrieved from https://www.mayoclinic.org/diseases-conditions/autism-spectrum-disorder/diagnosis-treatment/drc-20352934 on April 15, 2019.
Journal of the American Medical Association. (2018). Prevalence of Autism Spectrum Disorder Among US Children and Adolescents, 2014-2016. Retrieved from https://jamanetwork.com/journals/jama/article-abstract/2667712?resultClick=1&redirect=true on April 15, 2019.
Manhattan Psychology Group. (2018). Children & Adolescents with Autism Spectrum Disorders. Retrieved from https://manhattanpsychologygroup.com/children-teens-autism-spectrum-disorder on April 15, 2019.
CRC Health Group (2018). Teenagers With Autism: Symptoms, Treatment, & Help. Retrieved from https://www.crchealth.com/troubled-teenagers/autism-in-teenagers/ on April 15, 2019.
University of California – San Diego Autism Center. (2018). Early Warning Signs of Autism. Retrieved from https://autism-center.ucsd.edu/treating-early-autism/Pages/signs.aspx on April 15, 2019.
Carmosino, A. (2019). Autism Spectrum Disorder (ASD) In-Depth. Psych Central. Retrieved on April 6, 2020, from https://psychcentral.com/autism/autism-spectrum-disorder-asd-in-depth/