Autism Causes, Symptoms, Types, Disorders, Treatment, and FAQs

Autism

Autism, also called classic autism or autistic disorder, developmental disorder affecting physical, social, and language skills, with an onset of signs and symptoms typically before age three. The term autism (from the Greek autos, meaning “self”) was coined in 1911 by Swiss psychiatrist Eugen Bleuler, who used it to describe withdrawal into one’s inner world, a phenomenon he observed in individuals with schizophrenia.

The use of the word autism to describe the condition as it is known today originated in 1943 when Austrian-born American psychiatrist Leo Kanner distinguished the disorder from schizophrenia. Autism is associated with a combination of genetic and environmental factors. Risk factors during pregnancy include certain infections, such as rubella, toxins including valproic acid, alcohol, cocaine, pesticides and air pollution, fetal growth restriction, and autoimmune diseases.

Controversies surround other proposed environmental causes; for example, the vaccine hypothesis, which has been disproven. Autism affects information processing in the brain and how nerve cells and their synapses connect and organize; how this occurs is not well understood. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), combines autism and less severe forms of the condition, including Asperger syndrome and pervasive developmental disorder not otherwise specified (PDD-NOS) into the diagnosis of autism spectrum disorder (ASD).

The exact cause of ASD is unknown. The most current research demonstrates that there’s no single cause.

Some of the suspected risk factors for autism include:

• Having an immediate family member with autism.
• Genetic mutations
• Fragile X syndrome and other genetic disorders
• Being born to older parents
• Low birth weight
• Metabolic imbalances
• Exposure to heavy metals and environmental toxins
• A history of viral infections
• Fetal exposure to the medications valproic acid (Depakene) or thalidomide (Thalomid)

According to the National Institute of Neurological Disorders and Stroke (NINDS), both genetics and environment may determine whether a person develops autism.

Multiple sources, old and new, have concluded that the disorder isn’t caused by vaccines, however.

A controversial 1998 study proposed a link between autism and the measles, mumps, and rubella (MMR) vaccine.

Autism Tests and Diagnosis

An ASD diagnosis involves several different screenings, genetic tests, and evaluations.

Developmental screenings

The American Academy of Pediatrics (AAP) recommends that all children undergo screening for ASD at the ages of 18 and 24 months.

Screening can help with the early identification of children who could have ASD. These children may benefit from early diagnosis and intervention.

The Modified Checklist for Autism in Toddlers (M-CHAT) is a common screening tool used by many pediatric offices. This 23-question survey is filled out by parents. Pediatricians can then use the responses provided to identify children that may be at risk of having ASD.

It’s important to note that screening isn’t a diagnosis. Children who screen positively for ASD don’t necessarily have the disorder. Additionally, screenings sometimes don’t detect every child that has ASD.

Other screenings and tests

Your child’s physician may recommend a combination of tests for autism, including:

• DNA testing for genetic diseases
• Behavioral evaluation
• Visual and audio tests to rule out any issues with vision and hearing that aren’t related to autism
• Occupational therapy screening
• Developmental questionnaires, such as the Autism Diagnostic Observation Schedule (ADOS)

Diagnoses are typically made by a team of specialists. This team may include child psychologists, occupational therapists, or speech and language pathologists.

Autism Treatment

There are no “cures” for autism, but therapies and other treatment considerations can help people feel better or alleviate their symptoms.

Many treatment approaches involve therapies such as:

• Behavioral therapy
• Play therapy
• Occupational therapy
• Physical therapy
• Speech therapy

Massages, weighted blankets and clothing, and meditation techniques may also induce relaxing effects. However, treatment results will vary.

Some people on the spectrum may respond well to certain approaches, while others may not.

Shop for weighted blankets here.

Alternative treatments

Alternative treatments for managing autism may include:

• high-dose vitamins
• chelation therapy, which involves flushing metals from the body
• hyperbaric oxygen therapy
• melatonin to address sleep issues

Research on alternative treatments is mixed, and some of these treatments can be dangerous.

Before investing in any of them, parents and caregivers should weigh the research and financial costs against any possible benefits. Learn more about alternative treatments for autism.

Interventions

Among the treatment interventions that may be beneficial are:

Applied Behavior Analysis (ABA): In ABA, an instructor at first tries to learn about the particular behaviors of a person with ASD. They will also want to know about the effects of their environment on this behavior, and how the person learns. ABA aims to increase desirable behaviors and reduce harmful or isolating ones by using positive reinforcement.

ABA can help improve communication, memory, focus, and academic performance. By analyzing current behaviors and teaching new actions step-by-step, an instructor can provide both a person with ASD and the people around them with tools for support.

Early Start Denver Model (ESDM): This type of behavioral therapy occurs during play and helps children between the ages of 1 and 4 years old.

A psychologist, behavioral specialist, or occupational therapist uses joint activities and play to help a child with autism build positive relationships with a sense of fun. Parents can then continue the therapy at home.

ESDM supports communication skills and cognitive abilities.

Floortime: This involves parents joining children in the play area and building relationships. ABA therapies might also use floortime to support treatment and vice versa. Parents let the children lead the game, allowing the child’s strengths to develop.

Through this engagement, a child with ASD learns two-way and complex communication, emotional thought, and intimacy. They also learn to take the lead of regulating themselves and engaging with their environment.

Occupational therapy (OT): This helps a person with autism develop the skills for everyday living and learn independence.

These skills include dressing without assistance, grooming and hygiene, and fine motor skills. People with ASD then practice these skills outside of the therapy sessions, which are usually between 30 and 60 minutes long.

Pivotal response treatment (PRT): This therapy aims to support motivation and the ability to respond to motivational cues in children with ASD. It is a play-based therapy that focuses on natural reinforcement.

For example, if a child wants a toy car and asks in an appropriate way, they get the toy car, not an unrelated reward, such as candy. This also encourages children with ASD to start social interactions, as well as merely responding to them.

Relationship development intervention (RDI): This treatment revolves around the importance of dynamic thinking, or the ability to adapt thoughts and process situations flexibly, to help improve quality of life in people with autism.

The focus of RDI includes understanding other people’s perspectives, processing change, and absorbing information from several sources at once, such as sight and sound, without experiencing distress.

Speech therapy: This helps to address the challenges in communication that people with autism might experience.

Assistance might include matching emotions with facial expressions, learning how to interpret body language, and responding to questions. A speech therapist might also try to teach the nuances of vocal tone and help the individual strengthen their speech and clarity.

TEACCH: This program helps to integrate the needs of children with autism into a classroom environment, with an emphasis on visual learning and support for the attention and communication difficulties that might arise.

Special education providers and social workers, as well as medical professionals providing other treatments, such as psychologists and speech therapists, can use this system to support children with ASD.

Verbal behavior therapy (VBT): This helps a child with ASD connect language and meaning. Practitioners of VBT focus not on words, but on the reasons for using them.

Autism Medications

If a doctor prescribes medicine for a child or adult with ASD, they will usually be trying to address seizures, depression, or disturbed sleep. Again, medications may or may not be right for an individual with autism on a case by case basis.

Coping strategies and skills

Children with ASD often develop a range of behaviors that help them process the isolating effects of the condition.

These behaviors are attempts by the child to protect themselves from stimuli that may overwhelm them and increase sensory input to enhance feeling. They may also enact these behaviors to bring some level of organization or logic to their everyday lives.

While not all coping strategies for autism are harmful, some can inhibit social interaction and lead to isolation and distress.

These behaviors include:

• Isolating themselves and avoiding contact with others
• Repetitive patterns while playing and relying on familiar occurrences during the day
• Talking to themselves, humming, or whistling
• Becoming highly attached to preferred objects
• Choosing to seek out or avoid certain experiences to an extreme extent

The important factor in managing potentially isolating behaviors is not to discourage these behaviors, but to add other coping strategies that can make a child’s journey through autism easier, such as:

• Seeking help
• Using language more openly
• Relaxing and taking breaks
• Making their needs clear
• Managing sensory input

The following are effective ways to achieve this:

• Understanding that speech processing may undergo delays and accounting for this when speaking to a child with ASD.
• Restricting noise, movement, and the presence of nearby objects to help a child concentrate when presenting information to them.
• Helping a child to structure activities by giving the order-based cues, such as “First, do this, then…” or “Get ready… get set … go!”
• Demonstrating appropriate adult socialization in front of the child with ASD.
• Clearly defining a play space by using visual markers, such as beanbags, to promote a feeling of safety around other children.
• Making sure information about events is both clear and visible, in terms of routine activities and those that fall outside of routine and may cause distress.
• Running through and practicing these coping strategies during play.

Different people experience ASD to varying extents and with a range of behaviors. However, these strategies and skills can help increase the tools available to each person with the condition and improve their quality of life.

Frequently Asked Question about Autism

What are Autism Spectrum Disorders?

Autism spectrum disorders (ASDs) represent a range of brain disorders that are characterized by restricted patterns of behavior and impairments in social communication and interactions. These disorders share common origins and features but are classified as spectrum disorders because symptoms and severity vary among individuals.

What are the Symptoms of Autism Spectrum Disorders?

Symptoms/behaviors of ASDs can range from mild to severe and may seem to appear gradually or suddenly. Atypical development may be observed from birth, or more commonly, become noticeable during the 12- to 36-month period. Symptoms include:

• Social Deficits – Children with autism have difficulty in social interactions. They may avoid eye contact and interactions with people and resist or passively accept attention. They are often unable to read social cues or exhibit emotional reciprocity. Thus, they are unable to predict or understand other peoples’ behavior. They may also have difficulty controlling emotion, maybe disruptive or aggressive at times, or may lose control, especially when frustrated or presented with a new situation or environment. Head-banging, hair-pulling, and arm-biting may occur.
• Communication Difficulties – Communication skills are affected in children with autism, but difficulties vary. Some children may have good basic language skills, but exhibit difficulty initiating or sustaining conversations, such as not giving others the opportunity to respond. Others may experience delays or regression in language development; still, others remain mute or may use language in unusual ways, such as repeating a phrase, or parroting what they hear (echolalia). Body language is also often hard to read in children with autism. Facial expressions, tone of voice and gestures often do not match verbal content and emotions. They have difficulty expressing what they want or need. They may also appear deaf, not responding to their names or attempts at conversation.
• Repetitive Behaviors – Patterns of behavior, interests, and activities may be restricted, repetitive or stereotyped. For example, a child may spend long periods of time arranging specific toys in a particular manner, rather than playing with the toys. Intense preoccupation with certain topics, such as obsessively studying maps, may also be seen. Odd repetitive motions, either extreme or subtle, such as arm-flapping, freezing, rocking back and forth or walking on their toes may also occur. Often, people with autism demand consistency in their environment. A minor change in routine may be tremendously upsetting.
• Sensory Difficulties – In children with autism, the brain seems unable to balance the senses appropriately. Many autistic children are highly attuned or even painfully sensitive to certain sounds, textures, tastes or smells. Some seem oblivious to cold or pain but react hysterically to things that wouldn’t bother other children. In some people, the senses are even scrambled. For example, touching a certain texture may induce a gagging response.
• Unusual Abilities – In rare cases, some children with ASDs display remarkable abilities, such as drawing detailed, realistic pictures at a young age or playing an instrument without training. Some can memorize difficult lists of items, such as statistics or names (this is called islets of intelligence or savant skills).

What is Autistic Disorder?

Autistic disorder, commonly referred to as autism, is the most prevalent ASD and severely impairs a child’s social interaction and communication abilities.

What is Asperger’s Syndrome?

Asperger’s Syndrome is the second most common ASD and is a milder form of autism. Children with Asperger’s Syndrome exhibit higher language development than children with autism and often have normal intellectual ability combined with a disinterest in social communication. Children with Asperger’s may not initiate or sustain a conversation and do not compensate for their limited language by using nonverbal means of communication, thus limiting their peer relationships. Similar to autism, children with Asperger’s do not share enjoyment or interests with others.

What are the other ASDS (Besides Autism and Asperger’s Syndrome?

Other disorders in the spectrum include pervasive developmental disorder not otherwise specified (PDDNOS) and two rarer disorders—childhood disintegrative disorder (CDD) and Rett’s syndrome. Children with PDDNOS demonstrate symptoms similar to autistic disorder but do not meet all criteria for the disorder. Children with CDD, which affect more boys than girls, develop normally until approximately the first two years of life (average onset of symptoms is between 3 and 4 years) but they then regress in most areas and continue worsening. Specifically, they experience a pronounced loss in motor, language, social and intellectual skills. They also lose bowel and bladder control. Seizures may even occur.

What is Rett Syndrome?

Rett syndrome is a genetic disorder almost exclusively found in females. After early normal development, autistic symptoms begin to develop between 6 and 18 months, which typically include shunning social contact, talking cessation, unique motor behaviors, and regression in skills. A single gene mutation has been identified as a cause of Rett syndrome, a finding that may enable researchers to develop improved diagnostics, earlier interventions and better treatments for the condition.

Who develops Autism Spectrum Disorders (ASDS)?

ASDs are usually evident by the age of 3, though the diagnosis may be made as early as 12 to 18 months, and as late as 4 to 6 years (or later). According to the Center for Disease Control (CDC), about 1 in 59 children have an autism spectrum disorder. ASDs are three to four times more common in boys than in girls. However, girls with these disorders tend to have more severe symptoms and lower intelligence. Some children will need ongoing supervision, while others, with the right support, may pursue higher education and fulfilling jobs. These disorders affect people of all racial, ethnic and socioeconomic groups.

How are ASDS Diagnosed?

To date, no biological diagnostic tests exist that detect autism. But scientists are hopeful that advanced imaging techniques and differences in blood levels of proteins in autistic versus normal children may have implications for diagnosis. Already, improved diagnostic procedures have allowed clinicians to diagnose children at a younger age.

Formal diagnosis involves parental input and structured and systematic screening instruments, such as the Modified Checklist for Autism in Toddlers (M-CHAT) and the Autism Behavioral Checklist (ABC) for older children. The Childhood Autism Rating Scale (CARS) and the Autism Diagnostic Inventory-Revised (ADI-R) are used, as well. These tools measure the prevalence of symptoms. Symptoms may be present from birth or may occur after months of normal development. However, no two children with these disorders behave the same way. Children as young as 18 months may be diagnosed, but have different clinical features than an older child with autism.

Between 18 months and 36 months, symptoms may include:

• Limited pretend play
• Lack of pointing to demonstrate an interest
• Reduced gaze following
• Less frequent demonstration of repetitive, stereotypic behaviors
• In children with autism between 2 years and 3 years of age, the following features may be observed:
• Communication difficulties
• Socialization deficits with caregivers
• Perceptual sensitivity
• Other difficult behaviors

What are the causes of Autism Spectrum Disorders (ASDS)?

Some combination of genetic, biological and environmental factors is believed to cause ASDs. Researchers are exploring several genes that are believed to contribute to the development of these disorders as well as several brain regions that have been linked to the disorders. Abnormal brain development during the first months of life is being studied to determine if structural abnormalities, such as in the mirror neuron systems, may be caused by genetic and/or environmental factors. Researchers are also exploring the effects of genetic imprinting in which a gene’s expression is determined by which parent donates the gene copy. Certain neurotransmitters, such as serotonin, dopamine, and epinephrine, may also function abnormally. In some cases, scientists are exploring the possibility that a faulty immune response to a virus, elevated concentrations of proteins in the blood at birth, dysregulation of specific neuropeptides or major stress during pregnancy may lead to the disorder.

How are ASDS Treated?

There is no one treatment for ASDs; however, it is widely accepted that the earliest interventions allow the best outcomes. Treatments generally address both cognitive and behavioral functioning. They may include a combination of medications (for challenging behaviors), behavioral therapy, psycho-education, family support groups, educational interventions, speech and language therapy, occupational therapy and specialized training to develop and improve the acquisition of necessary skills.

Research has found that a newer class of atypical antipsychotic medications may better treat serious behavioral disturbances in children with autism who are between 5 and 17 years old. The applied behavioral analysis may be an effective adjunctive treatment in reinforcing desirable and reducing undesirable behaviors. Other work focuses on improving social communication in children with autism. Some have found that structured multidisciplinary behavioral programs are more successful. Parental involvement, a predictable schedule, regular behavior reinforcement and active engagement of attention in highly structured activities to enhance strength or ability may all contribute to creating an effective treatment program.