Autism Spectrum Disorder
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Autisme autism spectrum disorder (ASD)
Autisme adalah salah satu dari kelompok masalah perkembangan yang serius dan disebut autismspectrum disorder (ASD) yang terjadi pada awal masa kanak-kanak ±biasanya sebelum umum 3 tahun.Gejala dan tingkat keparahannya bervariasi, semua autisme mempengaruhi kemampuan anak-anak dalam berkomunikasi dan berinteraksi dengan orang lain.Tidak ada penyembuh untuk kondisi autisme ini, perawatan dini dan intensif dapat membuat perubahan besar dalam hidup banyak anak dengan gangguan ini.
Anak dengan autisme umumnya memiliki masalah pada tiga area krusial perkembangannya ±interaksisocial, bahasa dan kebiasaan. Tetapi karena gejala autisme sangat berbeda-beda, dua anak dengandiagnosis yang sama dapat memiliki kebiasaan dan kemampuan yang berbeda. Pada banyak kasus,autisme yang parah ditandai dengan ketidakmampuan secara total untuk berkomunikasi atau berinteraksi dengan orang lain.Beberapa anak menunjukkan gejala autisme pada awal masa pertumbuhannya. Anak lain tumbuhsecara normal pada beberapa bulan atau tahun pertama kemudian secara tiba-tiba mengalamikemunduran, menjadi agresif atau hilang kemampuan berbahasa yang telah mereka miliki. Meskipunanak dengan autisme memiliki pola masing-masing yang unik, ada beberapa gejala autisme yangumum, antara lain:Kemampuan bersosialisasi:
Gagal menyebutkan namanya
Kontak mata yang sedikit
Sering tidak mendengarkan orang yang berbicara kepadanya
Tidak mau dipeluk atau digenggam
Muncul ketidaksadaran akan perasaan lain
Suka bermain sendiri ±tenggelam di dalam ³dunia´nyaBahasa
Mulai berbicara setelah berusia 2 tahun, dan memiliki penundaan kemampuan dalam 30 bulan
ilang kemampuan yang telah dimiliki sebelumnya untuk berkata
Tidak membuat kontak mata ketika meminta sesuatu
Berbicara dengan nada atau ritme yang tidak normal ±mungkin menggunakan suara sepertimenyanyi atau seperti robot
Tidak dapat memulai pembicaraan atau mempertahankan pembicaraan
Mungkin mengulang kata atau ucapan, tetapi tidak mengerti bagaimana menggunakannyaKebiasaan
Menunjukkan gerakan yang berulang, seperti berayun, berputar atau bertepuk tangan
Menunjukkan ritual atau rutinitas tertentu
Bergerak secara konstan
Kagum terhadap bagian benda tertentu, seperti roda mobil mainan yang berputar Anak dengan autisme juga memiliki waktu yang sulit untuk berbagi pengalaman dengan orang lain.Pengembangan kemampuan bersosialisasi di usia dini krusial pada perkembangan berbahasa dan bersosialiasi di kemudian hari.Setelah dewasa, beberapa anak dengan autisme menjadi lebih akrab dengan orang lain danmenunjukkan sedikit gangguan pada kebiasaannya. Beberapa diantaranya biasanya telah menjadihidup secara normal atau mendekati normal dengan berakhirnya masalah yang parah saat sebelumnya.Beberapa yang lain memiliki kesulitan pada kemampuan berbahasa atau bersosialisasi, dan usiadewasa dapat berarti memburuknya masalah ini.Banyak anak dengan autisme lambat untuk meningkatkan kemampuan atau pengalaman baru, dan beberapa memiliki tanda rendahnya kecerdasan. Anak lain dengan autisme normal untuk memilikikecerdasan tinggi. Anak ini belajar dengan cepat saat memiliki kesulitan berkomunikasi, menerapkanapa yang mereka ketahui dalam hidup setiap hari dan menyesuaikan diri pada situasi sosial. Sejumlahkecil diantara anak dengan autisme adalah ³sarjana autistic´ dan memiliki kemampuan luar biasa padahal tertentu yang spesifik, seperti seni, matematika atau musik.
enyebab & Faktor Risiko
PenyebabAutisme adalah masalah yang kompleks. Dua anak dengan autisme tidaklah serupa. Pada banyak kasus penyebab kondisi ini antara lain:
Masalah genetik. Beberapa gen menunjukkan keterkaitan dengan autisme. Beberapa mungkinmembuat anak lebih rentan terkena gangguan; mempengaruhi perkembangan otak atau cara selotak berkomunikasi.
aktor lingkungan. Banyak masalah kesehatan terjadi akibat faktor genetik dan lingkungan.Sebagai contoh para ahli menemukan bahwa infeksi virus dan polusi udara memainkan peranterhadap autisme.
aktor risikoAutisme mempengaruhi anak-anak dari semua ras dan bangsa, tetapi faktor tertentu meningkatkanrisiko. Antara lain:
Anak laki-laki tiga atau empat kali lebih mungkin terkena autisme daripada anak perempuan.
Keluarga yang memiliki satu anak dengan autisme mengalami peningkatan risiko memilikianak lain dengan gangguan ini.
Anak dengan kondisi medis tertentu memiliki risiko lebih tinggi mengalami autisme. Kondisitersebut antara lain fragile X syndrome, faktor keturunan yang menyebabkan masalahkecerdasan, tuberous sclerosis, kondisi dimana tumor jinak terjadi di otak, gangguanneurological Tourette syndrome dan epilepsi yang menyebabkan kejang.
Memiliki anak pada usia tua meningkatkan risiko memiliki anak dengan autisme.
Tidak ada cara untuk mencegah autisme. Autisme dapat dilakukan perawatan dan anak-anak dapatmemperbaiki kemampuan berbahasa dan bersosialiasi dengan perawatan tersebut. Jika anak andadidiagnosis dengan autisme, katakan pada dokter anak anda mengenai mengenai membuat strategi perawatan untuk anak anda. Tetap ingat bahwa anda mungkin perlu mencoba beberapa perawatanyang berbeda sebelum menemukan kombinasi terbaik untuk anak anda.
Autism Spectrum Disorders (ASDs)What is autism?Autism is a complex developmental disability that causes problems with social interaction and communication. Symptoms usually start before age three and can cause delays or problems in many different skills that develop from infancy to adulthood.
What is an autism spectrum disorder?Different people with autism can have very different symptoms. Health care providers think of autism as a “spectrum” disorder, a group of disorders with similar features. One person may have mild symptoms, while another may have serious symptoms. But they both have an autism spectrum disorder.
Currently, the autism spectrum disorder category includes:
Autistic disorder (also called “classic” autism) Asperger syndrome Pervasive Developmental Disorder Not Otherwise Specified (or atypical autism)
In some cases, health care providers use a broader term, pervasive developmental disorder, to describe autism. This category includes the autism spectrum disorders above, plus Childhood Disintegrative Disorder and Rett syndrome.
This Web site uses “autism spectrum disorder” and “autism” to mean the same thing.
What are the symptoms of autism?The main signs and symptoms of autism involve problems in the following areas:
Communication - both verbal (spoken) and non-verbal (unspoken, such as pointing, eye contact, and smiling)
Social - such as sharing emotions, understanding how others think and feel, and holding a conversation
Routines or repetitive behaviors (also called stereotyped behaviors) - such as repeating words or actions, obsessively following routines or schedules, and playing in repetitive ways
The symptoms of autism can usually be observed by 18 months of age.
There are many possible red flags for autism - behaviors that may be signs or symptoms of autism. Some features may mean a delay in one or more areas of development, while others may be more typical of autism spectrum disorders. If you think your child shows red flags for autism, talk to your health care provider.
What are the treatments for autism?
There is no cure for autism, nor is there one single treatment for autism spectrum disorders. But there are ways to help minimize the symptoms of autism and to maximize learning.
Behavioral therapy and other therapeutic options
o Behavior management therapy helps to reinforce wanted behaviors, and reduce unwanted behaviors. It is often based on Applied Behavior Analysis (ABA).
o Speech-language therapists can help people with autism improve their ability to communicate and interact with others.
o Occupational therapists can help people find ways to adjust tasks to match their needs and abilities.
o Physical therapists design activities and exercise to build motor control and improve posture and balance.
Educational and/or school-based optionso Public schools are required to provide free, appropriate public education from
age 3 through high school or age 21, whichever comes first.o Typically, a team of people, including the parents, teachers, caregivers, school
psychologists, and other child development specialists work together to design an Individualized Education Plan (IEP) to help guide the child’s school experiences.
Medication optionso Currently there are no medications that can cure autism spectrum disorders or
all of the symptoms. The U.S. Food and Drug Administration has not approved any medications specifically for the treatment of autism, but in many cases medication can treat some of the symptoms associated with autism.
o Selective serotonin reuptake inhibitors (SSRIs), tricyclics, psychoactive/anti-psychotics, stimulants, and anti-anxiety drugs are among the medications that a health care provider might use to treat symptoms of autism spectrum disorders.
o Secretin—a hormone that helps digestion—is not recommended as a treatment for autism.
For more information about treatments, check out the What are the treatments for autism? section of the NICHD publication Autism Overview: What We Know.
Is there a link between autism and vaccines?There is no conclusive scientific evidence that any part of a vaccine or combination of vaccines causes autism, even though researchers have done many studies to answer this important question. There is also no proof that any material used to make or preserve the vaccine plays a role in causing autism.
Although there have been reports of studies that relate vaccines to autism, these findings have not held up under further investigation.
Currently the U.S. Centers for Disease Control and Prevention (CDC) provides the most accurate and up-to-date information about research on autism and vaccines. Its Vaccines and Autism Theory web site provides information from the federal government and from independent organizations about vaccines and autism.
Is autism more common in certain groups of people?Three groups are at higher-than-normal risk for autism spectrum disorders, including:
Boys Siblings of those with autism
People with certain other developmental disorders, such as Fragile X syndrome
What Are the Autism Spectrum Disorders?
The autism spectrum disorders are more common in the pediatric population than are some better known disorders such as diabetes, spinal bifida, or Down syndrome.2 A recent study of a U.S. metropolitan area estimated that 3.4 of every 1,000 children 3-10 years old had autism.3 The earlier the disorder is diagnosed, the sooner the child can be helped through treatment interventions. Pediatricians, family physicians, daycare providers, teachers, and parents may initially dismiss signs of ASD, optimistically thinking the child is just a little slow and will “catch up.”
All children with ASD demonstrate deficits in 1) social interaction, 2) verbal and nonverbal communication, and 3) repetitive behaviors or interests. In addition, they will often have unusual responses to sensory experiences, such as certain sounds or the way objects look. Each of these symptoms runs the gamut from mild to severe. They will present in each individual child differently. For instance, a child may have little trouble learning to read but exhibit extremely poor social interaction. Each child will display communication, social, and behavioral patterns that are individual but fit into the overall diagnosis of ASD.
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. Some other children start off well enough. Oftentimes between 12 and 36 months old, the differences in the way they react to people and other unusual behaviors become apparent. Some parents report the change as being sudden, and that their children start to reject people, act strangely, and lose language and social skills they had previously acquired. In other cases, there is a plateau, or leveling, of progress so that the difference between the child with autism and other children the same age becomes more noticeable.
ASD is defined by a certain set of behaviors that can range from the very mild to the severe. The following possible indicators of ASD were identified on the Public Health Training Network Webcast, Autism Among Us.4
Possible Indicators of Autism Spectrum Disorders
Does not babble, point, or make meaningful gestures by 1 year of age Does not speak one word by 16 months Does not combine two words by 2 years Does not respond to name Loses language or social skills
Some Other Indicators
Poor eye contact Doesn't seem to know how to play with toys Excessively lines up toys or other objects Is attached to one particular toy or object
Doesn't smile At times seems to be hearing impaired
From the start, typically developing infants are social beings. Early in life, they gaze at people, turn toward voices, grasp a finger, and even smile.
In contrast, most children with ASD seem to have tremendous difficulty learning to engage in the give-and-take of everyday human interaction. Even in the first few months of life, many do not interact and they avoid eye contact. They seem indifferent to other people, and often seem to prefer being alone. They may resist attention or passively accept hugs and cuddling. Later, they seldom seek comfort or respond to parents' displays of anger or affection in a typical way. Research has suggested that although children with ASD are attached to their parents, their expression of this attachment is unusual and difficult to “read.” To parents, it may seem as if their child is not attached at all. Parents who looked forward to the joys of cuddling, teaching, and playing with their child may feel crushed by this lack of the expected and typical attachment behavior.
Children with ASD also are slower in learning to interpret what others are thinking and feeling. Subtle social cues—whether a smile, a wink, or a grimace—may have little meaning. To a child who misses these cues, “Come here” always means the same thing, whether the speaker is smiling and extending her arms for a hug or frowning and planting her fists on her hips. Without the ability to interpret gestures and facial expressions, the social world may seem bewildering. To compound the problem, people with ASD have difficulty seeing things from another person's perspective. Most 5-year-olds understand that other people have different information, feelings, and goals than they have. A person with ASD may lack such understanding. This inability leaves them unable to predict or understand other people's actions.
Although not universal, it is common for people with ASD also to have difficulty regulating their emotions. This can take the form of “immature” behavior such as crying in class or verbal outbursts that seem inappropriate to those around them. The individual with ASD might also be disruptive and physically aggressive at times, making social relationships still more difficult. They have a tendency to “lose control,” particularly when they're in a strange or overwhelming environment, or when angry and frustrated. They may at times break things, attack others, or hurt themselves. In their frustration, some bang their heads, pull their hair, or bite their arms.
By age 3, most children have passed predictable milestones on the path to learning language; one of the earliest is babbling. By the first birthday, a typical toddler says words, turns when he hears his name, points when he wants a toy, and when offered something distasteful, makes it clear that the answer is “no.”
Some children diagnosed with ASD remain mute throughout their lives. Some infants who later show signs of ASD coo and babble during the first few months of life, but they soon
stop. Others may be delayed, developing language as late as age 5 to 9. Some children may learn to use communication systems such as pictures or sign language.
Those who do speak often use language in unusual ways. They seem unable to combine words into meaningful sentences. Some speak only single words, while others repeat the same phrase over and over. Some ASD children parrot what they hear, a condition called echolalia. Although many children with no ASD go through a stage where they repeat what they hear, it normally passes by the time they are 3.
Some children only mildly affected may exhibit slight delays in language, or even seem to have precocious language and unusually large vocabularies, but have great difficulty in sustaining a conversation. The “give and take” of normal conversation is hard for them, although they often carry on a monologue on a favorite subject, giving no one else an opportunity to comment. Another difficulty is often the inability to understand body language, tone of voice, or “phrases of speech.” They might interpret a sarcastic expression such as “Oh, that's just great” as meaning it really IS great.
While it can be hard to understand what ASD children are saying, their body language is also difficult to understand. Facial expressions, movements, and gestures rarely match what they are saying. Also, their tone of voice fails to reflect their feelings. A high-pitched, sing-song, or flat, robot-like voice is common. Some children with relatively good language skills speak like little adults, failing to pick up on the “kid-speak” that is common in their peers.
Without meaningful gestures or the language to ask for things, people with ASD are at a loss to let others know what they need. As a result, they may simply scream or grab what they want. Until they are taught better ways to express their needs, 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. As a result they may become anxious or depressed.
Although children with ASD usually appear physically normal and have good muscle control, odd repetitive motions may set them off from other children. These behaviors might be extreme and highly apparent or more subtle. Some children and older individuals spend a lot of time repeatedly flapping their arms or walking on their toes. Some suddenly freeze in position.
As children, they might spend hours lining up their cars and trains in a certain way, rather than using them for pretend play. If someone accidentally moves one of the toys, the child may be tremendously upset. ASD children need, and demand, absolute consistency in their environment. A slight change in any routine—in mealtimes, dressing, taking a bath, going to school at a certain time and by the same route—can be extremely disturbing. Perhaps order and sameness lend some stability in a world of confusion.
Repetitive behavior sometimes takes the form of a 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.
Problems That May Accompany ASD
Sensory problems. When children's perceptions are accurate, they can learn from what they see, feel, or hear. On the other hand, if sensory information is faulty, the child's experiences of the world can be confusing. Many ASD children are highly attuned or even painfully sensitive to certain sounds, textures, tastes, and smells. Some children find the feel of clothes touching their skin almost unbearable. Some sounds—a vacuum cleaner, a ringing telephone, a sudden storm, even the sound of waves lapping the shoreline—will cause these children to cover their ears and scream.
In ASD, the brain seems unable to balance the senses appropriately. Some ASD children are oblivious to extreme cold or pain. An ASD child may fall and break an arm, yet never cry. Another may bash his head against a wall and not wince, but a light touch may make the child scream with alarm.
Mental retardation. Many children with ASD have some degree of mental impairment. When tested, some areas of ability may be normal, while others may be especially weak. For example, a child with ASD may do well on the parts of the test that measure visual skills but earn low scores on the language subtests.
Seizures. One in four children with ASD develops seizures, often starting either in early childhood or adolescence. 5 Seizures, caused by abnormal electrical activity in the brain, can produce a temporary loss of consciousness (a “blackout”), a body convulsion, unusual movements, or staring spells. Sometimes a contributing factor is a lack of sleep or a high fever. An EEG (electroencephalogram—recording of the electric currents developed in the brain by means of electrodes applied to the scalp) can help confirm the seizure's presence.
In most cases, seizures can be controlled by a number of medicines called “anticonvulsants.” The dosage of the medication is adjusted carefully so that the least possible amount of medication will be used to be effective.
Fragile X syndrome. This disorder is the most common inherited form of mental retardation. It was so named because one part of the X chromosome has a defective piece that appears pinched and fragile when under a microscope. Fragile X syndrome affects about two to five percent of people with ASD. It is important to have a child with ASD checked for Fragile X, especially if the parents are considering having another child. For an unknown reason, if a child with ASD also has Fragile X, there is a one-in-two chance that boys born to the same parents will have the syndrome. 6 Other members of the family who may be contemplating having a child may also wish to be checked for the syndrome.
A distinction can be made between a father's and mother's ability to pass along to a daughter or son the altered gene on the X chromosome that is linked to fragile X syndrome. Because both males (XY) and females (XX) have at least one X chromosome, both can pass on the mutated gene to their children.
A father with the altered gene for Fragile X on his X chromosome will only pass that gene on to his daughters. He passes a Y chromosome on to his sons, which doesn't transmit the condition. Therefore, if the father has the altered gene on his X chromosome, but the mother's X chromosomes are normal, all of the couple's daughters would have the altered gene for
Fragile X, while none of their sons would have the mutated gene. Because mothers pass on only X chromosomes to their children, if the mother has the altered gene for Fragile X, she can pass that gene to either her sons or her daughters. If the mother has the mutated gene on one X chromosome and has one normal X chromosome, and the father has no genetic mutations, all the children have a 50-50 chance of inheriting the mutated gene.
The odds noted here apply to each child the parents have 7 in terms of prevalence, the latest statistics are consistent in showing that 5% of people with autism are affected by fragile X and 10% to 15% of those with fragile X show autistic traits.
Tuberous Sclerosis. Tuberous sclerosis is a rare genetic disorder that causes benign tumors to grow in the brain as well as in other vital organs. It has a consistently strong association with ASD. One to 4 percent of people with ASD also have tuberous sclerosis.8
DefinitionBy Mayo Clinic staff
Autism is one of a group of serious developmental problems called autism spectrum disorders (ASD) that appear in early childhood — usually before age 3. Though symptoms and severity vary, all autism disorders affect a child's ability to communicate and interact with others.
The number of children diagnosed with autism appears to be rising. It's not clear whether this is due to better detection and reporting of autism, a real increase in the number of cases, or both.
While there is no cure for autism, intensive, early treatment can make a big difference in the lives of many children with the disorder.
SymptomsBy Mayo Clinic staff
Children with autism generally have problems in three crucial areas of development — social interaction, language and behavior. But because autism symptoms vary greatly, two children with the same diagnosis may act quite differently and have strikingly different skills. In most cases, though, severe autism is marked by a complete inability to communicate or interact with other people.
Some children show signs of autism in early infancy. Other children may develop normally for the first few months or years of life but then suddenly become withdrawn, become aggressive or lose language skills they've already acquired. Though each child with autism is likely to have a unique pattern of behavior, these are some common autism symptoms:
Fails to respond to his or her name Has poor eye contact Appears not to hear you at times Resists cuddling and holding Appears unaware of others' feelings Seems to prefer playing alone — retreats into his or her "own world"
Starts talking later than age 2, and has other developmental delays by 30 months Loses previously acquired ability to say words or sentences Doesn't make eye contact when making requests Speaks with an abnormal tone or rhythm — may use a singsong voice or robot-like speech Can't start a conversation or keep one going May repeat words or phrases verbatim, but doesn't understand how to use them
Performs repetitive movements, such as rocking, spinning or hand-flapping Develops specific routines or rituals Becomes disturbed at the slightest change in routines or rituals Moves constantly May be fascinated by parts of an object, such as the spinning wheels of a toy car May be unusually sensitive to light, sound and touch and yet oblivious to pain
Young children with autism also have a hard time sharing experiences with others. When read to, for example, they're unlikely to point at pictures in the book. This early-developing social skill is crucial to later language and social development.
As they mature, some children with autism become more engaged with others and show less marked disturbances in behavior. Some, usually those with the least severe problems, eventually may lead normal or near-normal lives. Others, however, continue to have difficulty with language or social skills, and the adolescent years can mean a worsening of behavioral problems.
Most children with autism are slow to gain new knowledge or skills, and some have signs of lower than normal intelligence. Other children with autism have normal to high intelligence. These children learn quickly yet have trouble communicating, applying what they know in everyday life and adjusting in social situations. A small number of children with autism are "autistic savants" and have exceptional skills in a specific area, such as art, math or music.
When to see a doctorBabies develop at their own pace, and many don't follow exact timelines found in some parenting books. But children with autism usually show some signs of delayed development by 18 months. If you suspect that your child may have autism, discuss your concerns with your doctor. The earlier treatment begins, the more effective it will be.
Your doctor may recommend further developmental tests if your child:
Doesn't babble or coo by 12 months Doesn't gesture — such as point or wave — by 12 months Doesn't say single words by 16 months Doesn't say two-word phrases by 24 months Loses previously acquired language or social skills at any age
CausesBy Mayo Clinic staff
Autism has no single, known cause. Given the complexity of the disease, the range of autistic disorders and the fact that no two children with autism are alike, there are likely many causes. These may include:
Genetic problems. A number of genes appear to be involved in autism. Some may make a child more susceptible to the disorder; others affect brain development or the way brain cells communicate. Still others may determine the severity of symptoms. Each problem in genes may account for a small number of cases, but taken together, the influence of genes
may be substantial. Some genetic problems seem to be inherited, whereas others happen spontaneously.
Environmental factors. Many health problems are due to both genetic and environmental factors, and this is likely the case with autism as well. Researchers are currently exploring whether viral infections and air pollutants, for example, play a role in triggering autism.
No link between vaccines and autismOne of the greatest controversies in autism is centered on whether a link exists between autism and certain childhood vaccines, particularly the measles-mumps-rubella (MMR) vaccine. No reliable study has shown a link between autism and the MMR vaccination. A study published in 1998 that theorized there could be a link has been retracted because there's little evidence to support that theory.
Avoiding childhood vaccinations can place your child in danger of catching serious diseases, including whooping cough (pertussis), measles or mumps.
Risk factorsBy Mayo Clinic staff
Autism affects children of all races and nationalities, but certain factors increase a child's risk. They include:
Your child's sex. Boys are three to four times more likely to develop autism than girls are. Family history. Families who have one child with autism have an increased risk of having
another child with the disorder. It's also not uncommon for the parents or relatives of an autistic child to have minor problems with social or communication skills themselves or to engage in certain autistic behaviors.
Other disorders. Children with certain medical conditions have a higher than normal risk of having autism. These conditions include fragile X syndrome, an inherited disorder that causes intellectual problems; tuberous sclerosis, a condition in which benign tumors develop in the brain; the neurological disorder Tourette syndrome; and epilepsy, which causes seizures.
Parents' ages. Having an older father (being 40 or older) may increase a child's risk of autism. There may also be a connection between children being born to older mothers and autism, but more research is necessary.
Tests and diagnosisBy Mayo Clinic staff
Your child's doctor will look for signs of developmental delays at regular checkups. If your child shows some signs of autism, you may be referred to a specialist in treating children with autism. This specialist, working with a team of professionals, can perform a formal evaluation for the disorder.
Because autism varies widely in severity, making a diagnosis may be difficult. There isn't a specific medical test to pinpoint the disorder. Instead, an autism specialist will observe your child and talk to you about how your child's social skills, language skills and behavior have
developed and changed over time. To help reach a diagnosis, your child may undergo a number of developmental tests covering speech, language and psychological issues.
Although the signs of autism often appear by 18 months, the diagnosis sometimes isn't made until age 2 or 3, when there may be more obvious delays in language development and social interactions. Early diagnosis is important because early intervention — preferably before age 3 — appears to be the most helpful.
Diagnostic criteria for autismFor your child to be diagnosed with autism, he or she must meet the symptom criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.
To be diagnosed with autism, your child must have six or more of the following symptoms and two or more of those symptoms must fall under the social skills category.
Has difficulty with nonverbal behaviors, such as making eye contact, making facial expressions or using gestures
Has difficulty forming friendships with peers and seems to prefer playing alone Doesn't share experiences or emotions with other people, such as sharing achievements or
pointing out objects or other interests Appears unaware of others' feelings
Starts talking later than age 2 and has other developmental delays by 30 months, and doesn't make an attempt to communicate with gestures or miming
Can't start a conversation or keep one going May repeat words or phrases verbatim, but doesn't understand how to use them Doesn't play make-believe or doesn't imitate the behavior of adults when playing
Develops interests in objects or topics that are abnormal in intensity or focus Performs repetitive movements, such as rocking, spinning or hand-flapping Becomes disturbed at the slightest change in routines or rituals May be fascinated by parts of an object, such as the spinning wheels of a toy car
Treatments and drugsBy Mayo Clinic staff
No cure exists for autism, and there is no "one-size-fits-all" treatment. The range of home-based and school-based treatments and interventions for autism can be overwhelming.
Your doctor can help identify resources in your area that may work for your child. Treatment options may include:
Behavior and communication therapies. Many programs have been developed to address the range of social, language and behavioral difficulties associated with autism. Some programs focus on reducing problem behaviors and teaching new skills. Other programs focus on teaching children how to act in social situations or how to communicate better with other people. Though children don't always outgrow autism, they may learn to function well with the disorder.
Educational therapies. Children with autism often respond well to highly structured education programs. Successful programs often include a team of specialists and a variety of activities to improve social skills, communication and behavior. Preschool children who receive intensive, individualized behavioral interventions show good progress.
Medications. No medication can improve the core signs of autism, but certain medications can help control symptoms. Antidepressants may be prescribed for anxiety, for example, and antipsychotic drugs are sometimes used to treat severe behavioral problems.
Managing other medical conditionsAutistic children may also have other medical conditions, such as epilepsy or gastrointestinal problems. Talk to your child's doctor about how to best manage your child's conditions together, and always tell each of your child's health care providers all the medications and supplements your child is taking. Some medications and supplements can interact, causing dangerous side effects.
Alternative medicineBy Mayo Clinic staff
Because autism is an incurable disease, many parents seek out alternative therapies. Though some families have reported good results with special diets and other complementary approaches, researchers aren't sure how useful the treatments are. Some of the most common alternative therapies include:
Creative therapies. Some parents choose to supplement educational and medical intervention with art therapy, music therapy or sensory integration, which focuses on reducing a child's sensitivity to touch or sound.
Special diets. Several diet strategies have been suggested as possible treatments for autism, including restriction of food allergens; probiotics; a yeast-free diet; a gluten-free, casein-free diet; and dietary supplements such as vitamin A, vitamin C, vitamin B-6 and magnesium, folic acid, vitamin B-12, and omega-3 fatty acids. One popular diet eliminates gluten — a protein found in most grains, including wheat — and casein (a milk protein), but more research is necessary to see if the diet has any effect on autism signs and symptoms. To find out more, talk to a registered dietitian with special expertise in autism.
Chelation therapy. This treatment is said to remove mercury and other heavy metals from the body. However, there's no known link between mercury and autism, and chelation therapy can be very dangerous. Chelation therapy can cause kidney failure. Some people who have participated in chelation therapy studies have died.
Coping and supportBy Mayo Clinic staff
Raising a child with autism can be physically exhausting and emotionally draining. These ideas may help:
Find a team of trusted professionals. You'll need to make important decisions about your child's education and treatment. Find a team of teachers and therapists who can help look at the options in your area and explain the resources for children with disabilities. Make certain this team includes a case manager or service coordinator, who can help access financial services and government programs.
Take time for yourself and other family members. Caring for a child with autism can be a round-the-clock job that puts stress on your marriage and your whole family. To avoid burnout, take time out to relax, exercise or enjoy your favorite activities. Try to schedule one-on-one time with your other children and plan date nights with your spouse — even if it's just watching a movie together after the children go to bed.
Seek out other families of autistic children. Other families struggling with the challenges of autism can be a source of useful advice. Many communities have support groups for parents and siblings of children with autism.
Learn about the disorder. There are many myths and misconceptions about autism. Learning the truth can help you better understand your child and his or her attempts to communicate. With time, you'll likely be rewarded by seeing your child grow and learn and even show affection — in his or her own way.
PreventionBy Mayo Clinic staff
There's no way to prevent autism. Autism can be treated, and children can have improved language and social skills with treatments. If your child is diagnosed with autism, talk to your child's doctors about creating a treatment strategy for your child. Keep in mind that you may need to try several different treatments before finding the best combination of therapies for your child.
Types of ASDs
ASD Fact Sheet
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There are three different types of ASDs:
Autistic Disorder (also called “classic” autism)This is what most people think of when hearing the word “autism.” People with autistic disorder usually have significant language delays, social and communication challenges, and unusual behaviors and interests. Many people with autistic disorder also have intellectual disability.
Asperger SyndromePeople with Asperger syndrome usually have some milder symptoms of autistic disorder. They might have social challenges and unusual behaviors and interests. However, they typically do not have problems with language or intellectual disability.
Pervasive Developmental Disorder – Not Otherwise Specified (PDD-NOS; also called “atypical autism”)People who meet some of the criteria for autistic disorder or Asperger syndrome, but not all, may be diagnosed with PDD-NOS. People with PDD-NOS usually have fewer and milder symptoms than those with autistic disorder. The symptoms might cause only social and communication challenges.
Signs and Symptoms
ASDs begin before the age of 3 and last throughout a person's life, although symptoms may improve over time. Some children with an ASD show hints of future problems within the first few months of life. In others, symptoms might not show up until 24 months or later. Some children with an ASD seem to develop normally until around 18 to 24 months of age and then they stop gaining new skills, or they lose the skills they once had.
A person with an ASD might:
Not respond to their name by 12 months
Not point at objects to show interest (point at an airplane flying over) by 14 months Not play "pretend" games (pretend to "feed" a doll) by 18 months Avoid eye contact and want to be alone Have trouble understanding other people's feelings or talking about their own feelings Have delayed speech and language skills Repeat words or phrases over and over (echolalia) Give unrelated answers to questions Get upset by minor changes Have obsessive interests Flap their hands, rock their body, or spin in circles Have unusual reactions to the way things sound, smell, taste, look, or feel