Mitchel G. Katz, MD Connecticut ADHD Associates
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As a parent, you’ve probably spent hours poring over books, Web sites, and magazine articles to determine if your child is developing normally.
While there is a wide range of “normal,” most children hit milestones like smiling, crawling, walking, and talking at about the same age. But what
if your child consistently lags behind his peers, especially in communication and social skills? You might be tempted to “wait it out” or chalk it up
to shyness, but it is wise to resist that temptation. Instead, think about having your child screened for an autism spectrum disorder (ASD).This
broad label covers five related developmental disorders: autism, Asperger syndrome, childhood disintegrative disorder, Rett syndrome, and
“pervasive developmental disorder” (PDD).
ASDs (referred to here as “autism”) are difficult to define in broad terms because the symptoms and their severity vary from person to person.
However, the National Institute of Child Health & Human Development has created a list of typical “red flags” that may point to autism.
Because autism is a genetic disorder, there is no single treatment or medication that can “cure” it. However, early identification and intervention,
through medication and therapy, can limit symptoms and help the child enjoy a better quality of life.
These efforts are paying off. Many experts have attributed the increased prevalence of autism in recent years not to a greater incidence of the
disorder itself but to improved awareness of the early signs and symptoms by parents and pediatricians alike. In fact, the U.S. Centers for
Disease Control and Prevention (CDC) has revised the autism diagnosis rate over the past few years from 6 in 1,000 to roughly 9 in 1,000 (or
nearly 1 in 110) children.
Improved awareness, along with a number of research projects, also is helping to reduce the social stigma associated with autism and dispel
some of the myths.
One myth is that routine vaccinations can bring on autism in a normally developing child. Many studies have looked at this claim and, to date,
none have found any scientific evidence to support it.
Autism spectrum disorders are lifelong conditions with no known cure. However, children with ASD can progress developmentally and learn new
skills. Some children may improve so much that they no longer meet the criteria for ASD, although milder symptoms may often persist.
No 2 children with ASD have the exact same symptoms, but the criteria are somewhat standardized. The number of symptoms and how severe
they are can vary greatly. The following are examples of how a child with ASD may act:
Social Differences
Communication Differences
Behavioral Differences (Stereotypic, Repetitive, And Restrictive Patterns)
Many children with ASD may show developmental differences throughout their infancy, especially in social and language skills. Because they
usually sit, crawl, and walk on time, these more subtle differences often go unnoticed. A child with ASD may have
All children with autism show significant language delays. Those children later diagnosed with Asperger syndrome will seem to have met
language milestones during the toddler years, but use of language may be abnormal.
About 25% of children will seem to have normal development until about 18 months, after which they will gradually or suddenly
Although all children with ASD will need developmental and educational services and most will need therapy and behavioral interventions, only
certain children may need medicine. Medicine may be needed to control behaviors that could interfere with ASD interventions. Aggressive or
disruptive behaviors can become a problem when they cause physical harm to others (or to the child himself) or when they prevent him from
cooperating with therapists or teachers.
Parents are encouraged to learn as much as they can about all the different treatments available. Treatment should focus on supporting the child
to succeed in the real world.
While there is a wide range of “normal,” most children hit milestones like smiling, crawling, walking, and talking at about the same age. But what
if your child consistently lags behind his peers, especially in communication and social skills? You might be tempted to “wait it out” or chalk it up
to shyness, but it is wise to resist that temptation. Instead, think about having your child screened for an autism spectrum disorder (ASD).This
broad label covers five related developmental disorders: autism, Asperger syndrome, childhood disintegrative disorder, Rett syndrome, and
“pervasive developmental disorder” (PDD).
ASDs (referred to here as “autism”) are difficult to define in broad terms because the symptoms and their severity vary from person to person.
However, the National Institute of Child Health & Human Development has created a list of typical “red flags” that may point to autism.
Because autism is a genetic disorder, there is no single treatment or medication that can “cure” it. However, early identification and intervention,
through medication and therapy, can limit symptoms and help the child enjoy a better quality of life.
These efforts are paying off. Many experts have attributed the increased prevalence of autism in recent years not to a greater incidence of the
disorder itself but to improved awareness of the early signs and symptoms by parents and pediatricians alike. In fact, the U.S. Centers for
Disease Control and Prevention (CDC) has revised the autism diagnosis rate over the past few years from 6 in 1,000 to roughly 9 in 1,000 (or
nearly 1 in 110) children.
Improved awareness, along with a number of research projects, also is helping to reduce the social stigma associated with autism and dispel
some of the myths.
One myth is that routine vaccinations can bring on autism in a normally developing child. Many studies have looked at this claim and, to date,
none have found any scientific evidence to support it.
Autism spectrum disorders are lifelong conditions with no known cure. However, children with ASD can progress developmentally and learn new
skills. Some children may improve so much that they no longer meet the criteria for ASD, although milder symptoms may often persist.
No 2 children with ASD have the exact same symptoms, but the criteria are somewhat standardized. The number of symptoms and how severe
they are can vary greatly. The following are examples of how a child with ASD may act:
Social Differences
- Doesn't snuggle when picked up, but arches back instead
Doesn't keep eye contact or makes very little eye contact
Doesn't respond to parent's smile or other facial expressions
Doesn't look at objects or events parents are looking at or pointing to
Doesn't point to objects or events to get parents to look at them
Doesn't bring objects to show to parents just to share his interest
Doesn't often have appropriate facial expressions
Unable to perceive what others might be thinking or feeling by looking at their facial expressions
Doesn't show concern (empathy) for others
Unable to make friends
Communication Differences
Doesn't say single words by 15 months or 2-word phrases by 24 months
Repeats exactly what others say without understanding its meaning (parroting or echolalia)
Doesn't respond to name being called, but does respond to other sounds (like a car horn or a cat's meow)
Refers to self as "you" and others as "I" (pronominal reversal)
Often doesn't seem to want to communicate
Doesn't start or can't continue a conversation
Doesn't use toys or other objects to represent people or real life in pretend play
May have a good rote memory, especially for numbers, songs, TV jingles, or a specific topic
Loses language milestones, usually between the ages of 15 to 24 months in a few children (regression)
Behavioral Differences (Stereotypic, Repetitive, And Restrictive Patterns)
Rocks, spins, sways, twirls fingers, or flaps hands (stereotypic behavior)
Likes routines, order, and rituals
Obsessed with a few activities, doing them repeatedly during the day
Plays with parts of toys instead of the whole toy (for example, spinning the wheels of a toy truck)
May have splinter skills, such as the ability to read at an early age, but often without understanding what it means
Doesn't cry if in pain or seem to have any fear
May be very sensitive or not sensitive at all to smells, sounds, lights, textures, and touch
Unusual use of vision or gaze—looks at objects from unusual angles
May have unusual or intense but narrow interests
Many children with ASD may show developmental differences throughout their infancy, especially in social and language skills. Because they
usually sit, crawl, and walk on time, these more subtle differences often go unnoticed. A child with ASD may have
Not smiled back to you or smiled less often or less enthusiastically than you expected.
Not cuddled like other children.
Not made as much eye contact with others.
Not responded to her name being called.
Seemed to tune others out. At other times, she may have seemed to hear environmental sounds, even very faint ones, perfectly well.
This was probably confusing and may have caused you to worry about a hearing problem.
All children with autism show significant language delays. Those children later diagnosed with Asperger syndrome will seem to have met
language milestones during the toddler years, but use of language may be abnormal.
About 25% of children will seem to have normal development until about 18 months, after which they will gradually or suddenly
Stop talking (if they had begun to say a few words).
Stop waving goodbye.
Stop turning their heads when their names are called.
Withdraw into a shell and seem more distant and less interested in their surroundings.
Although all children with ASD will need developmental and educational services and most will need therapy and behavioral interventions, only
certain children may need medicine. Medicine may be needed to control behaviors that could interfere with ASD interventions. Aggressive or
disruptive behaviors can become a problem when they cause physical harm to others (or to the child himself) or when they prevent him from
cooperating with therapists or teachers.
Parents are encouraged to learn as much as they can about all the different treatments available. Treatment should focus on supporting the child
to succeed in the real world.
Autistic
Spectrum
Disorders
(ASDs)
Spectrum
Disorders
(ASDs)