Autism: Features, assessment, and support (original) (raw)

Autism spectrum disorder (ASD) accounts for the range of strengths and support needs that autistic people have. Autism is a neurodevelopmental condition that affects social interaction, behavior, and communication.

Autistic individuals vary widely in their strengths and need for support. For this reason, people often refer to autism as autism spectrum disorder (ASD).

The features of autism often appear in the early years. Autism is not a disease, but early intervention can equip children to manage some of the specific challenges they may face in the wider world.

In the United States, about 1 in 54 children are on the autism spectrum, according to the Centers for Disease Control and Prevention (CDC). Males are diagnosed with ASD four times more often than females. One explanation may be that females present with different signs and symptoms that may go unrecognized.

ASD is an umbrella term that includes a range of neurodevelopmental features. Autism is not a disease, but it can have a significant impact on a person’s life.

Its effects can vary widely. Some people will need lifelong support, while others can live and work independently.

In some cases, the features of the condition may be present from infancy. In others, the signs may become more obvious as the individual becomes older.

Parents or caregivers may notice that a young child:

• does not babble by the age of 12 months or produce words by 16 months
• does not respond when people talk to them but reacts to other sounds
• does not make eye contact
• lines up toys or objects excessively
• does not want to be cuddled
• does not play with others or play make-believe games

An older child may:

• have difficulty starting conversations
• have difficulty making friends and interacting with others
• use repetitive or atypical language
• be uncomfortable with changes to their routine
• be extremely passionate about specific topics or objects

ASD can affect a person’s way of perceiving the world. The person may be hypersensitive to some stimuli, such as light, sound, and taste, leading to the overstimulation of one or more senses. This is called sensory overload.

It can make everyday experiences, such as going to a shopping mall, confusing and overwhelming.

Other people may notice that the person with ASD has:

• atypical speech patterns and tone of voice
• late development of speech skills
• difficulty maintaining or responding to conversation
• limited eye contact
• limited response to social interaction
• repetitive speech and behavior patterns
• difficulty in understanding other people’s feelings and expressing their own

The individual may also show repetitive behaviors, such as:

• hyperfocus on a specific topic, such as cars or train timetables
• a preoccupation with particular objects, such as a toy or household item
• repetitive movements, such as rocking from side to side
• lining up or arranging toys or objects in an orderly way
• needing to go through a predictable routine each day

For an autistic person, a break in routine, an unexpected event, or exposure to loud, overstimulating environments can be overwhelming. Such situations can lead to outbursts of anger, frustration, distress, sadness, or shutdown that others may misinterpret as “bad” behavior.

Approximately 1 in 10 autistic people show signs of savant syndrome, in which a person has extraordinary abilities in a particular field. Their skill could be playing a musical instrument, calculating complex sums at high speed, or memorizing vast amounts of knowledge.

Autistic people may also have a higher risk of other conditions, such as:

• depression
• anxiety
• obsessive-compulsive disorder (OCD)
• gastrointestinal problems
• sleep disorders
• obesity
• high blood pressure
• diabetes
• seizures

The features of autism often appear during early childhood, and a reliable diagnosis is usually possible at the age of 2 years.

However, many people do not receive a diagnosis until much later. Sometimes, having an early diagnosis helps enable a child to get support during their developmental years that will benefit them throughout their life.

The features of autism vary widely, but if a parent or caregiver has concerns about a child’s reactions or behavior, they should seek help and advice.

There is no one test for autism, but doctors and psychologists will use behavioral assessments, questionnaires, observations, and criteria from the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) to determine whether ASD is present.

They will also need to rule out other possible causes of some behaviors and symptoms seen in ASD, such as hearing loss.

ASD is a lifelong condition, but various interventions can help people manage the challenges they may face.

Medication and therapy can help with

• speech development
• social interaction
• epilepsy
• depression
• OCD
• sleep disturbances
• behavioral challenges

A multidisciplinary team comprising ASD specialists, speech therapists, teachers, and psychologists can work with the individual and their parents or caregivers to provide support.

Strategies and skills

Autistic people may behave in ways that appear unusual to others. In fact, these behaviors — for example, performing a repetitive movement — are most likely to be strategies for helping them cope when they feel overwhelmed.

These behaviors may be ways for a person to:

• protect themselves from an environment that feels overwhelming
• manage their emotions
• establish a sense of order

Neurotypical people may not understand these reactions, which can lead to the person feeling isolated and distressed.

Parents, caregivers, and others can maximize a child’s quality of life by learning about ASD and providing support.

• learning how ASD affects the child
• accepting that while an autistic person may be different than a neurotypical person, they are still a complete person with their own strengths and weaknesses
• being consistent in routines and rules
• building on the child’s strengths and interests
• researching and building up a support network
• following routines where possible
• planning and preparing for changes in advance
• avoiding overstimulating environments where possible or introducing them gradually
• encouraging cooperative behavior by setting limits and offering choices
• listening to autistic people who speak and write about their experiences

They can also work with the child to find out:

• what triggers a reaction
• what reactions are likely to occur and when
• what they enjoy and dislike
• how they best communicate
• how they prefer to learn
• what their strengths and weaknesses are

Researchers are still trying to find out why ASD occurs.

Factors that may play a role include:

• genetic features
• environmental factors
• early disruption of brain growth
• preterm birth
• being male, as ASD affects about four times as many males as females
• having a twin who is autistic

Researchers have found no evidence that vaccinations or parenting practices contribute to the condition.

The autism spectrum covers several disorders with a wide range of features. Each autistic person is unique, and no single definition can describe an individual or predict how their life will be.

Some people will have high support needs throughout their life, while others will live independently, attend college, and be high achievers.

ASD is a lifelong condition, but support and therapies can help autistic people manage the varied challenges that they can face.

Parents or caregivers who suspect that a child may have signs of autism can help by seeking professional advice as soon as possible. Early intervention can help maximize the chances of an autistic individual achieving their full potential.

Autism is a complex neurodevelopmental condition that can affect how a person reacts to and relates to the world around them.

The impact of autism varies widely among individuals. Some autistic people live independently, while others need lifelong care and support.

Current therapies include occupational therapy and speech therapy. Various other forms of support are also available.