Autism spectrum disorder (ASD) includes a group of developmental disorders that affect communication, social interactions, and behavior. The condition starts in early childhood and continues throughout life. Children usually do not outgrow ASD.

ASD affects each child differently. Some children with ASD have above-average intelligence. Others have severe intellectual disabilities. Some children can do most activities or learn to do them. Others require a lot of assistance.

What are the causes?

The exact cause of this condition is not known. Most experts believe that ASD is caused by genes that are passed down through families.

What increases the risk?

This condition is more likely to develop in children who:

• Are male.
• Have a family history of the condition.
• Were born before 26 weeks of pregnancy (prematurely).
• Were born with another genetic disorder.
• Were conceived when their parents were older than 35–40 years of age.
• Were exposed to a seizure medicine called valproic acid while in their mother's womb.

What are the signs or symptoms?

Symptoms of this condition often start before age 2. Early symptoms include:

• Not making eye contact.
• Not wanting to be hugged or cuddled.
• Not pointing or looking when someone else is pointing.
• Not being interested in others or not responding to others.
• Not babbling by age 1 or not using single words by 16 months.
• Not using two-word phrases by age 2.

Later symptoms include:

• Repeating unusual movements or behaviors, such as rocking or head banging.
• Being completely focused on an object or excessively lining up toys or other objects.
• Not playing pretend games.
• Repeating words or phrases over and over (echolalia).
• Being very sensitive to noises, loud voices, touch, lights, or sudden movement.
• Not using words, or using words incorrectly.
• Lacking friendships or having no interest in making friends.

How is this diagnosed?

This condition is diagnosed with a comprehensive assessment. Your child may need to see a team of health care providers, which may include:

• A developmental pediatrician.
• A child psychologist or psychiatrist.
• A neurologist.
• A speech and language therapist.
• An occupational therapist.

Your child's health care providers will assess his or her behavior and development. The health care team will determine whether your child has level 1, level 2, or level 3 ASD based on the amount of support that your child requires. Each level has specific criteria for diagnosis.

Level 1

Level 1 ASD is the mildest form of the condition. With treatment, this form may not be noticeable. If your child has this form, he or she may:

• Speak in full sentences.
• Have no repetitive behaviors.
• Have trouble starting interactions or friendships with others.
• Have trouble switching between two or more activities.

Level 2

Level 2 ASD is a moderate form of the condition. If your child has this form, he or she may:

• Speak in simple sentences.
• Repeat certain behaviors, which interferes with daily activities from time to time.
• Only interact with others about specific, shared interests.
• Have trouble coping with change.
• Have unusual nonverbal communication skills.

Level 3

Level 3 ASD is the most severe form of the condition. This form interferes with daily life. If your child has this form, he or she may:

• Speak rarely or use very few understandable words.
• Repeat certain behaviors often, which gets in the way of daily activities.
• Interact with others awkwardly and not very often.
• Have extreme difficulty coping with change.

How is this treated?

There is no cure for this condition, but treatment may make symptoms less severe. It is best to start treatment before age 3. A team of health care providers will design a treatment program to meet your child's needs. Treatment usually involves a combination of therapies that address:

• Social skills.
• Language and communication.
• Behavior.
• Skills for daily living.
• Movement and coordination.
• Imitation.
• Play.

Sometimes, medicines are prescribed to treat depression, anxiety, seizures, or certain behavioral problems. Training and support for you and other family members may also be a part of your child's treatment program. You and your child may benefit from cognitive behavioral therapy to help deal with anxiety or depression.

In the U.S., the Individuals with Disabilities Education Act (IDEA) guarantees your child support at school. A teacher who specializes in working with students who have ASD will develop an Individualized Education Program (IEP) with you for your child.

Follow these instructions at home:

Activity

• Ask your child's health care providers what activities are safe for your child.
• Learn what therapies are helping your child and practice those therapies at home.

General instructions

• Learn as much as you can about ASD. Make sure you understand your child's rights for early intervention and free public education under IDEA.
• Work closely with your child's health care providers and therapists, and be an active member of your child's treatment team.
• Meet with your child's teachers and school counselors regularly. Make sure that they are taking the same approach with your child. Ask them if they notice any problems and ask what progress your child is making at school.
• Give over-the-counter and prescription medicines only as told by your child's health care provider.
• Keep all follow-up visits as told by your child's health care providers. This is important.

Contact a health care provider if:

• Your child has new symptoms.
• You need more support at home to care for your child.
• Your child becomes depressed. Signs of depression include:
  • Unusual sadness.
  • Decreased appetite.
  • Weight loss.
  • Lack of interest in things that he or she normally enjoys.
  • Trouble sleeping.
• Your child becomes anxious. Signs of anxiety include:
  • Worrying a lot.
  • Restlessness.
  • Irritability.
  • Trembling.
  • Trouble sleeping.

Get help right away if:

• Your child develops convulsions. You may notice:
  • Jerking and twitching.
  • Sudden falls for no reason.
  • Lack of response.
  • Dazed behavior for brief periods.
  • Staring.
  • Rapid blinking.
  • Unusual sleepiness.
  • Irritability when waking.
• Your child is behaving in ways that may be harmful to himself or herself or to others.
• Your child's symptoms are getting worse or are not responding to treatment.

If you ever feel like your child may hurt himself or herself or others, or shares thoughts about taking his or her own life, get help right away. You can go to your nearest emergency department or call:

• Your local emergency services (911 in the U.S.).
• A suicide crisis helpline, such as the National Suicide Prevention Lifeline at 1-800-273-8255. This is open 24 hours a day.

Summary

• Autism spectrum disorder (ASD) is a group of developmental disorders that affect communication, social interactions, and behavior.
• There is no cure for this condition, but treatment can make symptoms less severe. It is best to start treatment before age 3.
• Medicines may be prescribed to treat depression, anxiety, seizures, or certain behavioral problems. Training and support for you and other family members may also be a part of your child's treatment program.
• Get help right away if your child's symptoms are getting worse or are not responding to treatment.