Autism Spectrum Disorder, Pediatric

Autism spectrum disorder (ASD) is a group of developmental disorders that start during early childhood. They affect the way a child learns, communicates, interacts with others, and behaves. Most children do not outgrow ASD.

ASD affects each child in different ways. Some children with ASD have above-average intelligence. Others have severe learning disabilities. Some children can do or learn to do most activities. Other children need a lot of help.

What are the causes?

The exact cause of this condition is not known. It may be caused by genes that are passed down through families.

What increases the risk?

• Are male.
• Have a family history of ASD.
• 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 in the womb.

What are the signs or symptoms?

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

• Repeating weird movements or behaviors, such as rocking or head banging.
• Being very focused on an object or on lining up toys or other objects.
• Not playing pretend games.
• Repeating words or phrases over and over (echolalia).
• Being 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?

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

The health care team will assess behavior and development. They will determine what level of ASD your child has. Each level has its own criteria for diagnosis.

Level 1

• Speak in full sentences.
• Have no repetitive behaviors.
• Have trouble switching between activities.
• Have trouble or show no interest in interacting with others.
• Have trouble starting friendships.

Level 2

• Speak in simple sentences.
• Repeat certain behaviors. These may sometimes get in the way of daily activities.
• Only interact with others about certain shared interests.
• Have trouble coping with change.
• Have unusual nonverbal communication skills.
• Have trouble starting conversations or asking questions.

Level 3

• Speak rarely or use few understandable words.
• Repeat certain behaviors often. These get in the way of daily activities.
• Interact with others rarely and awkwardly.
• Have extreme difficulty coping with change.

How is this treated?

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

Medicines may be prescribed to treat depression, anxiety, seizures, or behavior problems. You may receive training and support as part of your child's treatment program. You and your child may benefit from cognitive behavioral therapy to help with anxiety or depression.

The Individuals with Disabilities Education Act (IDEA) guarantees your child support at school. This includes an Individualized Education Plan (IEP) made by teachers who specialize in working with students who have ASD.

Follow these instructions at home:

Activity

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

General instructions

• Learn as much as you can about ASD. Make sure you understand your child's rights under IDEA.
• Work with your child's health care providers. Be an active member of your child's treatment team.
• Meet with your child's teachers and school counselors. Make sure they take the same approach with your child. Ask them about any problems and any 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. Treatment is more effective when started early.

Contact a health care provider if:

• Your child has new symptoms.
• You need more support at home.
• Your child becomes depressed. Signs include:
  • Unusual sadness.
  • Decreased appetite.
  • Weight loss.
  • Lack of interest in things your child normally enjoys.
  • Trouble sleeping.
• Your child becomes anxious. Signs include:
  • Worrying a lot.
  • Acting restless.
  • Acting irritable.
  • Trembling.
  • Trouble sleeping.

Get help right away if:

• Your child develops seizures. You may notice:
  • Jerking and twitching.
  • Sudden falls for no reason.
  • Lack of response, staring, or dazed behavior for brief periods.
  • Rapid blinking.
  • Unusual sleepiness.
  • Irritability when waking.
• Your child behaves in ways that may be harmful to them or others.
• Your child's symptoms get worse or do not respond to treatment.

• Call 911.
• Call the National Suicide Prevention Lifeline at 1-800-273-8255 or 988. This is open 24 hours a day.
• Text the Crisis Text Line at 741741.

Summary

• ASD affects the way a child communicates, interacts with others, and behaves.
• There is no cure for ASD. Treatment can make symptoms less severe.
• Get help right away if your child's symptoms get worse or do not respond to treatment.