Therapist working with a patient with autism.

Autism 101: What it is, Early Signs and Treatment

Over 3.5 million Americans have autism spectrum disorder (ASD) — a condition that impairs one’s ability to communicate and interact with others.

Currently, the Centers for Disease Control and Prevention estimate it affects 1 in 59 children. April, also known as Autism Awareness Month, has a national campaign promoting the inclusion and appreciation of those living with the disorder. Join the effort by learning more about early recognition, the diagnosis and treatment options available.

What is the “Autism Spectrum?”

Autism spectrum disorder manifests itself in a wide variety of behaviors based on symptom type and severity. Prior to 2013, autism was diagnosed using one of three conditions: autistic disorder, Asperger’s syndrome, and pervasive developmental disorder—not otherwise specified (PDD-DOS). Today, this spectrum disorder, which includes verbal and nonverbal challenges, has links to a group of complex neurodevelopmental conditions.

Autism can present itself differently in each person. While some individuals may exhibit notable speech delays and intellectual disabilities, others can experience barriers such as little to no language and/or have unusual interests and difficulty following social cues. It’s not uncommon for those on the spectrum to struggle in certain areas, while easily excelling in others. Communication and socialization issues may often be paired with a high aptitude for math, science, art or music. 

Early Signs

Signs of autism generally arise during early childhood. While certain signs are distinct, others may prove to be less obvious.

  • Avoiding eye contact
  • Develops specific routines or rituals, is disturbed at the slightest change
  • Difficulty understanding others
  • Fixation on items, projects, etc.
  • Lack of interest in imaginative play or make-believe
  • Learning disability
  • Little interest in peer-to-peer relationships or interactions
  • May exhibit high level of activity
  • May not smile or follow instructions
  • Performs activities that could cause self-harm, such as biting or head-banging
  • Repetitive movements or mannerisms like rocking, spinning, or hand flapping/gestures
  • Seeming unaware of surroundings
  • Slow language or speech development
  • Specific food preferences, i.e. eating only a few foods, or refusing foods with certain textures.

To diagnose autism spectrum disorder, a physician can use the Diagnostic and Statistical Manual (DSM-V) of the American Psychiatric Association. This tool provides guidelines to help identify and separate autism symptoms from similar disabilities. Developmental pediatric specialists/pediatricians may also use the Modified Check list for Autism in Toddlers (M-CHAT), the Childhood Autism Rating Scale (CARS), or The Autism Observation Diagnostic Schedule (ADOS), which was developed at the University of Michigan to evaluate children between 12 and 30 months.

Treatment

There is no single treatment for autism. Physicians often work with the family to create a plan that’s tailored to the patient’s symptoms and individual needs. Some treatment options may include:

  • Medication: While medication cannot cure autism, it can help manage related symptoms and complications stemming from the disorder. Anxiety, depression, high energy levels and seizures can all be regulated through medication.
  • Therapy: Therapy is a joint effort between the family, patient, physician and specialty trained multidisciplinary professionals that emphasizes structure, direction and organization. Behavioral therapy focuses on positive actions and relationship development. Occupational therapy encourages independence through mastering daily tasks such as bathing, dressing and eating. Speech therapy helps to improve verbal and non-verbal communication skills, while sensory integration teaches how to cope with sights, sounds and smells.
  • Dietary Changes: There is little scientific evidence that supports autism treatment through a modified diet. Yet, some medical professionals experience varying degrees of success on a case-by-case basis. Dietary changes can include the removal of certain foods, or the addition of vitamins and minerals.

About the author: Dr. T. Jann Caison-Sorey is a pediatrician, adolescent medicine physician and senior medical director at Blue Cross Blue Shield of Michigan. 

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Photo credit: Katarzyna Bialasiewicz

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