What Is Autism Spectrum?

adult hand with an autism awareness wrist band holding an autistic baby hand

March 30, 2019

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Posted in: Parenting Concerns

Children with autism have significant challenges with social interactions and communication and a very restricted repertoire of activities and interests.  Issues with social reciprocity are very severe (it’s not just being shy or a bit detached) and include: 1) difficulties with nonverbal behaviors, such as very poor or nonexistent eye contact; 2) an inability to recognize others’ feelings (or even recognize the presence of another person); and 3) trouble establishing or maintaining friendships (to the point of being unaware of others’ needs or presence).

Print out text: Features of Autism 1. Impairment in social interaction that can include challenges with: • nonverbal behaviors (such as poor eye contact) • developing normal peer relationships (such as trouble making and keeping friends) • the ability to reciprocate socially or emotionally with others (such as an inability to share in the excitement or happiness of others) 2. Difficulties in communication that can include: • a delay in language or a lack of communication skills (such as not speaking in sentences until 4 years old or not using any words until age 2 ½) • trouble sustaining conversation (such as not being able to make small talk or sustain any type of a conversation with peers) • repetitive or unusual language (such as mixing-up pronouns or referring to self in the third person) • play skills that are nonexistent or inappropriate for age (such as trouble with imaginative play) 3. Hyper- or hyposensitivity to sensory input, such as sounds, tastes, pain, or scents 4. Unusual patterns of behavior that can include an: • abnormal preoccupation with certain objects or a restricted interest in certain objects (such as things that spin) • a need to usual rules or routines (such as a need to line up all of their toys in a particular order) • repeated motor movements (such as hand or arm flapping or finger flicking) • an overwhelming preoccupation with parts of objects. (such as being interested in how the door of a toy car open, rather than using the toy car as a whole play object)

           Print Out: Features of Autism

Children with autism also have challenges with communication that can include delayed speech, unusual speech, or problems comprehending the speech of others.  Stereotyped behaviors or repetitive behaviors are observed in children with autism and these behaviors can include rocking, a fascination with objects that spin, a fascination with a simple object such as a string, or an occupation with parts of objects (such as a button or a specific part of the body).

In order to meet criteria for a diagnosis of autism, a child must have a significant delay or atypical functioning in one of these areas before the age of three years old:

  • social interaction
  • language (particularly that used in social communication)
  • imaginative play

Most children with autism have never had a period of typical development, although some parents do report typical development until the age of one or two years. The diagnosis of autism has changed over the years. It’s important to note that autism occurs along a spectrum and kids with autism can look quite different from each other.

How is Autism Assessed?

Early identification of children with autism is key. The sooner a child is evaluated the sooner intervention can begin – and early intervention is key to the best possible outcome.

Because autism is a diagnosis that can affect many areas of functioning, a comprehensive evaluation is usually necessary. A comprehensive evaluation can include interviews with the child’s parents and caretakers, direct observation of the child in the doctor’s office and at home or school, and tests of intelligence, language and day-to-day living skills.  The evaluator may ask you to complete forms that measure symptoms of autism in addition to completing a structured observation of your child, him or herself.  For example, an activity the Autism Diagnostic Observation Schedule (ADOS) uses assess whether a child displays behaviors relevant to autism is by engaging the child in telling a story or in playing a game, and seeing whether she’s able to be engaged – or even able to do – these activities.

Sidebar text: Are Rates of Autism Increasing? The idea of an “autistic epidemic” has been expressed in both the psychological literature and in the news media. Yes, rates of autism have increased; this is in a large part due to better detection. Research has also documented that as rates of autism have risen, rates of mental retardation (also known as Intellectual Deficiency) have decreased. In other words, psychologists and other mental health diagnosticians are more likely to diagnosis autism – perhaps in part due to the increasing social acceptance of a diagnosis of autism as compared to mental retardation. One controversial issue is that rates of autism are increasing due to mercury in children’s vaccines. To date, research has clearly demonstrated that there is no connection between vaccines and autism. In fact, rates of autism have actually increased in countries that no longer use of mercury in vaccines.

Are Rates of Autism Increasing?

What are the Effective Treatments for Autism?

Children with autism have been shown to benefit considerably from early, intensive, comprehensive programs. Comprehensive programs for children less than 5 years of age typically includes behavior therapy, such as Applied Behavior Analysis (ABA), speech and language therapy, occupational therapy, and social skills training.  Research has shown that children can make significant gains in these types of programs and that these gains are typically maintained years later.

There are a number of common elements to successful programs for children of any age with autism, which includes:

  • a focus on communication, attention, and social skills;
  • a highly structured school environment with a low student-to-teacher ratio;
  • a predictable home, school and therapy environment; and
  • a high level of structured family involvement.

When parents are more involved in the treatment process, children are more likely to generalize and maintain what they learn in school and in therapy. The most effective treatments are ones that are very intensive in that they are given for many hours per day and in different environments (such as at home and in school).  Some children may need behavior therapy to address concerns such as self-stimulation, aggression, and tantrums.  Social skill facilitation has also been found to be effective, particularly if this facilitation occurs through the school day, in addition to occurring in structured therapy groups.

Unfortunately, there are no magic bullets or pills that can treat autism, although medication can be useful in treating some of the associated symptoms such as inattention, aggression, and self-injurious behavior. Some children with autism may have seizure disorders and medication is used to treat these conditions. Finally, research has shown that many other types of treatments are not very helpful in treating the underlying causes of autism.  These include vitamins, auditory and visual training exercises, skills patterning, and functional communication.

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Ellen Braaten

Ellen Braaten, Co-Director

Ellen Braaten, Ph.D. is co-director of The MGH Clay Center for Young Healthy Minds, and director of the Learning and Emotional Assessment Program (LEAP) at Massachusetts General Hospi...

To learn more about Ellen, or to contact her directly, please see Our Team.