Autism Spectrum Disorder

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Autism spectrum disorder (ASD) is a complex set of developmental disorders. It includes a wide range of symptoms that may be mild or can cause severe impairment. ASD can affect your child’s ability to communicate and socialize with others.

ASD is an umbrella term that includes several conditions that were previously considered separate. These disorders are:

  • Autism
  • Asperger syndrome
  • Pervasive developmental disorder not otherwise specified
  • Childhood disintegrative disorder

Children with ASD may appear withdrawn or disinterested in interacting with others. They may lack social awareness. Children with ASD may have trouble communicating and may avoid eye contact.  They may also have trouble recognizing facial expressions and emotions. Often, they may exhibit repetitive behavior or may need routines and rituals to get through their day.

Although ASD can be very challenging, children with ASD may also be able to perform certain mental tasks very well. Many children with ASD exhibit above-average intelligence and may excel in math, science, music or art.

Causes of Autism Spectrum Disorder in Children

The cause of ASD is unclear. Other known factors include:

  • Family history of ASD
  • Older age of the parents at the time of conception
  • Infections or exposure to toxins before birth (pesticides, phthalates)
  • Problems during delivery 

Boys are much more likely to develop ASD. Genetics may also be a factor. Certain genetic disorders in families may cause your child to have an increased risk of developing ASD. These are: 

  • Fragile-X syndrome
  • Neurofibromatosis
  • Phenylketonuria
  • Tuberous sclerosis
  • Chromosome issues

Most commonly, the symptoms of ASD begin to appear by the age of 3. The symptoms of ASD roughly fall into 2 categories: those around behavior (such as repetitive actions) and those around communication and social interaction. The symptoms will be different for each case but may include: 

  • Behavioral:
    • Repeats words or phrases (called echolalia)
    • Repeats dialogue from TV or movies
    • Rocking, flapping fingers or hands, or other repetitive movements
    • Needs rituals or routines
    • Overly sensitive or exhibits minimal reaction to their environment (lights, sounds, touch or taste)
    • Overly focused interests
  • Social:
    • Does not communicate well
    • Develops speech at a later age than other children or doesn’t speak at all
    • Doesn’t use speech in social interactions despite being able to speak
    • Problems making eye contact
    • Problems interacting with other children
    • Overly sensitive to disruptions in routines or rituals
    • Emotional response may not match or be appropriate for the situation
    • Uses words or expressions in unique ways that may only be known to them
    • Uses facial expressions that do not match or are not appropriate to what they are saying

Diagnosis & Treatment at UVA Health Children's

ASD can be diagnosed as early as 2 years of age. During your well-child visits, your child’s healthcare provider will examine your child and evaluate your child for ASD using a set of guidelines. Items on this guideline include: 

  • No babbling or gesturing by 1 year of age
  • No single words spoken by 16 months of age
  • No two-word phrases by 24 months of age (just repeats words or sounds heard from others)
  • No eye contact at 3 to 4 months of age
  • At any age, loss of any language or social skills

If your child exhibits any of the above behaviors, your child’s healthcare provider will then do more extensive screening for developmental disorders. These screenings may include:

  • Examination of the nervous system
  • Imaging
  • Mental health examination
  • Genetic testing

Your child’s healthcare provider will work with you on a specific plan for your child’s treatment. Treatment may include:

  • Behavior change programs that address problem behaviors by teaching social, physical and thinking skills
  • Special education programs that focus on social skills, speech and language, self-care and other life skills
  • Medications
  • Mental health therapy that may include the whole family