General Information on Autism

Autism spectrum disorder (ASD) is a developmental disorder marked by impaired social interaction, limited communication, behavioral challenges, and a limited range of activities and interests. It has been estimated to affect one in 40 individuals in the United States and it is more common in boys than girls.
In 2020, the CDC (Center for Disease Control) estimated that 1 in 54 children in the U.S. are diagnosed with autism. Boys are four times as likely to be diagnosed than girls. Children can be diagnosed reliably at age 2, but most children are diagnosed after 4. There is not a medical test that can be done to determine if a child has autism. For a child to be diagnosed with autism, the assessor (usually a neurologist, developmental pediatrician, developmental psychologist), will observe the child and and may give a diagnosis according to the DSM – 5 (Diagnostic Statistical Manual, 5thEdition) criteria. A more comprehensive evaluation with assessment tools, can be completed upon request. Families can get a referral from their insurance provider to seek a diagnosis or they may be able to contact the local Regional Center.
People affected by ASD can have varying ranges from mild to severe functioning levels and affects individuals in the areas of communication, social emotional development, cognition, and adaptive skills.
Individuals with ASD can show a wide variety of behavioral symptoms, some which include having difficulty developing appropriate peer relationships, to delays or deficits in communication. For individuals who do speak, there may be a repetitive use of language or a delay in the ability to sustain a conversation with others. Symptoms of autism can also include hyperactivity, short attention span, impulsivity, aggressiveness, self-injurious behavior, and temper tantrums.

Communication

Communication begins early on with eye contact, gestures, listening to caregivers, and babbling. As the child grows, they develop joint attention (attending to the same object at the same time and acknowledging each other) and imitation skills naturally. Children with autism may not gain these skills naturally and therefore may need therapy to learn these skills. When a child does not naturally develop joint attention, he/she can lose out on learning opportunities, for example, initiating interaction with their loved ones by requesting for help in handling an object, naming an unknown item, sharing toys, etc. Furthermore, children with ASD may focus on objects or different sensory input, such as the sound of the whirling fan, the spinning fan itself, the feel of certain textures, or may focus on visual stimuli. This heightened focus on sensory stimuli could distract them from learning opportunities or other factors (e.g. their parents’ voice, parents’ expression, parents’ gaze, etc.).
Some children with ASD may have an extensive vocabulary and have the ability to learn language easily. However, as they continue to develop, they may have difficulty recognizing social communication (e.g. body language, facial expression, eye gaze, tone of voice, emotion, etc.); or may have difficulty engaging in appropriate social communication with others. Complex language (e.g. idioms, analogies, sarcasm, humor) can also be challenging.

Social Skills

Social Skills is an area where children learn to react and interact with others, identify their own and others' emotions, take on others' perspectives, and understand social cues, in addition to other social skills. For an individual to interact with others appropriately, a person would have to learn to understand different points of view others have (theory of mind). This may be important to form friendships, to play with others cooperatively, and to be able to share with others. Children with ASD may have difficulty developing social skills, but may have the ability to learn these important skills with an individualized intervention.

Cognition

Many children with ASD are affected in the area of cognition. Cognition involves abilities such as sustaining attention, memory, recalling events, imitation, problem solving, answering questions, executive functioning, and other decision making areas. Children with ASD may have difficulty in these areas; however, they can be taught these skills.

Adaptive/Daily Living Skills

Adaptive skills can be challenging for many; however, children with ASD may have difficulty learning new adaptive skills that involve self-care or safety skills. To name a few, challenges can be experienced with feeding, dressing, brushing teeth, taking baths/showers, walking next to adults while out in the community, and etc. Completing self-care activities can be challenging as there may be avoidant behaviors that can get in the way of learning important skills. These areas can be addressed with the appropriate intervention.

Comorbidity

Comorbidity is when an individual is diagnosed with other disorders outside of ASD. Other disorders can include but are not limited to the following: ADHD genetics (chromosome abnormalities), anxiety disorders, bipolar disorder, gastrointestinal symptoms, depression, epilepsy, Fragile X Syndrome, and intellectual disability. It is important to understand the interactions between comorbid conditions and ASD. To that extent, Milestones will consider other diagnoses when developing an individualized treatment plan.