What is Autism?
Autism spectrum disorder (ASD) is a neurologic-based disability that affects a child's social skills, communication, and behavior. It occurs in about 1 in 68 children. The number of children reported to have autism has increased since the early 1990s. The increase could be caused by many factors. Many families are more aware of ASD. Pediatricians are doing more screening for ASD, as recommended by the AAP, and children are identified earlier. Also, there have been changes in how ASD is defined and diagnosed. In the past, only children with the most severe autism symptoms were diagnosed. Now children with milder symptoms are being identified and helped.
Symptoms
Many children with ASD may show developmental differences when they are babies, especially their social and language skills. Because they usually sit, crawl, and walk on time, less obvious differences in the development of gesture, pretend play, and social language often go unnoticed. In addition to delays in spoken language and behavioral differences, families may notice differences in the way their child interacts with his or her peers. One child with ASD will not have exactly the same symptoms as another child with ASD—the number and severity of symptoms can vary greatly.
If you have concerns about how your child plays, learns, speaks, acts, or moves, talk with your pediatrician. Before you go to the appointment, complete a MCHAT questionnaire. Remember, you know your child best and your concerns are important. Together, you and your pediatrician will find the best way to help your child. If you're uneasy about the doctor's advice, seek a second opinion. Don't wait. Acting early can make a big difference!
Diagnosis
Typically, an evaluation to assess language and social delays includes observation of the child and child-caregiver interactions and a detailed history and physical examination. A referral to early childhood intervention for developmental assessment of all skills (motor, language, social, self-help, cognitive) is helpful. ASD is suspected when the child's social and language functioning are significantly more impaired than the overall level of motor, adaptive, and cognitive skills. All children with any speech delays should have their hearing formally tested.
There is no easy test to diagnose ASD. Autism may be associated with a known syndrome or medical condition. Laboratory tests may be indicated to rule out other possible medical conditions that could cause ASD symptoms based on the child's history and physical examination. If needed, the child may be referred to other specialists, such as a geneticist or a pediatric neurologist, or psychiatrist, to help diagnose medical conditions that might cause or be associated with symptoms of ASD.