Autism Spectrum Disorder, or more commonly referred to as Autism, is a neurological disability that causes problems with social communication and restricted interests or patterns of behavior. It was first described in the medical literature over seventy years ago, and has been considered a rare condition until recent years.
The most common sign that first raises concerns is delayed language, as parents and health professionals note that a child isn’t speaking as much as other children during the second year of life. Although language delay is common, it is not universal. Many people with a diagnosis of autism may have no significant language delay, but may have other communication issues, such as with non-verbal language. These children often don’t use non-verbal communication to indicate their wants or needs. For instance, they don’t point to the cookie jar when they want a cookie or they don’t rub or point to their tummy when they have a stomachache. They often don’t look where others are pointing, and aren’t engaged in the current situation as others are.
Often, individuals with autism may have good language skills, but have non-verbal communication problems, such as difficulty reading facial expressions or the tone of someone’s voice. As a result, a person with autism may not pick up on another person’s anger, fear or frustration. These social communication problems often make it difficult for people with autism to develop and maintain friendships.
Similarly, a desire for repetition and routine may cause problems, such as when a student melts down when told it is time to switch from math to reading. Sometimes, a child with autism has repetitive behaviors such as hand flapping or repeating sounds or words. Other children with a diagnosis of autism may have an unusually intense interest on certain things such as dinosaurs or trains, spending hours on the subject. This can lead to instances when the child doesn’t want to switch to another activity, as is expected in school and even at home. This insistence on doing the same thing can also lead to severe tantrums when forced to change. For instance, parents often report that their child breaks down when they try to get in the car or serve a meal with a new or uncommon food.
Over the past twenty years, the diagnostic criteria for autism has changed and there has been increased awareness and screening of autism among health professionals. This has also led us to recognize that the symptoms of autism range from mild to severe, with many variations between individuals. Current research on autism is examining possible genetic causes and potential relationships between environmental factors and autism, but there is still a lot that we do not know. For instance, recent studies have found that autism characteristics often differ by gender and can be harder to recognize or diagnose in girls than in boys, and children in some racial or ethnic groups may also be less likely to receive a diagnosis of autism from health professionals.
At Nationwide Children’s Hospital we have one of the foremost autism spectrum disorder programs in the country. If you have concerns that a family member may have autism, or have questions about treatment of autism, contact Nationwide Children’s Hospital Behavioral Health department for further information.
Daniel L. Coury, MD, is Chief of the Section of Developmental and Behavioral Pediatrics at Nationwide Children’s Hospital and a Professor of Clinical Pediatrics and Psychiatry at The Ohio State University College of Medicine.
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