What Is Autism Spectrum Disorder?

A Developmental and Neurological Disorder

Autism spectrum disorder (sometimes referred to as autism) is a developmental and neurological disorder. Common characteristics of autism spectrum disorder include:

  • Difficulty communicating and interacting with others

  • Restricted or repetitive behaviors

  • Symptoms that make functioning at school, work, or other activities difficult

This article discusses autism spectrum disorder symptoms, causes, diagnosis, and treatment options, as well as considerations that go into living with autism spectrum disorder or caring for someone who does.

<p>Cavan Images / Getty Images</p>

Cavan Images / Getty Images

Autism spectrum disorder is named as such because it exists on a spectrum, and there is a lot of variation in the type and severity of symptoms people with autism spectrum disorder experience. There is also variation in skills each person has and in their level of ability and functioning.

Some people with autism spectrum disorder can perform all activities of daily life on their own, while others need a lot of support to do so.

Autism Spectrum Disorder Symptoms

As autism spectrum disorder is a condition that exists on a spectrum, the types and severity of symptoms vary. In other words, there is no single set of characteristics that defines autism spectrum disorder. However, there are common signs and symptoms. For example, about 1 in 3 people with autism spectrum disorder experience an intellectual disability.

Generally, symptoms can be grouped into these three buckets:

  • Communication and interaction skills

  • Restricted or repetitive behaviors

  • Other characteristics

Communication and interaction characteristics may include:

  • Avoiding eye contact or making little eye contact

  • Not responding, or being slow to respond, to your name

  • Infrequently sharing interest in, enjoyment of, or emotions with activities or objects (such as not showing things to others)

  • Having trouble with back-and-forth conversations

  • Having a sing-song or robotic tone of voice

Restricted or repetitive behaviors may include:

  • Being upset by small changes in routine

  • Repeating certain behaviors, including repeating words or phrases

  • Having a lasting and intense interest in certain topics, like numbers or facts

Other characteristics related to autism spectrum disorder may include:

  • Delayed movement or language skills

  • Delayed learning or cognitive skills

  • Impulsive, inattentive, or hyperactive behavior

While not necessarily signs of autism spectrum disorder, there are some common strengths among people with autism spectrum disorder, including being strong visual and auditory learners, being able to retain information for a long time, and learning things in detail.

People with autism spectrum disorder don’t have a distinct appearance.

What Causes Autism Spectrum Disorder?

The primary cause of autism spectrum disorder is unknown. However, research suggests that genetics, biology, and the environment someone lives in play a role.

For example, a person’s genetic makeup may combine with environmental factors to affect their development and lead to autism spectrum disorder. While certain environmental factors like nutritional deficiencies have been studied for how they may increase the risk of autism spectrum disorder, such studies have significant limitations and require further investigation.

Autism spectrum disorder can affect people from all backgrounds, but some are more at risk. Characteristics of autism spectrum disorder include:

  • Being male (males are 4 times more likely than females to develop autism spectrum disorder)

  • Having certain genetic conditions (e.g., fragile X syndrome or Down syndrome)

  • Having older parents

Is Autism Spectrum Disorder Genetic?

Genes are considered an important factor when discussing the causes of autism spectrum disorder. People with a family history of autism spectrum disorder are more likely to have autism spectrum disorder or have a child with the disorder. Having a sibling with autism spectrum disorder is also a risk factor for developing autism spectrum disorder.

Advances in genetic research have allowed scientists to better understand the genetic background of autism spectrum disorder and how certain genetic mutations are associated with certain subtypes of autism spectrum disorder. The more that is known about the possible genetic origins of autism spectrum disorder, the more accurate the diagnosis and counseling or treatment can be.

What Tests Diagnose Autism Spectrum Disorder?

Healthcare providers can diagnose autism spectrum disorder by assessing a person’s development and behavior. There are many tools to help diagnose autism spectrum disorder, and no single tool by itself should serve as the basis for a diagnosis.

Examples of diagnostic tools include:

  • Childhood Autism Rating Scale (CARS)

  • Autism Diagnosis Interview–Revised (ADI-R)

  • Gilliam Autism Rating Scale–Second Edition (GARS-2)

  • Autism Diagnostic Observation Schedule–Generic (ADOS-G)

  • American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)

These tools rely on the following two sources of information:

  • A healthcare provider’s observation of the child’s behavior

  • The parent or caregiver’s description of their child’s development and behavior

Sometimes, a parent/caregiver will be referred to a specialist to help reach a diagnosis.

There are also screening tools to help identify developmental delays. A screening tool is often not specific to a developmental disorder, and the screening does not lead to a diagnosis. The screening simply provides information for follow-up assessment.

Examples of screening tools that may be used to evaluate whether a child is experiencing developmental delays related to autism spectrum disorder include:

  • Communication and Symbolic Behavior Scales (CSBS)

  • Screening Tool for Autism in Toddlers and Young Children (STAT)

  • Parents’ Evaluation of Developmental Status (PEDS)

Autism spectrum disorder can usually be reliably diagnosed by age 2, though it may be detected as soon as 18 months or younger. However, some people may not get diagnosed until adolescence or even adulthood. Early diagnosis is crucial to ensuring a child gets started on the help they need.

Delayed Diagnosis in Boys vs. Girls

Girls are significantly more likely to have a delayed diagnosis of autism spectrum disorder than boys.

One study found that not only were girls at a significantly higher age at diagnosis than boys, but they also experienced a longer delay in getting referred to mental health services.

Most of the research has been conducted on male samples, and recent research has suggested that males and females may display signs of autism spectrum disorder differently. This leads to girls being insufficiently diagnosed. Underdiagnosis among girls means that significantly higher rates of autism spectrum disorder among boys may not be accurate.

More research is needed on the sex differences in autism spectrum disorder symptoms to ensure that girls are adequately diagnosed and receive the support they need.

Is There Treatment for Autism Spectrum Disorder?

Treatment for autism spectrum disorder may involve multiple medical and behavioral professionals in various settings, like education or at home.

As autism spectrum disorder impacts people differently, treatment is tailored to the individual. The goal of treatment is to reduce symptoms to improve functioning in everyday life and improve quality of life.

Types of treatments can be broken down into the following categories:

  • Developmental, such as speech and language therapy

  • Social-relational, such as social skills groups

  • Behavioral, such as applied behavior analysis (ABA)

  • Educational, such as the Treatment and Education of Autistic and Related Communication-Handicapped Children (TEACCH) approach

  • Psychological, such as cognitive behavioral therapy (CBT)

  • Pharmacological, such as medications to treat the inability to focus, though there are no medications to treat the core symptoms of autism spectrum disorder

  • Complementary and alternative medicine (CAM), such as art therapy or animal therapy

What Kind of Providers Specialize in Autism Spectrum Disorder?

People with autism spectrum disorder may be referred to medial professionals specializing in behavioral, educational, psychological, and skill-building interventions to build treatment plans.

The type of specialist needed will depend on the type and severity of symptoms the person with autism spectrum disorder experiences. Even when specialists are involved, programs to help those with autism spectrum disorder often also require the cooperation of caregivers and other family members.

A pediatric neurologist can be a good first specialist to see.

Complications of Autism Spectrum Disorder

People with autism spectrum disorder may experience a range of other characteristics that can impact their daily life and overall quality of life on top of the core symptoms of autism spectrum disorder. Such complications can include:

  • Epilepsy or seizure disorder

  • Gastrointestinal (GI) issues (such as constipation)

  • Unusual eating or sleeping habits

  • Excessive anxiety, stress, or worry

  • Unusual emotional reactions or moods

  • More fear than expected or lack of fear

Living With Autism Spectrum Disorder

For people with autism spectrum disorder and their families, daily life can be challenging. Resources and setting expectations can help.

Tips for Living With Autism Spectrum Disorder

Everyday life isn’t always easy when living with autism spectrum disorder. Support comes in a variety of ways from a variety of people and depends on what your experience of living with autism spectrum disorder is like. Even for those with high-functioning autism, life is still challenging.

Below are some tips that may make life with autism spectrum disorder just a little easier each day:

  • Try to maintain basic healthy behaviors, such as exercising and getting plenty of rest, to give yourself a solid foundation in everyday life.

  • Regular checkups with your medical professionals are important. Find providers who are comfortable working with people who have autism spectrum disorder.

  • Changes can be really difficult to face. Plan ahead to give yourself plenty of time to process the transition and what to expect.

  • Remember, there are many people who know what it’s like to live with autism spectrum disorder. Finding a support group can open doors to meeting more people like you and learning from their personal experiences to help you on your own.

Autism Stigma

Autism spectrum disorder is highly stigmatized.

The stigma around autism spectrum disorder stems from people’s misunderstanding of the condition and the interpretation of visible traits. For example, a person may notice someone with autism spectrum disorder having trouble maintaining a back-and-forth conversation and judge them unfairly.

Stigma affects both the person with autism spectrum disorder and their families. People with autism spectrum disorder may experience ignorance, discrimination, and prejudice.

Autism stigma hurts well-being, including physical and mental health, and can lead to fewer social connections.

Stigma may also cause people with autism spectrum disorder to try to hide their autistic traits. Families of people with autism spectrum disorder also experience stigma, which can negatively impact their well-being.

Reducing stigma and ensuring there are autistic-friendly spaces to go to is important for reducing the negative effects on the mental, physical, and social health of those with autism spectrum disorder and their families.

Sometimes the phrase “on the spectrum” is used to describe others with signs thought to be associated with autism spectrum disorder.

Such a phrase should be used carefully as it can be stigmatizing and inaccurate.

Caring for Someone With Autism Spectrum Disorder

Taking care of someone with autism spectrum disorder and meeting their needs can put caregivers and families under a lot of stress mentally, physically, and financially.

Learning to communicate with a person with autism spectrum disorder is crucial and may be an ongoing process.

Remembering that the person may not find the words to express their feelings is also important. For example, head banging may be related to their symptoms, or it could be they have a headache but don’t know how to communicate that. Patience is key.

Because transitions and change can be distressing for someone with autism spectrum disorder, making a schedule and keeping a routine is very important. When transitions are inevitable, such as changing schools, planning and making that known ahead of time can help make the change easier to handle.

Make sure to take time for play during the day. School, work, and therapy schedules can mean that most of the day is structured. Scheduling a time to play can help everyone unwind. Play looks different among people with autism spectrum disorder, including children, so finding how they like to play may mean trying different things.

Outlook for Autism Spectrum Disorder

Living with autism spectrum disorder or caring for someone who does isn’t easy and can make daily life more difficult. While it can be very structured and intense, treatment can greatly improve everyday quality of life. The earlier the diagnosis the better for being able to start treatment and experience its benefits.

Resources for Autism Spectrum Disorder

Besides healthcare providers and the specialized care they can give someone with autism spectrum disorder, some resources can help individuals and families live a little easier. Support groups may be beneficial for finding community among those with autism spectrum disorder or those who care for them. People with autism and their families may also be eligible to receive government disability benefits.

There are also many programs for people with disabilities to access resources like employment, housing, community life, and other benefits. Check with your healthcare provider to locate resources and programs specific to autism spectrum disorder in your area. Also, thanks to technology, you may be able to connect with resources and people outside your immediate area as well.