Here’s how to identify autism spectrum disorder in children
Q: My 2-year-old niece has had several issues since birth, and she is behind in her communications and attention. I wonder if she may be on the autism spectrum. Before I mention it to my sister, can you explain autism and how it is best treated? A: Autism is one of a group of developmental problems called autism spectrum disorder that appears in early childhood. Though symptoms and severity vary, all autism spectrum disorders affect children’s ability to communicate and interact with others.
Children with autism generally have problems in three areas of development: social interaction, language and behavior. Some children show signs of autism spectrum disorder in early infancy, such as reduced eye contact, lack of response to their name or indifference to caregivers. Others develop normally for the first few months or years of life, but then they suddenly become withdrawn or aggressive, or lose language skills they had already acquired. Signs usually are seen by age 2.
Children with autism spectrum disorder are likely to have a unique pattern of behavior and level of severity. Some children with the disorder have difficulty learning, and some have signs of lower-than-normal intelligence. Other children have normal to high intelligence. While they learn quickly, they have trouble communicating and applying what they know in everyday life, and adjusting to social situations. Common signs include:
Resists cuddling and holding, and seems to prefer playing alone.
Doesn’t speak or has delayed speech, or loses previous ability to say words or sentences.
Speaks with an abnormal tone or rhythm, and may use a singsong voice or robot-like speech.
Repeats words or phrases verbatim but doesn’t understand how to use them.
Doesn’t express emotions or feelings, and appears unaware of others’ feelings.
Has difficulty recognizing nonverbal cues, such as interpreting other people’s facial expressions, body postures or tone of voice.
Children with autism spectrum disorder may have limited, repetitive patterns of behavior, interests or activities, including:
Performs repetitive movements, such as hand-flapping, rocking or spinning.
Performs activities that could cause selfharm, such as biting or head-banging.
Develops specific routines or rituals, and becomes upset at the slightest change.
Has odd, stiff or exaggerated body language.
Is fascinated by details of an object, such as the spinning wheels of a toy car, but doesn’t understand the overall purpose or function of the object.
Is unusually sensitive to light, sound or touch, but may be indifferent to pain or temperature.
Fixates on an object or activity with abnormal intensity or focus.
Some children with the disorder become more engaged with others and show fewer disturbances as they mature. Others continue to have difficulty with language or social skills, and the teen years can bring worse problems.
While there is no cure for autism, intensive, early diagnosis and treatment can make a big difference. The ultimate goal of treatment is to increase children’s ability to function, reduce symptoms and help children’s development and learning. Autism symptoms and severity differ greatly. Thus, treatment options also vary. Typically, treatment options can include individualized behavioral interventions, speech and occupational therapy, medications and other therapies.
— Tanushree Singhal, M.D., Pediatric and Adolescent Medicine, Mayo Clinic Health System, Eau Claire, Wisconsin