About Autism Spectrum Disorder

Jayne Laurin Kinney DNP, PNP-BC.

April is Autism Awareness Month. Autism spectrum disorder (ASD) is a developmental disability that affects a child’s social skills, communication and behavior. Autism is known as a “spectrum” disorder because there is wide variation in the type and severity of symptoms people experience.  Other names for ASD have included autistic like disorder, pervasive developmental disorder and Asperger syndrome.  These used be diagnosed separately, but now a diagnosis of ASD includes all of these. Children with ASD might repeat certain behaviors and it may be difficult to change their routines. Signs of ASD begin in early childhood and will typically last a person’s entire life.

About 1 in 68 children have autism and it is more common in boys. The number of children who have ASD has increased over the past several years. One reason for the increase may be that more children are screened for autism during routine physical exams.  The American Academy of Pediatrics (AAP) recommends that all children be screened for ASD at their 18 month and 24 month well-child checkups. This is good because research shows that starting an intervention program as soon as possible can improve outcomes for many children with autism.

We know that there is no one cause of autism. Research suggests that autism develops from a combination of genetic and environmental influences. There has been a lot of research over the past several years to determine whether there is any link between childhood vaccinations and autism. The results of this research is clear: Vaccines do not cause autism. The American Academy of Pediatrics has compiled a list of this research. You can see and download the list at https://www.healthychildren.org/English/safety-prevention/immunizations/Pages/Vaccine-Studies-Examine-the-Evidence.aspx

Signs of ASD can include social, communication and behavioral differences

 Social Differences in Children with Autism

  • Doesn’t keep eye contact or makes very little eye contact
  • Doesn’t respond to a parent’s smile or other facial expressions
  • Doesn’t look at objects or events a parent is looking at or pointing to
  • Doesn’t point to objects or events to get a parent to look at them
  • Doesn’t bring objects of personal interest to show to a parent
  • Doesn’t often have appropriate facial expressions
  • Unable to perceive what others might be thinking or feeling by looking at their facial expressions
  • Doesn’t show concern (empathy) for others
  • Unable to make friends or uninterested in making friends

Communication Differences in Children with Autism

  • Doesn’t point at things to indicate needs or share things with others
  • Doesn’t say single words by 16 months
  • Repeats exactly what others say without understanding the meaning (often called parroting or echoing)
  • Doesn’t respond to name being called but does respond to other sounds (like a car horn or a cat’s meow)
  • Refers to self as “you” and others as “I” and may mix up pronouns
  • Often doesn’t seem to want to communicate
  • Doesn’t start or can’t continue a conversation
  • Doesn’t use toys or other objects to represent people or real life in pretend play
  • May have a good rote memory, especially for numbers, letters, songs, TV jingles, or a specific topic
  • May lose language or other social milestones, usually between the ages of 15 and 24 months (often called regression)

Behavioral Differences (Repetitive & Obsessive Behaviors) in Children with Autism

  • Rocks, spins, sways, twirls fingers, walks on toes for a long time, or flaps hands (called “stereotypic behavior”)
  • Likes routines, order, and rituals; has difficulty with change
  • Obsessed with a few or unusual activities, doing them repeatedly during the day
  • Plays with parts of toys instead of the whole toy (e.g., spinning the wheels of a toy truck)
  • Doesn’t seem to feel pain
  • May be very sensitive or not sensitive at all to smells, sounds, lights, textures, and touch
  • Unusual use of vision or gaze—looks at objects from unusual angles

Pediatrics West screens children for developmental and communication challenges from their very first well-child visit.  We look at things like how your baby laughs, looks to you for reassurance, tries to get your attention when you are speaking to us, points or waves, how they respond when we enter the examination room and how they respond to their name.  These observations along with a family history and the answers you provide us are extremely valuable in helping identify children at risk for ASD.  We also do formal screening at all 18 month and 24 month well-child visits as recommended by the American Academy of Pediatrics.  In addition, we offer a more specialized screening to evaluate children ages 18 months to 39 months suspected of being on the autism spectrum in order to expedite a more comprehensive evaluation.

Screening and diagnosing is not the same.  It is important to know that if your child has a positive screen for ASD it does not mean they will be diagnosed with autism. Also, screening does not identify all children with ASD.

If you think your child might have ASD or you think there could be a problem with the way your child plays, learns, speaks, or acts, let us know. We are ready to listen.  You should always feel comfortable bringing up any concerns you have about your child’s behavior or development. We know the value of early diagnosis and intervention and know where to refer you if we identify any concerns.

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