Autism Spectrum

Autism Spectrum Disorder (ASD) is a developmental disorder diagnosed in children with symptoms generally appearing in the first two years of life. There is a wide variation in the type and severity of symptoms a child might display. The American Academy of Pediatrics recommends that all children be screened for autism. The pediatricians at The Jackson Clinic conduct a thorough screening on each child during their routine Well-Child Checkups. If the screening indicates any concerns, children are referred for further evaluation to The Jackson Clinic’s Pediatric/Child Psychologist. 

In order to meet criteria for autism spectrum disorder, a child must show both social deficits or difficulties with social understanding and restricted interests or repetitive behaviors. These symptoms must be present early in development and cause impairment in the child’s functioning.

Possible symptoms shown by children with ASD include: 

• Not point at objects to show interest (for example, not point at an airplane flying over)
• Not look at objects when another person points at them
• Have trouble relating to others or not have an interest in other people at all
• Avoid eye contact and want to be alone
• Have trouble understanding other people’s feelings or talking about their own feelings
• Prefer not to be held or cuddled, or might cuddle only when they want to
• Appear to be unaware when people talk to them, but respond to other sounds
• Be very interested in people, but not know how to talk, play, or relate to them
• Repeat or echo words or phrases said to them, or repeat words or phrases in place of normal language
• Have trouble expressing their needs using typical words or motions
• Not play “pretend” games (for example, not pretend to “feed” a doll)
• Repeat actions over and over again
• Have trouble adapting when a routine changes
• Have unusual reactions to the way things smell, taste, look, feel, or sound
• Lose skills they once had (for example, stop saying words they were using)

It is important to understand that every child with autism spectrum disorder is different. One child with autism may seem very different from another child with autism— even if they are in the same family. For example, some children with ASD do not show any social interest, whereas other children may be very interested in their peers but may interact in an unusual way or not respect their peers’ personal boundaries. Some children may show very obvious signs of autism, such as lining up toys or flapping their hands, whereas others may show more subtle symptoms such as difficulties coordinating non-verbal communication with verbal communication. Many children showing more obvious symptoms can be diagnosed as early as 18 months of age. However, children who have a less severe form of ASD (often referred to as “High Functioning Autism”) may not fully manifest symptoms until they are older or show more subtle symptoms, resulting in a later diagnosis.  Some children with ASD may be diagnosed with another disorder, such as ADHD or an anxiety disorder, before receiving a diagnosis of ASD.

Autism is not curable; however, children with autism can make great progress with participation in therapies. Many children’s symptoms become less severe with appropriate support and some symptoms may disappear altogether. Early intervention is especially important for children with autism spectrum disorder. Common therapies for children with autism may include behavioral therapy (including applied behavior analysis), speech therapy, occupational therapy, and physical therapy. 

If you are concerned that your child may have autism spectrum disorder, talk to a pediatrician at The Jackson Clinic. They will provide further assessment or refer to a psychologist or developmental pediatrician for a comprehensive assessment, which includes a thorough developmental history and a structured behavior observation (i.e., Autism Diagnostic Observation Schedule, Second Edition). Most evaluations will also include measures of intelligence, behavior, emotions, and adaptive behavior as well.  Autism rating scales (i.e. Gilliam Autism Rating Scales) or an informal behavioral observation may be used as a supplement to the evolution but should not be used to replace a structured behavioral observation.