What is autism?
Autism is a brain disorder that often makes it hard to communicate with and relate to others. With autism, the
different areas of the brain fail to work together.
Most people with autism will always have some trouble relating to others. But early diagnosis and treatment have
helped more and more people with autism to live independently as adults.
What causes autism?
Autism tends to run in families, so experts think it may be something that you inherit. Scientists are trying to find
out exactly which genes may be responsible for passing down autism in families.
Other studies are looking at whether autism can be caused by other medical problems or by something in your
child’s surroundings.
Some people think that childhood vaccines cause autism, especially the measles-mumps-rubella, or MMR,
vaccine. But studies have not shown this to be true. It’s important to make sure that your child gets all childhood
vaccines. They help keep your child from getting serious diseases that can cause harm or even death.
What are the symptoms?
Symptoms almost always start before a child is 3 years old. Usually, parents first notice that their toddler has not
started talking yet and is not acting like other children the same age.
Symptoms of autism include:
There is no "typical" person with autism. People can have many different kinds of behaviors, from mild to severe.
Parents often say that their child with autism prefers to play alone and does not make eye contact with other
people.
Autism may also include other problems:
How is autism diagnosed?
There are guidelines your doctor will use to see if your child has symptoms of autism. The guidelines put
symptoms into three categories:
Your child may also have a hearing test and some other tests to make sure that problems are not caused by
some other condition.
How is it treated?
Treatment for autism involves special behavioral training. Behavioral training rewards good behavior (positive
reinforcement) to teach children social skills and to teach them how to communicate and how to help themselves
as they grow older.
With early treatment, most children with autism learn to relate better to others. They learn to communicate and to
help themselves as they grow older.
Depending on the child, treatment may also include such things as speech therapy or physical therapy. Medicine
is sometimes used to treat problems such as depression or obsessive-compulsive behaviors.
Exactly what type of treatment your child needs depends on the symptoms, which are different for each child and
may change over time. Because people with autism are so different, something that helps one person may not
help another. So it’s important to work with everyone involved in your child’s education and care to find the best
way to manage symptoms.
How can your family deal with having a child with autism?
An important part of your child's treatment plan is making sure that other family members get training about
autism and how to manage symptoms. Training can reduce family stress and help your child function better.
Some families need more help than others.
Take advantage of every kind of help you can find. Talk to your doctor about what help is available where you live.
Family, friends, public agencies, and autism organizations are all possible resources.
Remember these tips:
Raising a child with autism is hard work. But with support and training, your family can learn how to cope.
Who is affected by autism
Date updated: June 07, 2006
Sabra L. Katz-Wise
Content provided by Healthwise
Studies show that autism may be recognized more often than it used to. This may be because of better detection
and a broader definition of autism. For example, some children who were previously diagnosed with mental
retardation are now being diagnosed with autism. More study is needed to find the reason for the increased
diagnosis of autism.
Pervasive developmental disorders
Date updated: June 07, 2006
Sabra L. Katz-Wise
Content provided by Healthwise
Pervasive developmental disorders (PDDs) is an umbrella term used to define a class of disorders.
Disorders included in this class are:
development, including:
from parents and other caregivers. Other children are mildly affected and can develop adequate skills to lead
independent lives as adults. Many children are affected at levels somewhere between these two extremes.
Pervasive developmental disorders are present at birth. However, the signs of these disorders may not be noticed
until later, usually during the first 3 years of a child's life.
Asperger's disorder
Date updated: June 07, 2006
Sabra L. Katz-Wise
Content provided by Healthwise
Asperger's disorder, also called Asperger's syndrome, is a type of pervasive developmental disorder (PDD) as
defined by the American Psychiatric Association.1 Asperger's disorder is similar to high-functioning autism in how
it affects a child's mannerisms and socialization traits.
A distinction between Asperger's disorder and autism is that young children with Asperger's have normal
language development, although the rhythm, pitch, and emphasis are irregular. Unlike autism, Asperger's
disorder does not delay other aspects of development; a child usually has age-appropriate self-reliance and an
interest in the world around him or her. However, like autism, children with Asperger's disorder have abnormal
social interactions, facial expressions, and gestures.
Asperger's disorder affects males 9 times more than females.2 Its cause is unknown. More research is needed
to confirm whether Asperger's disorder is a condition that is genetically related to autism.
References
Citations
1. American Psychiatric Association (2000). Autistic disorder. In Diagnostic and Statistical Manual of Mental
Disorders, 4th ed., text rev., pp. 70–75. Washington, DC: American Psychiatric Association.
2. Volkmar FR, et al. (2005). Pervasive developmental disorders. In BJ Sadock, VA Sadock, eds., Kaplan and
Sadock's Comprehensive Textbook of Psychiatry, 8th ed., vol. 2, pp. 3164–3182. Philadelphia: Lippincott Williams
and Williams
Autism and childhood vaccines
Date updated: June 07, 2006
Sabra L. Katz-Wise
Content provided by Healthwise
There has been ongoing controversy surrounding certain vaccines and their relationship to autism. Some parents
have been concerned that vaccines, specifically the measles-mumps-rubella (MMR) vaccine and preservatives
used in other childhood vaccines, play a role in children developing autism. Some stopped vaccinating their
children altogether because of this concern.
Thimerosal in vaccines
Parents questioned whether mercury-containing thimerosal (used as a preservative in vaccines) might cause
autism. Today, with the exception of some influenza vaccines, none of the vaccines used in the United States to
protect preschool-aged children against 12 infectious diseases contain thimerosal as a preservative. (Influenza
vaccine is currently available both with thimerosal as a preservative and preservative-free.) More importantly,
studies have not found a link between thimerosal-containing vaccines and autism.1
Vaccine combinations
Parents also questioned whether the MMR vaccine—which combines 3 vaccines into 1 injection—causes autism
since symptoms of the disorder often become apparent about the time children start getting immunized.
In response to this concern, researchers in Europe, Canada, and the United States looked closely at this issue.
Studies have looked at the timing of the vaccine and the vaccine itself and have found no link between the
vaccines and autism.
Because the exact cause of this sometimes devastating condition is not known, some parents will continue to
have concerns despite the evidence. In these cases, parents should be aware of the risks of serious disease in
children who are not vaccinated. In some areas, outbreaks of these dangerous diseases have occurred in people
who have not been immunized.
References
Citations
1. Centers for Disease Control and Prevention (2004). National Immunization Program: MMR vaccine and autism.
Available online: http://www.cdc.gov/nip/vacsafe/concerns/autism/autism-mmr-facts.htm.
Medical history for autism
Date updated: June 07, 2006
Sabra L. Katz-Wise
Content provided by Healthwise
A complete medical history will be taken along with a physical examination to help confirm the diagnosis of
autism or to see whether there are other causes for unusual behaviors.1 Additionally, the health professional will
ask questions to assess the child's strengths and weaknesses and the family's resources.
Information from this interview will help your health professional apply the diagnostic standards from the
American Psychiatric Association.2 These standards are the basis for recommendations used by the American
Academy of Pediatrics and the American Academy of Child and Adolescent Psychiatry (AACAP).
The health professional will ask questions about:
• The mother's pregnancy.
• The child's communication skills.
References
Citations
1. Committee on Children with Disabilities, American Academy of Pediatrics (2001). Technical report: The
pediatrician's role in the diagnosis and management of autistic spectrum disorder in children. Pediatrics, 107(5):
1–18.
2. American Psychiatric Association (2000). Autistic disorder. In Diagnostic and Statistical Manual of Mental
Disorders, 4th ed., text rev., pp. 70–75. Washington, DC: American Psychiatric Association.
Behavioral questionnaires to help diagnose autism
Date updated: June 07, 2006
Sabra L. Katz-Wise
Content provided by Healthwise
Behavioral questionnaires are commonly used to help identify autistic behaviors and to evaluate their severity.
The specific test used varies depending on the health professional's preference and the child's symptoms.
Commonly used assessments include the following.
Physical examination for autism
Date updated: June 07, 2006
Sabra L. Katz-Wise
Content provided by Healthwise
During the physical examination, the health professional looks for specific signs of autism. A child suspected of
having autism will have assessments, including:
Medicines for autism
Date updated: June 07, 2006
Sabra L. Katz-Wise
Content provided by Healthwise
Medicines have a limited role in improving symptoms of autism. However, some may help prevent self-injury and
other behaviors that are causing difficulty. Medicines may also take a child to a functional level at which they can
benefit from other treatments.
There is no standard medicine for the treatment of autism. The American Academy of Pediatrics (AAP) suggests
targeting the main one or two problem behaviors when considering medicines.1
Medicines that are sometimes used to treat behaviors related to autism include selective serotonin reuptake
inhibitors and antipsychotic medicines.1
Selective serotonin reuptake inhibitors (SSRIs)
Selective serotonin reuptake inhibitors (SSRIs) include citalopram (Celexa), fluoxetine (Prozac), and sertraline
(Zoloft, Lustral). The high rate of effectiveness for depression, anxiety, and obsessive, stereotypical behaviors has
made these medicines a popular choice for managing autism. They may also improve general behavior,
language, learning, and socialization. In addition, although SSRIs have side effects, such as weight gain,
insomnia, and increased agitation, they tend to be less serious than those of antipsychotic medicines.
FDA advisory. The U.S. Food and Drug Administration (FDA) has issued an advisory to patients, families, and
health professionals to closely monitor adults and children taking antidepressants for warning signs of suicide.
This is especially important at the beginning of treatment or when doses are changed.
The FDA also advises that patients be observed for increases in anxiety, panic attacks, agitation, irritability,
insomnia, impulsivity, hostility, and mania. It is most important to watch for these behaviors in children who may
be less able to control their impulsivity as much as adults and therefore may be at greater risk for suicide. The
FDA has not recommended that people stop using antidepressants but simply to monitor those taking the
medicines and, if concerns arise, to contact a health professional.
Antipsychotic medicines
Antipsychotic medicines, such as haloperidol (Haldol), risperidone (Risperdal), and thioridazine work by changing
the effects of brain chemicals. They may help decrease problem behaviors that can occur with autism. A well-
designed study found that risperidone was effective for the treatment of tantrums, aggression, and self-harming
behavior in children with autism.2, 3
However, these medicines can have side effects, including sleepiness, tremors, and weight gain. Their use is
usually considered only after behavior management has failed to address the problem behaviors.
Other medicines that are sometimes used include:1
with your health professional. Some health professionals may advise going off a medicine temporarily, in order to
identify whether it is having a positive or negative effect.
References
Citations
1. Committee on Children with Disabilities, American Academy of Pediatrics (2001). Technical report: The
pediatrician's role in the diagnosis and management of autistic spectrum disorder in children. Pediatrics, 107(5):
1–18.
2. McCracken JT, et al. (2002). Risperidone in children with autism and serious behavioral problems. New
England Journal of Medicine, 347(5): 314–321.
3. U.S. Food and Drug Administration (2006). FDA approves the first drug to treat irritability associated with
autism, risperdal.
Unproven therapies for autism
Date updated: June 07, 2006
Sabra L. Katz-Wise
Content provided by Healthwise
The safety and effectiveness of some therapies used to treat autism is not known. Many unproven treatments
circulate through Web sites, word of mouth, or the media. Most have not been subjected to thorough, sound
research and are considered nonstandard and controversial. Be especially cautious about a treatment if:
overactive behavior and induce sleep in some people with autism. These medicines have not been approved by
the U.S. Food and Drug Administration (FDA) to manage autism. Discuss the possible risks and benefits of
clonidine and melatonin with your health professional before using them.
Always talk with a health professional before starting any little-known treatment for your child with autism. As is
true for any treatment, be aware of the side effects and risks.
References
Citations
1. Committee on Children with Disabilities, American Academy of Pediatrics (2001). Technical report: The
pediatrician's role in the diagnosis and management of autistic spectrum disorder in children. Pediatrics, 107(5):
1–18.
2. Nye C, Brice A (2005). Combined vitamin B6-magnesium treatment in autism spectrum disorder. Cochrane
Database of Systematic Reviews (2). Oxford: Update Software.
3. Levy SE, et al. (2003). Children with autistic spectrum disorders: 1. Comparison of placebo and single dose of
human synthetic secretin. Archives of Disease in Childhood, 88: 731–736.
4. Committee on Children With Disabilities (1998). Auditory integration training and facilitated communication for
autism. Pediatrics, 102(2): 431–433.
Behavioral training and management for autism
Date updated: June 07, 2006
Sabra L. Katz-Wise
Content provided by Healthwise
Behavioral training teaches people of all ages with autism how to communicate appropriately. This type of training
can reduce behavior problems and improve adaptation skills.
Both behavioral training and behavioral management use positive reinforcement to improve behavior. They also
use social skills training to improve communication. The specific program should be chosen according to the
child's needs. High-functioning autistic children may be enrolled in mainstream classrooms and child care
facilities—watching the behavior of other normally developing children can provide examples for autistic children
to follow. However, other children are overstimulated in a regular classroom and work best in smaller, highly
structured environments.
Consistent use of these behavioral interventions produces the best results. The child's functional abilities,
behavior, and daily environment should be thoroughly assessed before behavioral training and management
begins.1 Parents, other family members, teachers, and caregivers of the autistic child should all be trained in
these techniques.
Many treatment approaches have been developed, including:
treatments are not covered by all insurance plans.
For more information, parents can find a review of all the educational programs that work in the book Educating
Children With Autism. Written by the National Research Council, the book is available through the National
Academies Press at http://www.nap.edu/catalog/10017.
References
Citations
1. Committee on Children with Disabilities, American Academy of Pediatrics (2001). Technical report: The
pediatrician's role in the diagnosis and management of autistic spectrum disorder in children. Pediatrics, 107(5):
1–18.
Community support and training for a family affected by autism
Date updated: June 07, 2006
Sabra L. Katz-Wise
Content provided by Healthwise
Having a family member with autism presents many challenges. Support and training for parents and siblings are
important components of treatment. Training family members about autism and how to effectively manage the
symptoms has been shown to reduce family stress and improve the functioning of the child with autism.1 Some
families will need more outside assistance than others, depending on their internal functioning, established
support systems, and financial situation.
It is important for parents to actively seek assistance from whatever sources are available. Talk to your health
professional and investigate what help is available locally. Family, friends, public agencies, and national or
community organizations are all potential resources.
Whatever the source of support, the following measures are helpful for all families who have a member with
autism.1
References
Citations
1. Committee on Children with Disabilities, American Academy of Pediatrics (2001). Technical report: The
pediatrician's role in the diagnosis and management of autistic spectrum disorder in children. Pediatrics, 107(5):
1–18.
Educational rights for children with disabilities
Date updated: June 07, 2006
Sabra L. Katz-Wise
Content provided by Healthwise
The Education for All Handicapped Children Act (EAHCA) of 1975, also known as Public Law 94–142, is a federal
law that requires public schools to provide appropriate educational services for all disabled people between ages
3 and 21. EAHCA was strengthened and expanded with the passage of the 1997 Individuals with Disabilities
Education Act (IDEA). Funds are granted to individual states with special education programs that comply with
federal guidelines. These guidelines outline only the minimum standards that states must meet in order to get
the funds; after meeting the guidelines, states are allowed flexibility in designing their own programs.
Some specific provisions of IDEA are related to:
Detailed documentation of this law is available on the following Web site: http://www.ed.
gov/offices/OSERS/Policy/IDEA/.
Caring for adults with autism
Date updated: June 07, 2006
Sabra L. Katz-Wise
Content provided by Healthwise
Although symptoms may change and even improve, autism is a lifelong condition that presents many challenges
through adulthood. Whether an adult with autism lives in a group home, independently, or with family, he or she
still requires parental or some support.
Just as children with autism vary in their capabilities, so do adults. Some autistic adults are completely
dependent on parents or other caregivers, while others are able to live a semi-independent life.
Resources for adults vary by state and community, but vocational training programs exist in many areas. These
programs can help eligible adults with autism work on daily living skills to help them be as independent as
possible. Sometimes supported employment opportunities are available, which allow both training and
employment for the disabled. Information about state programs can usually be found in the yellow pages of your
telephone book under the state Department of Vocational Rehabilitation. Contact support groups or a health
professional for help in finding regional programs.
Parents must plan for the future of a child with autism. The cost of care, eligibility for government assistance, and
the individual skills and abilities of the child should all be taken into consideration. Some government services
may pay in part or in full for your child's adult care, depending upon different factors, such as your income.
Become familiar with tax issues and estate planning to ensure that your child will have proper care and necessary
resources available should you die. If you have other children who have developed normally, include them in the
planning.
Autism Symptoms
Date updated: June 07, 2006
Sabra L. Katz-Wise
Content provided by Healthwise
Core symptoms
The severity of symptoms varies greatly between individuals; however, all people with autism have some core
symptoms in the areas of:
• Social interactions and relationships. Symptoms may include:
Symptoms during childhood
Symptoms of autism are usually noticed first by parents and other caregivers sometime during the child's first 3
years. Although autism is present at birth (congenital), signs of the disorder can be difficult to identify or diagnose
during infancy. Parents often become concerned when their toddler does not like to be held; does not seem
interested in playing certain games, such as peekaboo; and does not begin to talk. They also may be confused
about their child's hearing abilities. It often seems that a child with autism does not hear, yet at other times, he or
she may appear to hear a distant background noise, such as the whistle of a train.
With early and intensive treatment, most children improve their ability to relate to others, communicate, and help
themselves as they grow older. Contrary to popular myths about children with autism, very few are completely
socially isolated or "live in a world of their own."
Symptoms during adolescent and teen years
During the teen years, the patterns of behavior often change. Many teens gain skills but still lag behind in their
ability to relate to and understand others. Puberty and emerging sexuality may be more difficult for adolescents
and teens with autism than for others this age. Teens are at a slightly increased risk for developing problems
related to depression,, anxiety, and epilepsy.
Symptoms in adulthood
Some adults with autism are able to work and live on their own. The degree to which an adult with autism can
lead an independent life is related to intelligence and ability to communicate. At least 33% are able to achieve at
least partial independence.
Some adults with autism need a lot of assistance, especially those with low intelligence who are unable to speak.
Part- or full-time supervision can be provided by residential treatment programs. At the other end of the spectrum,
adults with high-functioning autism are often successful in their professions and able to live independently,
although they typically continue to have some difficulties relating to other people. These individuals usually have
average to above-average intelligence.
Other symptoms
Many people with autism have symptoms similar to attention deficit hyperactivity disorder (ADHD). But these
symptoms, especially problems with social relationships, are more severe for people with autism.
About 10% of people with autism have some form of savant skills—special limited gifts such as memorizing lists,
calculating calendar dates, drawing, or musical ability.1
Many people with autism have unusual sensory perceptions. For example, they may describe a light touch as
painful and deep pressure as providing a calming feeling. Others may not feel pain at all. Some people with
autism have strong food likes and dislikes and unusual preoccupations.
Other conditions
Autism is one of several types of pervasive developmental disorders (PDDs), also called autism spectrum
disorders (ASD). It is not unusual for autism to be confused with other PDDs, such as Asperger's disorder or
syndrome, or to have overlapping symptoms. A similar condition is called pervasive developmental disorder-NOS
(not otherwise specified). PDD-NOS occurs when children display similar behaviors but do not meet the criteria
for autism. It is commonly called just PDD. In addition, other conditions with similar symptoms may also have
similarities to or occur with autism.
Autism Home Treatment
Date updated: June 07, 2006
Sabra L. Katz-Wise
Content provided by Healthwise
Having a child with autism requires taking a proactive approach to learning about the condition and its treatment
while working closely with others involved in your child's care. You also need to take care of yourself so that you
are able to face the many challenges of having a child with autism.
Educate yourself about autism
Ask your health professional or contact autism organizations to find training about autism and how to manage
symptoms. Parent and family education has been shown to reduce family stress and improve a child's
functioning.4 Understanding the condition and knowing what to expect is an important part of helping your child
develop independence.
Become informed about your child's educational rights. Federal laws require services for handicapped children,
including those with autism. In addition, there may be state and local laws or policies to aid children with autism.
Find out what services are available for your child in your area.
Learning about autism will also help prepare you for when your child reaches adulthood. Some adults with
autism can live by themselves, work, and be as independent as other people their age. Others need continued
support.
Work closely with others who care for your child
Close communication with others involved in your child's education and care will help all concerned. The best
treatment for children with autism is a team approach and a consistent, structured program. Everyone involved
needs to work together to set goals for:6
to your concerns and are willing to work with you.
Take care of yourself
Learn ways to handle the normal range of emotions, fears, and concerns that go along with raising a child with
autism. The daily and long-term challenges put you and your other children at an increased risk for depression or
stress-related illnesses. The way you handle these issues influences other family members.
Information also is available from the following organizations:
Association for Science in Autism Treatment Autism National Committee (AUTCOM)
P.O. Box 188 P.O. Box 429
Crosswicks, NJ 08515-0188 Forest Knolls, CA 94933
info@asatonline.org http://www.autcom.org
http://www.asatonline.org
Tel: 781-397-8943
Fax: 781-397-8887
Autism Network International (ANI) Autism Research Institute (ARI)
P.O. Box 35448 4182 Adams Avenue
Syracuse, NY 13235-5448 San Diego, CA 92116
jisincla@mailbox.syr.edu director@autism.com
http://ani.autistics.org http://www.autismresearchinstitute.com
Tel: 619-281-7165
MAAP Services for Autism, Autism Society of America
Asperger's, and PDD 7910 Woodmont Ave.
P.O. Box 524 Suite 300
Crown Point, IN 46308 Bethesda, MD 20814-3067
info@maapservices.org http://www.autism-society.org
http://www.maapservices.org Tel: 301-657-0881
Tel: 219-662-1311 800-3AUTISM (328-8476)
Fax: 219-662-0638 Fax: 301-657-0869
Autism Speaks, Inc. National Dissemination Center for
2 Park Avenue Children with Disabilities
11th Floor U.S. Dept. of Education, Office of
New York, NY 10016 Special Education Programs
contactus@autismspeaks.org P.O. Box 1492
http://www.autismspeaks.org Washington, DC 20013-1492
Tel: 212-252-8584 nichcy@aed.org
California: 310-230-3568 http://www.nichcy.org
Fax: 212-252-8676Office of Tel: 800-695-0285
Fax: 202-884-8441
Autism is a brain disorder that often makes it hard to communicate with and relate to others. With autism, the
different areas of the brain fail to work together.
Most people with autism will always have some trouble relating to others. But early diagnosis and treatment have
helped more and more people with autism to live independently as adults.
What causes autism?
Autism tends to run in families, so experts think it may be something that you inherit. Scientists are trying to find
out exactly which genes may be responsible for passing down autism in families.
Other studies are looking at whether autism can be caused by other medical problems or by something in your
child’s surroundings.
Some people think that childhood vaccines cause autism, especially the measles-mumps-rubella, or MMR,
vaccine. But studies have not shown this to be true. It’s important to make sure that your child gets all childhood
vaccines. They help keep your child from getting serious diseases that can cause harm or even death.
What are the symptoms?
Symptoms almost always start before a child is 3 years old. Usually, parents first notice that their toddler has not
started talking yet and is not acting like other children the same age.
Symptoms of autism include:
- A delay in learning to talk, or not talking at all. A child may seem to be deaf, even though hearing tests are
normal. - Repeated and overused types of behavior, interests, and play. Examples include repeated body rocking,
unusual attachments to objects, and getting very upset when routines change.
There is no "typical" person with autism. People can have many different kinds of behaviors, from mild to severe.
Parents often say that their child with autism prefers to play alone and does not make eye contact with other
people.
Autism may also include other problems:
- Many children have below-normal intelligence.
- Teenagers often become depressed and have a lot of anxiety, especially if they have average or above-
average intelligence. - Some children get a seizure disorder such as epilepsy by their teen years.
How is autism diagnosed?
There are guidelines your doctor will use to see if your child has symptoms of autism. The guidelines put
symptoms into three categories:
- Social interactions and relationships. For example, a child may have trouble making eye contact. People
with autism may have a hard time understanding someone else’s feelings, such as pain or sadness. - Verbal and nonverbal communication. For example, a child may never speak. Or he or she may often
repeat a certain phrase over and over. - Limited interests in activities or play. For example, younger children often focus on parts of toys rather
than playing with the whole toy. Older children and adults may be fascinated by certain topics, like train
schedules or license plates.
Your child may also have a hearing test and some other tests to make sure that problems are not caused by
some other condition.
How is it treated?
Treatment for autism involves special behavioral training. Behavioral training rewards good behavior (positive
reinforcement) to teach children social skills and to teach them how to communicate and how to help themselves
as they grow older.
With early treatment, most children with autism learn to relate better to others. They learn to communicate and to
help themselves as they grow older.
Depending on the child, treatment may also include such things as speech therapy or physical therapy. Medicine
is sometimes used to treat problems such as depression or obsessive-compulsive behaviors.
Exactly what type of treatment your child needs depends on the symptoms, which are different for each child and
may change over time. Because people with autism are so different, something that helps one person may not
help another. So it’s important to work with everyone involved in your child’s education and care to find the best
way to manage symptoms.
How can your family deal with having a child with autism?
An important part of your child's treatment plan is making sure that other family members get training about
autism and how to manage symptoms. Training can reduce family stress and help your child function better.
Some families need more help than others.
Take advantage of every kind of help you can find. Talk to your doctor about what help is available where you live.
Family, friends, public agencies, and autism organizations are all possible resources.
Remember these tips:
- Plan breaks. Daily demands of caring for a child with autism can take their toll. Planned breaks will help
the whole family. - Get extra help when your child gets older. The teen years can be a very hard time for children with autism.
- Get in touch with other families who have children with autism. You can talk about your problems and
share advice with people who will understand.
Raising a child with autism is hard work. But with support and training, your family can learn how to cope.
Who is affected by autism
Date updated: June 07, 2006
Sabra L. Katz-Wise
Content provided by Healthwise
- Around the world, about 1 in every 1,000 children has autism.1 And an even larger number may show
some features of autism. A Centers for Disease Control and Prevention (CDC) study shows that as many
as 1 in 150 children age 8 have an autism spectrum disorder (ASD) in 14 areas of the U.S.2, 3 - It is likely that most cases of autism are passed down through families. Couples who have one child with
autism are more likely to have a second child with autism than couples who do not have a child with
autism.1 - Boys are up to 4 times more likely than girls to have autism.4
Studies show that autism may be recognized more often than it used to. This may be because of better detection
and a broader definition of autism. For example, some children who were previously diagnosed with mental
retardation are now being diagnosed with autism. More study is needed to find the reason for the increased
diagnosis of autism.
Pervasive developmental disorders
Date updated: June 07, 2006
Sabra L. Katz-Wise
Content provided by Healthwise
Pervasive developmental disorders (PDDs) is an umbrella term used to define a class of disorders.
Disorders included in this class are:
- Autistic disorder.
- Rett's disorder.
- Asperger's disorder.
- Childhood disintegration disorder (CDD).
- Pervasive developmental disorders–not otherwise specified (PDD-NOS). This term is used to identify
children who do not meet the diagnostic criteria for an established pervasive developmental disorder
(PDD) but who have developmental and behavioral problems that are similar to those found in autism.
These problems include abnormal sensitivities and unusual behavioral responses to certain situations.
However, children with PDD-NOS have better cognitive and communication skills than children with
autism or other types of PDDs.
development, including:
- Developing relationships with other people, including their parents and children their own age.
- Communicating with other people.
- Having unusual behaviors and interests.
from parents and other caregivers. Other children are mildly affected and can develop adequate skills to lead
independent lives as adults. Many children are affected at levels somewhere between these two extremes.
Pervasive developmental disorders are present at birth. However, the signs of these disorders may not be noticed
until later, usually during the first 3 years of a child's life.
Asperger's disorder
Date updated: June 07, 2006
Sabra L. Katz-Wise
Content provided by Healthwise
Asperger's disorder, also called Asperger's syndrome, is a type of pervasive developmental disorder (PDD) as
defined by the American Psychiatric Association.1 Asperger's disorder is similar to high-functioning autism in how
it affects a child's mannerisms and socialization traits.
A distinction between Asperger's disorder and autism is that young children with Asperger's have normal
language development, although the rhythm, pitch, and emphasis are irregular. Unlike autism, Asperger's
disorder does not delay other aspects of development; a child usually has age-appropriate self-reliance and an
interest in the world around him or her. However, like autism, children with Asperger's disorder have abnormal
social interactions, facial expressions, and gestures.
Asperger's disorder affects males 9 times more than females.2 Its cause is unknown. More research is needed
to confirm whether Asperger's disorder is a condition that is genetically related to autism.
References
Citations
1. American Psychiatric Association (2000). Autistic disorder. In Diagnostic and Statistical Manual of Mental
Disorders, 4th ed., text rev., pp. 70–75. Washington, DC: American Psychiatric Association.
2. Volkmar FR, et al. (2005). Pervasive developmental disorders. In BJ Sadock, VA Sadock, eds., Kaplan and
Sadock's Comprehensive Textbook of Psychiatry, 8th ed., vol. 2, pp. 3164–3182. Philadelphia: Lippincott Williams
and Williams
Autism and childhood vaccines
Date updated: June 07, 2006
Sabra L. Katz-Wise
Content provided by Healthwise
There has been ongoing controversy surrounding certain vaccines and their relationship to autism. Some parents
have been concerned that vaccines, specifically the measles-mumps-rubella (MMR) vaccine and preservatives
used in other childhood vaccines, play a role in children developing autism. Some stopped vaccinating their
children altogether because of this concern.
Thimerosal in vaccines
Parents questioned whether mercury-containing thimerosal (used as a preservative in vaccines) might cause
autism. Today, with the exception of some influenza vaccines, none of the vaccines used in the United States to
protect preschool-aged children against 12 infectious diseases contain thimerosal as a preservative. (Influenza
vaccine is currently available both with thimerosal as a preservative and preservative-free.) More importantly,
studies have not found a link between thimerosal-containing vaccines and autism.1
Vaccine combinations
Parents also questioned whether the MMR vaccine—which combines 3 vaccines into 1 injection—causes autism
since symptoms of the disorder often become apparent about the time children start getting immunized.
In response to this concern, researchers in Europe, Canada, and the United States looked closely at this issue.
Studies have looked at the timing of the vaccine and the vaccine itself and have found no link between the
vaccines and autism.
Because the exact cause of this sometimes devastating condition is not known, some parents will continue to
have concerns despite the evidence. In these cases, parents should be aware of the risks of serious disease in
children who are not vaccinated. In some areas, outbreaks of these dangerous diseases have occurred in people
who have not been immunized.
References
Citations
1. Centers for Disease Control and Prevention (2004). National Immunization Program: MMR vaccine and autism.
Available online: http://www.cdc.gov/nip/vacsafe/concerns/autism/autism-mmr-facts.htm.
Medical history for autism
Date updated: June 07, 2006
Sabra L. Katz-Wise
Content provided by Healthwise
A complete medical history will be taken along with a physical examination to help confirm the diagnosis of
autism or to see whether there are other causes for unusual behaviors.1 Additionally, the health professional will
ask questions to assess the child's strengths and weaknesses and the family's resources.
Information from this interview will help your health professional apply the diagnostic standards from the
American Psychiatric Association.2 These standards are the basis for recommendations used by the American
Academy of Pediatrics and the American Academy of Child and Adolescent Psychiatry (AACAP).
The health professional will ask questions about:
• The mother's pregnancy.
- How was the mother's general health during pregnancy? Was she exposed to infection? Did she drink
alcohol, smoke, or use drugs? - How was the child delivered, and were there problems during delivery?
- How much did the child weigh, and did he or she have problems after birth?
• The child's communication skills.
- Is the child able to speak at the same level as others his or her age?
- Does the child ever bring parents items that are of obvious interest or enthusiastically engage with
parents to point out objects or events? - Without making eye contact, will the child take a parent's hand and guide the parent to a desired object
instead of asking for it? - Can the child follow simple commands?
- Does the child respond to his or her name?
- Does the child have any unusual speech patterns, such as repeating heard phrases over and over
(echolalia), pronoun reversal, or using a monotone voice? - The child's social interaction.
- Is the child interested in social interaction, or does the child distance himself or herself from others?
- Does the child make and sustain eye contact?
- Does the child have a social smile that he or she initiates or responds with to others' gestures?
- Does the child have an attachment to any unusual objects, such as a hard, metal object, rather than a
blanket or stuffed animal? - Does the child stare frequently?
- Has the child ever had any seizures?
- Does the child play with toys in an unusual manner?
- Does the child play "pretend" (if older than age 2)?
- Does the child have severe temper tantrums that can last a long time?
- What are the parents' occupations and education? Other resources?
- Is there a family history of mood or anxiety problems?
- Are any other siblings developmentally disabled in any way? Have they had problems developing
language skills?
References
Citations
1. Committee on Children with Disabilities, American Academy of Pediatrics (2001). Technical report: The
pediatrician's role in the diagnosis and management of autistic spectrum disorder in children. Pediatrics, 107(5):
1–18.
2. American Psychiatric Association (2000). Autistic disorder. In Diagnostic and Statistical Manual of Mental
Disorders, 4th ed., text rev., pp. 70–75. Washington, DC: American Psychiatric Association.
Behavioral questionnaires to help diagnose autism
Date updated: June 07, 2006
Sabra L. Katz-Wise
Content provided by Healthwise
Behavioral questionnaires are commonly used to help identify autistic behaviors and to evaluate their severity.
The specific test used varies depending on the health professional's preference and the child's symptoms.
Commonly used assessments include the following.
- Modified Checklist for Autism in Toddlers (M-CHAT). This test is used to evaluate infants who are at least
24 months old. The M-CHAT is better than the original CHAT (Checklist for Autism in Toddlers) for
detecting autism. The test continues to be studied to identify milder autistic symptoms. - Pervasive Developmental Disorder Screening. This questionnaire is completed by parents to evaluate
early signs of autism. - Autism Screening Questionnaire. This test is for children 4 years of age and older.
- Autism Behavior Checklist. This is a screening tool completed by the child's teacher.
- Childhood Autism Rating Scale. This test rates how much a child's behavior varies from that of other
children the same age (older than 24 months). - Autism Diagnostic Interview. Parents provide information about their child's behaviors during this wide-
ranging, structured interview. - Autism Observation Schedule. During this test, a health professional observes a child as he or she
performs several activities involving communication, social interaction, play, interests, and other behaviors.
Physical examination for autism
Date updated: June 07, 2006
Sabra L. Katz-Wise
Content provided by Healthwise
During the physical examination, the health professional looks for specific signs of autism. A child suspected of
having autism will have assessments, including:
- Weight and height measurements, to determine whether he or she has a normal growth pattern.
- Head circumference measurements, to determine whether head size is normal. Some children with
autism have a larger- or smaller-than-average head. - Examination of the face, arms, and legs, to look for any birth defects.
- Routine tests to ensure that developmental delays aren't caused by hearing loss and/or vision problems.
- Evaluation for self-inflicted injuries. Sometimes injurious behaviors such as face slapping or head
banging are caused by an underlying infection or injury. - Reflex testing. Children with autism often have undeveloped reflexes.
- Exercises to determine hand dominance. Some autistic children have a delayed development of right- or
left-handedness.
Medicines for autism
Date updated: June 07, 2006
Sabra L. Katz-Wise
Content provided by Healthwise
Medicines have a limited role in improving symptoms of autism. However, some may help prevent self-injury and
other behaviors that are causing difficulty. Medicines may also take a child to a functional level at which they can
benefit from other treatments.
There is no standard medicine for the treatment of autism. The American Academy of Pediatrics (AAP) suggests
targeting the main one or two problem behaviors when considering medicines.1
Medicines that are sometimes used to treat behaviors related to autism include selective serotonin reuptake
inhibitors and antipsychotic medicines.1
Selective serotonin reuptake inhibitors (SSRIs)
Selective serotonin reuptake inhibitors (SSRIs) include citalopram (Celexa), fluoxetine (Prozac), and sertraline
(Zoloft, Lustral). The high rate of effectiveness for depression, anxiety, and obsessive, stereotypical behaviors has
made these medicines a popular choice for managing autism. They may also improve general behavior,
language, learning, and socialization. In addition, although SSRIs have side effects, such as weight gain,
insomnia, and increased agitation, they tend to be less serious than those of antipsychotic medicines.
FDA advisory. The U.S. Food and Drug Administration (FDA) has issued an advisory to patients, families, and
health professionals to closely monitor adults and children taking antidepressants for warning signs of suicide.
This is especially important at the beginning of treatment or when doses are changed.
The FDA also advises that patients be observed for increases in anxiety, panic attacks, agitation, irritability,
insomnia, impulsivity, hostility, and mania. It is most important to watch for these behaviors in children who may
be less able to control their impulsivity as much as adults and therefore may be at greater risk for suicide. The
FDA has not recommended that people stop using antidepressants but simply to monitor those taking the
medicines and, if concerns arise, to contact a health professional.
Antipsychotic medicines
Antipsychotic medicines, such as haloperidol (Haldol), risperidone (Risperdal), and thioridazine work by changing
the effects of brain chemicals. They may help decrease problem behaviors that can occur with autism. A well-
designed study found that risperidone was effective for the treatment of tantrums, aggression, and self-harming
behavior in children with autism.2, 3
However, these medicines can have side effects, including sleepiness, tremors, and weight gain. Their use is
usually considered only after behavior management has failed to address the problem behaviors.
Other medicines that are sometimes used include:1
- Clonidine (Catapres) and guanfacine hydrochloride (Tenex). These medicines are typically used to lower
blood pressure but are also used to treat impulsive and aggressive behaviors in children with autism. - Lithium (Eskalith, Eskalith-CR, Lithobid, Lithonate, Lithotabs) and anticonvulsants, such as
carbamazepine (Carbatrol, Epitol, Tegretol) and valproic acid (Depakene). Children who are occasionally
aggressive may become more stable when using these medicines, although monitoring the level of the
drug in the body through regularly scheduled blood tests is required.
with your health professional. Some health professionals may advise going off a medicine temporarily, in order to
identify whether it is having a positive or negative effect.
References
Citations
1. Committee on Children with Disabilities, American Academy of Pediatrics (2001). Technical report: The
pediatrician's role in the diagnosis and management of autistic spectrum disorder in children. Pediatrics, 107(5):
1–18.
2. McCracken JT, et al. (2002). Risperidone in children with autism and serious behavioral problems. New
England Journal of Medicine, 347(5): 314–321.
3. U.S. Food and Drug Administration (2006). FDA approves the first drug to treat irritability associated with
autism, risperdal.
Unproven therapies for autism
Date updated: June 07, 2006
Sabra L. Katz-Wise
Content provided by Healthwise
The safety and effectiveness of some therapies used to treat autism is not known. Many unproven treatments
circulate through Web sites, word of mouth, or the media. Most have not been subjected to thorough, sound
research and are considered nonstandard and controversial. Be especially cautious about a treatment if:
- The treatment is based upon oversimplified scientific theories.
- It benefits more than one condition.
- It provides dramatic and "miraculous" results.
- The only available evidence is based upon a few stories (anecdotal evidence), not scientific research.
- Specific treatment goals or target behaviors are not identified.
- Controlled, scientific research is said not to be needed because there are no risks or side effects.
- Nutritional supplements. Some studies have claimed that giving high doses of vitamin B6 and
magnesium improves autistic behaviors. A review of these studies found they lacked controls and
scientific design. - Restrictive diets. Elimination of milk and gluten from a child's diet is based upon an idea that autism is
triggered by digestive disorders. Parents of a child with autism who also has food allergies or intolerance
may be more likely to attempt this type of diet. However, food sensitivities are not proven to be more
common in children with autism than in normally developing children. - Immune globulin therapy. An intravenous (IV) injection of immune globulin is based on the assumption
that autism is caused by an autoimmune abnormality. - Secretin. This treatment uses an IV injection of secretin (a hormone that stimulates the pancreas and
liver) to manage autistic behavior. Studies show this treatment is not effective. - Chelation therapy. Mercury exposure as a cause of autism is the basis for this therapy, which uses
medications to help the body eliminate the toxins. Children with autism often have a craving for nonfood
items (pica) or unusual diets that may result in mercury exposure; therefore, mercury exposure may be
more an effect of autism than a cause. - Auditory integration training (AIT). Based upon a theory that autism is caused by hearing problems that
result in distorted sounds or oversensitivity to noises, this treatment delivers music through special
devices. - Facilitated communication. This method uses a keyboard to assist communication. It has not been found
to be helpful and in some cases has been harmful.
overactive behavior and induce sleep in some people with autism. These medicines have not been approved by
the U.S. Food and Drug Administration (FDA) to manage autism. Discuss the possible risks and benefits of
clonidine and melatonin with your health professional before using them.
Always talk with a health professional before starting any little-known treatment for your child with autism. As is
true for any treatment, be aware of the side effects and risks.
References
Citations
1. Committee on Children with Disabilities, American Academy of Pediatrics (2001). Technical report: The
pediatrician's role in the diagnosis and management of autistic spectrum disorder in children. Pediatrics, 107(5):
1–18.
2. Nye C, Brice A (2005). Combined vitamin B6-magnesium treatment in autism spectrum disorder. Cochrane
Database of Systematic Reviews (2). Oxford: Update Software.
3. Levy SE, et al. (2003). Children with autistic spectrum disorders: 1. Comparison of placebo and single dose of
human synthetic secretin. Archives of Disease in Childhood, 88: 731–736.
4. Committee on Children With Disabilities (1998). Auditory integration training and facilitated communication for
autism. Pediatrics, 102(2): 431–433.
Behavioral training and management for autism
Date updated: June 07, 2006
Sabra L. Katz-Wise
Content provided by Healthwise
Behavioral training teaches people of all ages with autism how to communicate appropriately. This type of training
can reduce behavior problems and improve adaptation skills.
Both behavioral training and behavioral management use positive reinforcement to improve behavior. They also
use social skills training to improve communication. The specific program should be chosen according to the
child's needs. High-functioning autistic children may be enrolled in mainstream classrooms and child care
facilities—watching the behavior of other normally developing children can provide examples for autistic children
to follow. However, other children are overstimulated in a regular classroom and work best in smaller, highly
structured environments.
Consistent use of these behavioral interventions produces the best results. The child's functional abilities,
behavior, and daily environment should be thoroughly assessed before behavioral training and management
begins.1 Parents, other family members, teachers, and caregivers of the autistic child should all be trained in
these techniques.
Many treatment approaches have been developed, including:
- Applied Behavior Analysis (ABA). This treatment is based on the theory that behavior rewarded is more
likely to be repeated than behavior ignored. It focuses on giving the child short simple tasks that are
rewarded when successfully completed. Children usually work for 30 to 40 hours a week one-on-one with
a trained professional. Some practitioners feel this method is too emotionally draining and demanding for
a child with autism. Yet, years of practice has shown that ABA techniques result in new skills and improved
behaviors in some children with autism. - TEACCH (Treatment and Education of Autistic and Related Communication Handicapped Children). This
is a structured teaching approach based on the idea that the environment should be adapted to the child
with autism, not the child to the environment. Teaching strategies are designed to improve
communication, social, and coping skills. Like ABA, TEACCH also requires intensive one-on-one training.
treatments are not covered by all insurance plans.
For more information, parents can find a review of all the educational programs that work in the book Educating
Children With Autism. Written by the National Research Council, the book is available through the National
Academies Press at http://www.nap.edu/catalog/10017.
References
Citations
1. Committee on Children with Disabilities, American Academy of Pediatrics (2001). Technical report: The
pediatrician's role in the diagnosis and management of autistic spectrum disorder in children. Pediatrics, 107(5):
1–18.
Community support and training for a family affected by autism
Date updated: June 07, 2006
Sabra L. Katz-Wise
Content provided by Healthwise
Having a family member with autism presents many challenges. Support and training for parents and siblings are
important components of treatment. Training family members about autism and how to effectively manage the
symptoms has been shown to reduce family stress and improve the functioning of the child with autism.1 Some
families will need more outside assistance than others, depending on their internal functioning, established
support systems, and financial situation.
It is important for parents to actively seek assistance from whatever sources are available. Talk to your health
professional and investigate what help is available locally. Family, friends, public agencies, and national or
community organizations are all potential resources.
Whatever the source of support, the following measures are helpful for all families who have a member with
autism.1
- Schedule breaks. Daily demands of caring for a child with autism can be overwhelming. Trained
personnel can relieve family members from these duties as needed. These breaks can help families
communicate in a less stressful context and allow parents to focus on their relationships with their other
children. Having regular breaks may also help a family continue to care for a child at home, rather than
becoming so exhausted that they resort to institutional care. Government programs exist to help families
who cannot afford this occasional care. - Seek assistance for a child with autism who is entering adolescence. Community services and public
programs can help families during what can be an especially difficult time for their child. An adolescent
child may benefit from group home situations, special employment, and other programs designed to help
the transition into adulthood. - Make contact with other families who have a child with autism. There are many families who share your
concerns and daily challenges. Local and national groups can help connect families and provide much-
needed sources of information. Most health professionals can recommend some of these organizations.
References
Citations
1. Committee on Children with Disabilities, American Academy of Pediatrics (2001). Technical report: The
pediatrician's role in the diagnosis and management of autistic spectrum disorder in children. Pediatrics, 107(5):
1–18.
Educational rights for children with disabilities
Date updated: June 07, 2006
Sabra L. Katz-Wise
Content provided by Healthwise
The Education for All Handicapped Children Act (EAHCA) of 1975, also known as Public Law 94–142, is a federal
law that requires public schools to provide appropriate educational services for all disabled people between ages
3 and 21. EAHCA was strengthened and expanded with the passage of the 1997 Individuals with Disabilities
Education Act (IDEA). Funds are granted to individual states with special education programs that comply with
federal guidelines. These guidelines outline only the minimum standards that states must meet in order to get
the funds; after meeting the guidelines, states are allowed flexibility in designing their own programs.
Some specific provisions of IDEA are related to:
- Duration of services. Your child may be eligible for services beyond the 180 days of a traditional school
year. - Identifying and evaluating the disability. Your child must be officially evaluated for having a disability
through specific testing procedures. Health, vision, hearing, social and emotional development,
intelligence, communication skills, and academic performance must all be included during this evaluation. - Free and appropriate education. The needs vary for each child with a disability but include education and
related services. This is a comprehensive requirement that may include services such as transportation,
psychological care, and physical therapy. However, medical services are excluded from this provision.
Although some services are free, this does not mean they are the best services available; some services
beyond those minimally required may be available on a sliding price scale based upon family income. - Least restrictive environment. Handicapped children are mainstreamed into traditional classrooms with
normally developing children whenever possible. Although this is not always feasible or appropriate,
attempts should be made to limit a child's isolation. - Individualized education program (IEP). Educational programs to fit specific needs are designed based
upon the evaluation of a child's disability. Meetings are held with school personnel and parents to identify
goals and establish a program to best help the child with available resources. - Early intervention services for infants and toddlers with physical, cognitive, communication, social or
emotional, or adaptive developmental disabilities. This also may include infants or toddlers at risk for
these developmental problems, depending upon the state.
Detailed documentation of this law is available on the following Web site: http://www.ed.
gov/offices/OSERS/Policy/IDEA/.
Caring for adults with autism
Date updated: June 07, 2006
Sabra L. Katz-Wise
Content provided by Healthwise
Although symptoms may change and even improve, autism is a lifelong condition that presents many challenges
through adulthood. Whether an adult with autism lives in a group home, independently, or with family, he or she
still requires parental or some support.
Just as children with autism vary in their capabilities, so do adults. Some autistic adults are completely
dependent on parents or other caregivers, while others are able to live a semi-independent life.
Resources for adults vary by state and community, but vocational training programs exist in many areas. These
programs can help eligible adults with autism work on daily living skills to help them be as independent as
possible. Sometimes supported employment opportunities are available, which allow both training and
employment for the disabled. Information about state programs can usually be found in the yellow pages of your
telephone book under the state Department of Vocational Rehabilitation. Contact support groups or a health
professional for help in finding regional programs.
Parents must plan for the future of a child with autism. The cost of care, eligibility for government assistance, and
the individual skills and abilities of the child should all be taken into consideration. Some government services
may pay in part or in full for your child's adult care, depending upon different factors, such as your income.
Become familiar with tax issues and estate planning to ensure that your child will have proper care and necessary
resources available should you die. If you have other children who have developed normally, include them in the
planning.
Autism Symptoms
Date updated: June 07, 2006
Sabra L. Katz-Wise
Content provided by Healthwise
Core symptoms
The severity of symptoms varies greatly between individuals; however, all people with autism have some core
symptoms in the areas of:
• Social interactions and relationships. Symptoms may include:
- Significant problems developing nonverbal communication skills, such as eye-to-eye gazing, facial
expressions, and body posture. - Failure to establish friendships with children the same age.
- Lack of interest in sharing enjoyment, interests, or achievements with other people.
- Lack of empathy. People with autism may have difficulty understanding another person's feelings, such
as pain or sorrow.
- Delay in, or lack of, learning to talk. As many as 50% of people with autism never speak.
- Problems taking steps to start a conversation. Also, people with autism have difficulties continuing a
conversation once it has begun. - Stereotyped and repetitive use of language. People with autism often repeat over and over a phrase they
have heard previously (echolalia). - Difficulty understanding their listener's perspective. For example, a person with autism may not
understand that someone is using humor. They may interpret the communication word for word and fail to
catch the implied meaning.
- An unusual focus on pieces. Younger children with autism often focus on parts of toys, such as the
wheels on a car, rather than playing with the entire toy. - Preoccupation with certain topics. For example, older children and adults may be fascinated by train
schedules, weather patterns, or license plates. - A need for sameness and routines. For example, a child with autism may always need to eat bread before
salad and insist on driving the same route every day to school. - Stereotyped behaviors. These may include body rocking and hand flapping.
Symptoms during childhood
Symptoms of autism are usually noticed first by parents and other caregivers sometime during the child's first 3
years. Although autism is present at birth (congenital), signs of the disorder can be difficult to identify or diagnose
during infancy. Parents often become concerned when their toddler does not like to be held; does not seem
interested in playing certain games, such as peekaboo; and does not begin to talk. They also may be confused
about their child's hearing abilities. It often seems that a child with autism does not hear, yet at other times, he or
she may appear to hear a distant background noise, such as the whistle of a train.
With early and intensive treatment, most children improve their ability to relate to others, communicate, and help
themselves as they grow older. Contrary to popular myths about children with autism, very few are completely
socially isolated or "live in a world of their own."
Symptoms during adolescent and teen years
During the teen years, the patterns of behavior often change. Many teens gain skills but still lag behind in their
ability to relate to and understand others. Puberty and emerging sexuality may be more difficult for adolescents
and teens with autism than for others this age. Teens are at a slightly increased risk for developing problems
related to depression,, anxiety, and epilepsy.
Symptoms in adulthood
Some adults with autism are able to work and live on their own. The degree to which an adult with autism can
lead an independent life is related to intelligence and ability to communicate. At least 33% are able to achieve at
least partial independence.
Some adults with autism need a lot of assistance, especially those with low intelligence who are unable to speak.
Part- or full-time supervision can be provided by residential treatment programs. At the other end of the spectrum,
adults with high-functioning autism are often successful in their professions and able to live independently,
although they typically continue to have some difficulties relating to other people. These individuals usually have
average to above-average intelligence.
Other symptoms
Many people with autism have symptoms similar to attention deficit hyperactivity disorder (ADHD). But these
symptoms, especially problems with social relationships, are more severe for people with autism.
About 10% of people with autism have some form of savant skills—special limited gifts such as memorizing lists,
calculating calendar dates, drawing, or musical ability.1
Many people with autism have unusual sensory perceptions. For example, they may describe a light touch as
painful and deep pressure as providing a calming feeling. Others may not feel pain at all. Some people with
autism have strong food likes and dislikes and unusual preoccupations.
Other conditions
Autism is one of several types of pervasive developmental disorders (PDDs), also called autism spectrum
disorders (ASD). It is not unusual for autism to be confused with other PDDs, such as Asperger's disorder or
syndrome, or to have overlapping symptoms. A similar condition is called pervasive developmental disorder-NOS
(not otherwise specified). PDD-NOS occurs when children display similar behaviors but do not meet the criteria
for autism. It is commonly called just PDD. In addition, other conditions with similar symptoms may also have
similarities to or occur with autism.
Autism Home Treatment
Date updated: June 07, 2006
Sabra L. Katz-Wise
Content provided by Healthwise
Having a child with autism requires taking a proactive approach to learning about the condition and its treatment
while working closely with others involved in your child's care. You also need to take care of yourself so that you
are able to face the many challenges of having a child with autism.
Educate yourself about autism
Ask your health professional or contact autism organizations to find training about autism and how to manage
symptoms. Parent and family education has been shown to reduce family stress and improve a child's
functioning.4 Understanding the condition and knowing what to expect is an important part of helping your child
develop independence.
Become informed about your child's educational rights. Federal laws require services for handicapped children,
including those with autism. In addition, there may be state and local laws or policies to aid children with autism.
Find out what services are available for your child in your area.
Learning about autism will also help prepare you for when your child reaches adulthood. Some adults with
autism can live by themselves, work, and be as independent as other people their age. Others need continued
support.
Work closely with others who care for your child
Close communication with others involved in your child's education and care will help all concerned. The best
treatment for children with autism is a team approach and a consistent, structured program. Everyone involved
needs to work together to set goals for:6
- Education.
- Identifying and managing symptoms of autism and any related conditions.
- Behavior and interactions with family and peers, adjustment to different environments, and social and
communication skills.
to your concerns and are willing to work with you.
Take care of yourself
Learn ways to handle the normal range of emotions, fears, and concerns that go along with raising a child with
autism. The daily and long-term challenges put you and your other children at an increased risk for depression or
stress-related illnesses. The way you handle these issues influences other family members.
- Get involved in a hobby, visit with friends, and learn ways to relax.
- Seek and accept support from others. Consider using respite care, which is a family support service that
provides a break for parents and siblings. In addition, support groups for parents and siblings are
generally available; people who participate in support groups can benefit from others' experiences. For
more information on support groups in your area, contact the Autism Society of America at http://www.
autism-society.org. - Talk with a health professional about whether counseling would help if you or one of your children is
having trouble handling the strains related to having a family member with autism.
Information also is available from the following organizations:
Association for Science in Autism Treatment Autism National Committee (AUTCOM)
P.O. Box 188 P.O. Box 429
Crosswicks, NJ 08515-0188 Forest Knolls, CA 94933
info@asatonline.org http://www.autcom.org
http://www.asatonline.org
Tel: 781-397-8943
Fax: 781-397-8887
Autism Network International (ANI) Autism Research Institute (ARI)
P.O. Box 35448 4182 Adams Avenue
Syracuse, NY 13235-5448 San Diego, CA 92116
jisincla@mailbox.syr.edu director@autism.com
http://ani.autistics.org http://www.autismresearchinstitute.com
Tel: 619-281-7165
MAAP Services for Autism, Autism Society of America
Asperger's, and PDD 7910 Woodmont Ave.
P.O. Box 524 Suite 300
Crown Point, IN 46308 Bethesda, MD 20814-3067
info@maapservices.org http://www.autism-society.org
http://www.maapservices.org Tel: 301-657-0881
Tel: 219-662-1311 800-3AUTISM (328-8476)
Fax: 219-662-0638 Fax: 301-657-0869
Autism Speaks, Inc. National Dissemination Center for
2 Park Avenue Children with Disabilities
11th Floor U.S. Dept. of Education, Office of
New York, NY 10016 Special Education Programs
contactus@autismspeaks.org P.O. Box 1492
http://www.autismspeaks.org Washington, DC 20013-1492
Tel: 212-252-8584 nichcy@aed.org
California: 310-230-3568 http://www.nichcy.org
Fax: 212-252-8676Office of Tel: 800-695-0285
Fax: 202-884-8441
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