Google the word “autism” and you can find many definitions. According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-V) from the American Psychiatric Association, autism spectrum disorder (ASD) is a neurological condition. It is identified by persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and manifest by specific symptoms.
Who Is Affected by ASD?
- ASD occurs in children across ethnic, racial and socioeconomic groups
- Rates of autism are significantly higher in the United States than other developed countries
- The United States has seen a steep increase in ASD since 2003
- The Centers for Disease Control (CDC) estimates that in the U.S., an average of 1 in 45 children will have ASD
- Children with autism are more likely to be boys
ASD is a Neurological Disorder
Research continues to investigate why the rate of autism is increasing from environmental factors to genetics, though the cause of autism is still unknown. What is known is that ASD is a neurological disorder that, when treated in early childhood with ABA therapy, can significantly decrease in its presentation of symptoms. Some studies have shown the loss of an autism diagnosis after intensive ABA treatment from 18 months to five years of age. While not all children will respond this positively to ABA treatment, all children who have ABA treatment (implemented correctly) will have decreased symptoms of autism.
Signs, Symptoms and Characteristics of ASD
ASD can be noticed in an infant as early as eight to ten months of age. These infants may exhibit symptoms such as not recognizing their name when called, delayed babbling, and not having an interest in people. The symptoms of ASD are likely to become more apparent as the child gets older, and some symptoms may not be noticeable until the child is two years old.
ASD Symptoms in Toddlers
ASD symptoms in toddlers may include a preference to play alone, difficulty engaging with peers, and a failure to imitate the actions of others. There are some children with ASD who appear to be developing at a normal rate, but around 18-24 months of age, they no longer are gaining new skills and start to lose the skills they already had. Studies have shown that approximately 80-90% of parents noticed symptoms of ASD by the time their child was two years old.
Symptoms of Children with ASD
The following is a list of common ASD symptoms. While some children who do not have ASD may also experience these symptoms, many are common to an autism diagnosis.
- Avoiding eye contact
- Becoming upset with small changes
- Delayed language
- Difficulty with play and connecting with others
- Social skills may be limited to parents
- Having obsessive interests
- Showing unusual reactions to the sound, smell, look, feel and taste of things
- Unusual eating habits
- Aggressive behavior
- Causing self-injury
- Lack of fear
- Temper tantrums
- Sleep disturbances
Unusual Interests and Behaviors in Children with ASD
Children with ASD typically have unusual interests or behaviors.
These may include:
- Becoming very upset by a minor change
- Being extremely organized
- Consistently playing with toys in the same way every time
- Flapping their hands, rocking their body or spinning in a circle
- Having obsessive interests
- Lining up toys or other objects
- Needing to follow certain routines
The Importance of ASD Routines
When a child has ASD, they usually are most successful when they have a consistent routine. If there is a change to their normal routine, it can cause them to become very upset and they may have a temper tantrum. Some children may have a certain routine that comes across as being unnecessary or unusual, but if the child is not able to follow this routine, it can cause them to feel frustrated and they may throw a temper tantrum.
Social skills are one of the most noticeable skill deficits that children with autism display. It is common for parents to detect this symptom first because as humans we are social by nature. When a child does not see social interactions as reinforcing, it is an indicator that they may have ASD. This doesn’t mean children with autism do not value their relationships; it means they do not understand them. The sooner a child with autism is taught the reinforcing qualities of social interaction, the better their long-term outcome will be.
Social Skills of Children with Autism
Children with autism will display their level of understanding social interaction in different ways. Commonly, young children with autism will avoid eye contact, fail to babble or point, not respond to language, have a preference of playing alone, and will not engage in pretend play. However, not all children with autism show a severe lack of social skills. These children with autism show a great interest in social relationships, but may not understand how to engage in them.
Honing Social Skills of Children with Autism
As children with autism get older, it is challenging to them to understand emotions or the perceptions of others. These social skills always have to be taught to enable the person with autism to fully understand their social world. With treatment, children with autism are able to learn how to express their own feelings and engage with others. Without treatment, people with autism often feel very isolated which can lead to anxiety or depression in their adolescent years.
Children with autism all have delays in their ability to communicate, but as with all symptoms, these delays vary. These symptoms can range in severity from the inability to produce language without specific ABA language programs to the late onset of speech without treatment from two to four years of age. If your child is not using language, or has limited language, it is incredibly important to get an autism screening as early as possible.
ABA Therapy and Communication
ABA therapy is the best treatment for communication deficits for children with autism because ABA therapists assess WHY language is not occurring, then create a tailored treatment plan to increase communication. Speech therapy is effective for understanding HOW language works and should be used in conjunction with ABA therapy. Until a family has worked intensively with an ABA team and speech therapy, they should not rule out their child’s ability to speak.
Ways People with ASD Communicate
ABA therapy focuses on:
- Exchanging pictures to request items
- Using speech devices
- Single words
- Multiple words
- Full sentences
ABA therapy will find the most effective way for their clients to communicate now, while also working to build up more complex language skills. A comprehensive ABA team will ensure that your child has programs focusing on occasional repeating speech, requesting items, labeling items, and back and forth speech.
Early Intervention Services
Research supports and many families are aware that early intervention services yield the best outcome for children with development delays. With the rise of autism, it is increasingly important to distinguish the type of early childhood intervention as it is not a one-size-fits-all service. Early intervention services include Occupational Therapy (OT), Physical Therapy (PT), Speech Therapy, Developmental Therapy and ABA Therapy.
Early intervention is defined by the age of the child when they receive the therapy, not the specific type of therapy the child receives. The type of early intervention a child needs is specific to their delay.
Early ABA Intervention Programs
To date, ABA therapy is the only evidence-based therapy and early intervention service for children with autism. While children with autism will benefit from various other early intervention services, it is crucial they also receive ABA therapy at least 20 hours per week.
Various early intervention programs offered through state-run organizations, while important, do not replace early intervention (birth to three years of age) ABA therapy for children with autism. If a child is showing signs of autism but has not been formally diagnosed, it is important to take them for a screening with their pediatrician. Once a diagnosis is given, funding paths for ABA are opened, although this does vary from state to state.