Autism Spectrum Disorder (ASD)

Autism spectrum disorder (ASD) is a developmental condition that causes neurodiversity (differences in brain patterns). People with ASD may experience some difficulty with social interactions, communication skills, and behaviors. Everyone experiences autism a bit differently, so symptoms can vary from person to person.

Research estimates that about one in 36 children and over five million adults in the United States have ASD—though the cause of the condition is not fully known. Globally, estimates show that 1% of people around the world have autism, which is equivalent to more than 75 million people.

Autism Signs and Symptoms

Signs and symptoms of autism can vary significantly from person to person. While people with ASD may experience communication and social challenges, many people with autism also excel in certain areas.

Verbal Communication

Difficulty communicating is a common sign of autism. These symptoms may include:

• Delays in speech development 
• Not speaking
• Limited vocabulary
• Echolalia (repeating words or phrases) 
• Trouble understanding language nuances like sarcasm 
• Atypical speech volume or tone 

Social Interaction 

Difficulties with communication can often affect your social interactions. This can sometimes make it hard for people with ASD to maintain friendships, feel comfortable in social situations, and excel in academic or work environments. Traits of autism that may affect social skills include:

• Trouble initiating or maintaining conversations
• Difficulty understanding facial expressions and body language
• Making little or no eye contact 
• Not appearing to listen 
• Not responding to your name 
• Reduced empathy skills
• Preferring solitary activities over socializing

Repetitive Behavior and Stimming

Repetitive actions involve doing the same thing repeatedly, often without any significant variation. These behaviors might include repetitive questioning, rigid routines, echolalia, or arranging items in rows or patterns.

Stimming (self-stimulatory behavior) is a subtype of repetitive behavior that helps a person manage emotions or regulate sensory input, such as sights, sounds, smells, and more. Someone with autism may use the following stimming methods:

• Chewing on hair or clothing
• Fiddling or fidgeting with objects
• Flicking light switches
• Intensely focusing on things that move (e.g., fans or lights)
• Opening and closing doors
• Pacing or walking in circles
• Banging on items
• Pushing buttons 
• Blinking repeatedly 
• Making repeated hand movements (e.g., clapping or snapping)
• Picking skin
• Swaying or rocking 
• Twirling
• Walking on tiptoes

For more insight into repetitive behaviors, consider checking out screening tests such as the Adult Repetitive Behaviours Questionnaire-2 (RBQ-2A) or the Repetitive Behavior Scale for Early Childhood (RBS-EC. 

Special Interests 

Intense interests can provide comfort and a sense of control in an otherwise unpredictable world. While these interests can be beneficial for people with ASD in specific contexts, they may limit social interactions and flexibility in daily routines. Some people with ASD may develop heightened interests in the following:

• Specific subjects like dinosaurs, space exploration, or trains
• Statistics or numbers
• Video games or computer technology
• Cartoons or animated characters
• Musical instruments or bands
• Historical events or time periods

Discomfort With Change

People with ASD may often experience discomfort with change. This may include difficulty transitioning between activities, new environments, unfamiliar people, or unexpected visits. They may also feel stressed when there is a change in their favorite TV show’s schedule, travel routes, foods, plans, or living arrangements.  

Sensory Sensitivities

ASD can increase sensitivity to the five senses—sights, sounds, smells, textures, or tastes, leading to irritability, sleep disturbances, pain, and emotional outbursts. This creates a feeling of overstimulation, which is when someone is overwhelmed by the information they're receiving from their senses.

For instance, a person with ASD may feel distress in a noisy environment, like a mall or airport. This heightened sensitivity may cause them to exhibit other ASD behaviors, such as stemming to help reduce the overstimulation they're experiencing.

Strengths

People with ASD are neurodiverse, meaning their brains work just a little bit differently. While ASD can cause some behavioral symptoms, people with this condition also have many important strengths. These include:

• Attention to detail
• A solid ability to focus on tasks
• Remarkable memory
• Intense creativity
• A talent for problem-solving.

These strengths can be valuable assets in academic, professional, and creative pursuits

What Causes Autism?

Scientists are not exactly sure what causes autism, but it seems to come from a mix of genetic and environmental factors.

Genes instruct how your body grows, and gene mutations (changes) can make you more likely to have certain health conditions. Environmental factors like toxins (lead, mercury, pesticides) or maternal infections (rubella, bacterial vaginosis, cytomegalovirus (CMV)) during pregnancy might also play a part. Together, these factors can disrupt brain structure, function, and neural (nerve) circuits, leading to ASD traits.

More research is still needed to understand the exact cause(s) of autism.

Risk Factors

Some people may have a higher risk of developing ASD. Consider the following factors:

• Having a family member with ASD
• Living with certain chromosomal conditions (like Down’s syndrome) 
• Being born prematurely or with a low birth weight
• Having older parents at birth
• Experiencing birth complications that decrease oxygenation

Diagnosis 

Routine screening tests, like the Modified Checklist for Autism in Toddlers (M-CHAT), help providers spot potential ASD traits, prompting further testing. However, screenings do not provide a diagnosis. A diagnosis requires an evaluation by a multidisciplinary team of pediatric healthcare providers, therapists, and autism specialists. 

Experts use screening tools, behavioral checklists, interviews, and observations for evaluation. During the assessment, which occurs over multiple sessions, the healthcare team notes if symptoms match the autism diagnostic criteria set by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). The diagnostic criteria include: 

• Difficulties with social interaction and communication
• Repetitive behaviors 
• Restricted interests or activities
• Symptoms that impair everyday functioning

Some children receive a diagnosis as early as the age of two, but most are five and older at the time of diagnosis. Some children do not exhibit traits until they experience academic or social pressure, causing a delay in diagnosis. The Autism Spectrum Screening Questionnaire (ASSQ) is an example of a screening tool for school-age children and teens.

If you have ASD symptoms as an adult but do not have a diagnosis, consider using the following screenings and consult a healthcare provider if these tests signal that you may have some ASD traits.

• Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R)
• Autism Spectrum Quotient (AQ) 
• Campoflaging Autistic Traits Questionnaire (CAT-Q)

Treatment

While there's currently no cure for ASD, early interventions help maximize developmental potential and address challenges you may be experiencing. Treatment options include various therapies, educational support, and medications. Your exact treatment plan may involve: 

• Behavioral therapy: Includes applied behavior analysis (ABA) or cognitive-behavioral therapy (CBT), which teaches new skills and helps manage behaviors by breaking them down into smaller steps and providing positive reinforcement
• Speech and language therapy: Helps improve communication skills and language understanding
• Occupational therapy: Enhances independence and helps you learn how to complete tasks by yourself
• Sensory therapy: Uses activities like playing with textures (e.g., sand or water beads) to help overcome sensory sensitivities
• Individualized education plan (IEP): Provides resources, tools, or technology (e.g., tablets, assistive devices, social skills apps, speech-generating devices, etc.) to ensure students have everything they need to do well in school and work and feel included
• Medications: Can help manage conditions that often co-occur with autism—such as depression or attention-deficit/hyperactivity disorder (ADHD)—which may include Prozac (fluoxetine) or Adderall (amphetamine/dextroamphetamine)

How To Prevent Autism

There's no proven way to prevent ASD. However, pregnant people can help reduce risk by attending prenatal appointments and avoiding things that could affect their baby's development. Your healthcare provider may also suggest correcting iodine or thyroid deficiencies (if applicable) and taking supplements like folic acid, omega-3 fatty acids, and vitamin D3.

Related Conditions 

Research has shown that people with ASD are more likely to experience the following conditions:

• Anxiety disorders
• Depression
  
• ADHD
  
• Constipation or diarrhea
• Epilepsy
• Acid reflux
• Sleep disturbances
• Hearing problems
• Learn disabilities

Living With Autism

Although ASD persists throughout life, therapies and adjustments can improve your quality of life significantly. These might involve speech-generating devices, visual aids, or social skills apps to help you better communicate and interact with others.

Noise-canceling headphones, weighted blankets, or designated sensory breaks can help you manage sensory overload. Music therapy and animal-assisted therapy are other unique avenues for expression and comfort.

ASD can be difficult to live with. However, it's important to advocate for your care and get the treatment you need. With proper interventions, you can make your quality of life more comfortable and suitable for your needs.