These three symptoms are usually present in children who have an ASD:

1. The ability to relate socially to other people does not develop normally. The child tends to avoid eye contact, ignore or resist cuddling and other physical contact, have little understanding of other people's feelings, and prefer to be in his or her "own little world". The child will be slow to initiate play with others and may not do so at all. The child may shy away when others try to initiate play with him or her.
   
   
2. Communication is typically slow to develop, and will have unusual qualities, such as repeatedly using particular words or phrases that have a meaning unique to the child, speaking in odd tones of voice, and talking at inappropriate times about things not related to the situation. The child may have his or her “own language” that sounds like gibberish. These children will also typically be slow to develop nonverbal forms of communication such as pointing or using gestures. An older child may struggle to understand abstract ideas (such as "wisdom"), or abstract emotions (such as "empathy"). Approximately 40% of children with autism do not speak at all. Some children with ASDs, particularly children with Asperger Syndrome, will have very large and advanced vocabularies; such children typically still have problems carrying on conversations with others.
   
   
3. Play interests and imagination are often very limited; the child’s behavior is inappropriate, repetitive and/or inflexible. "Play" may consist of lining things up, spinning or mouthing objects, fluttering fingers or hands, walking on tip-toe, twirling or jumping, etc. These children may also have strong reactions to any changes in their routines.

> Top of Page

There are other behaviors common to children who have ASDs:

Many but not all children who have ASDs have a hard time changing from one activity to another. The overall quality of their behavior is unusual and inappropriate for their mental or calendar age. Children who have ASDs have great difficulty understanding the world. They are often not able to process and integrate sensory information normally. They may ignore or be too sensitive to certain sounds or other sensations. They may pull away from being touched or even looked at by others. They may not understand what their own body tells them. Shadows may seem alive to these children, and words may have no meaning. They appear to withdraw into their own private world. Unfortunately, this withdrawal makes it more difficult for these children to learn normal social and communication skills from others.

The signs of an ASD may be most obvious in three to four year old children, but some autistic behaviors may show up even in infants. Some children who have an ASD begin to talk and play normally, but at some time between their first and third birthdays stop talking and seem to gradually withdraw into their own private world. Children with milder ASDs, such as Asperger Syndrome, may not be diagnosed until later in childhood.

> Top of Page

How common are ASDs?

No one is certain how common ASDs are. Recent estimates suggest that as many as 40 to 60 of every 10,000 children may have an autism spectrum disorder (Fombonne E. The Prevalence of Autism; JAMA 2003; 289(1): 87-89). Four out of five children who have ASDs are male, and there seems to be a genetic tendency toward these disorders in some families. Utah and other states are currently doing studies to more accurately find out how many children have ASDs. These studies are coordinated by the Centers for Disease Control and Prevention.

Older studies suggested that approximately one-third of children with ASDs are moderately to severely mentally retarded (IQ below 40): another third are mild to moderately mentally retarded (IQ between 40 and 70); and the other one-third have average or above average intelligence. Newer estimates suggest that approximately 50% of children with ASDs may be of average or above average intelligence. Children with the best long-term prognosis for independent living are those who are of average or above average intelligence.

> Top of Page

What causes ASDs?

In most children who have an ASD, the exact cause of their condition is unknown. It is strongly suspected that genetics play an important role in the development of ASDs. We know that if one child in a family has an ASD, it is more likely that another child in the same family will have an ASD than in families where no child has an ASD. The causes of most autistic behavior are biological, not social or emotional. Certain genetic disorders such as Fragile X syndrome and neurological conditions such as Landau-Kleffner Syndrome can be responsible, as can certain infectious diseases that affect the unborn child (rubella) or the newborn (herpes). Some conditions may also cause a child who does not have an ASD to show some behaviors seen in children with ASDs. For example, children with hearing problems may not respond consistently to their names. Children with vision problems may rock or sway their heads. If these physical problems are undetected, the child’s actions might be misinterpreted as behaviors that might suggest the child has an ASD. As another example, children who have been subjected to extreme abuse or neglect may avoid eye contact and withdraw from or seem fearful of people. These behaviors might also be misinterpreted as showing that the child might have an ASD if there is not a full understanding of the child’s history of abuse or neglect.

> Top of Page

What do I need to do if I think my child might have an ASD?

Parents who are concerned about their child’s development should have their child examined by a qualified professional. The child will need careful medical and psychological or developmental evaluation. The child’s vision and hearing should be checked and the child may need a neurological examination. Information provided by parents is very important, and parents need to be included in all aspects of the child's evaluation. It is especially important to know if the child's behaviors ever dramatically changed (particularly if the child lost social skills or stopped talking), whether or not the child attempts to communicate and relate to other people, and how the child reacts to various situations.

> Top of Page

What can I do to help my child who has an ASD?

By teaching children who have ASDs more appropriate ways to process incoming sensory information and cope with their environments, parents, teachers, and therapists can help children gain necessary developmental skills. Here are some specific activities you might want to try:

1. Engagement: Join the child's "play" as a way of making contact. Learn how to enter the child's world in ways that allow you to interact with him without being interfering or intrusive. Be gentle; be persistent. Follow the child's lead, but use your ingenuity to prolong the contact and give more meaning to it. Each meaningful contact (even if the child becomes angry with you) is an opportunity for interaction that can be built upon and expanded.



2. Communication: Meaningful, repeated contact with the child leads to anticipation of what will happen when one of you does or says a particular thing. You begin to understand each other. When a signal is sent, received, and answered, a ‘circle of communication’ has been completed. (Signals can be facial expressions, gestures, and body language as well as spoken words.) With each completed circle, the communication pathway becomes stronger. It becomes a way to teach the child how to better communicate with others. Therapeutic interventions that use nonverbal forms of communication (e.g., sign language or a picture exchange communication system – PECS) can be beneficial in helping the child learn to communicate with others. The use of these communication systems may help the child develop stronger verbal skills and, most importantly, will not interfere with the child’s learning to speak.



3. Structure and flexibility: All children need consistency in their lives; many children who have ASDs absolutely depend upon it. But successful living also requires changing and adapting to new situations. This is very difficult for children with ASDs. They need a great deal of support and practice in dealing with new behavior expectations; they will then begin to know what they are expected to do and what will happen as a result. At the same time, children with ASDs need to experience just enough change to keep them challenged and learning, but not overwhelmed or discouraged. A structured behavior modification approach tends to be most useful; however, some children with ASDs may respond better to a more flexible approach. Some children do best with a program combining both methods. Every child needs a treatment program designed just for him or her.



4. Multiple treatment services: Children with ASDs will benefit from the help of many people. Parents and siblings can serve as informal ‘therapists’; other people who can help include physical and/or occupational therapists (to help with motor skills and sensory integration difficulties), speech therapists (to encourage communication and speech development), teachers with specialized training in autism and related disorders, child development specialists (who can help families and treatment teams to focus on the "whole" child at his developmental level), psychologists and psychiatrists (to help with emotional and behavior concerns), and pediatricians. Counselors can be very helpful to parents and other family members. All team members must share information and understand one another's goals, so that everyone works together.



5. On-going professional support and guidance for parents and other caregivers: Children with ASDs may be very difficult to live with; their behavior can disrupt families and cause parents to doubt their own abilities. Parents are essential participants in the child's treatment, but they cannot be expected to "go it alone". Parents may benefit from meeting with a counselor who knows their child to talk over their concerns, to learn how to apply teaching methods and goals into their life at home, and to help them "read" the child's signals and use them to expand the child's learning experiences.

> Top of Page

Where can families go for help?

Here are a few places to get you started. You may also wish to go to Where Can I Get Help? for more resources.

Your doctor or public health nurse can put you in touch with programs that provide assessment and treatment (or referrals for treatment). By federal law, every state must provide early intervention services for eligible children from birth through two years, special education preschool services for children from three to five years, and special education services for school age children. In Utah, the Utah Department of Health’s Division of Community & Family Health Services has the Children with Special Health Care Needs program (801-584-8284 or 1-800-829-8200) and the Baby Watch/Early Intervention program (1-800-961-4226). Both programs serve children and their main offices are located at 44 Medical Drive, Salt Lake City, Utah 84114. Call your local school district or the Utah State Office of Education (801-538-7500) for information about special education services.

Valley Mental Health serves Salt Lake, Tooele and Summit Counties and operates the Carmen B. Pingree School for Children with Autism. This school serves children with autism who live in the Salt Lake area. Community Mental Health Centers throughout the state also offer services for children with autism. To find the Community Mental Health Center serving your area, contact the Utah Department of Human Services’ Division of Mental Health (801-538-4270).

The University of Utah Child & Adolescent Specialty Clinics offer comprehensive evaluations, assessments, and treatment services for children and adolescents with ASDs (801-585-1212).

For support, you may want to contact the Utah Parent Center (801-272-1051 or 1-800-468-1160). This is a statewide organization that works to provide training, information, referral and assistance to parents of children and youth with disabilities.

Because recent research has changed our understanding of ASDs and how to identify and treat them, many older books and pamphlets on these subjects may be outdated and misleading. When you consult your local library or bookstore, be sure that the materials you read contain up to date information. The book list from the Autism Society of Utah (PDF File) includes many recommended references.

Many libraries subscribe to The Exceptional Parent magazine, an excellent resources for parents of children with all disabilities, including ASDs. To get a subscription of your own contact The Exceptional Parent at 65 East Route 4, River Edge, NJ 07661 or by telephone (201-489-4111). The magazine publishes a yearly listing of all national organizations involved with disabilities, and an annual directory of resources for communication aids and other useful equipment.

Many of the disorders associated with ASDs and/or autistic-like behaviors are represented by their own national and/or local organizations. The National Organization for Rare Disorders (NORD) can give you information about these disorders and the support groups associated with them (203-744-0100 or 1-800-999-6673). This information is also available in Utah through the University of Utah Medical Genetics program, 50 North Medical Drive, Salt Lake City, Utah 84112 (801-581-8943).

> Top of Page

Page last updated