Autism Spectrum Disorder

Autism spectrum disorder (ASD), commonly called autism, is a developmental disorder that affects a person’s communication and behavior. Symptoms tend to appear during the first two years of life, but ASD can be diagnosed at any age. Most people with ASD have difficulty communicating effectively and interacting with others. They may also engage in repetitive behaviors and have other symptoms that make it difficult for them to function well in school, at work, or in life in general. 

Autism is considered a spectrum disorder because there are varying degrees of symptoms. Some people with ASD can function almost normally, while others have difficulty engaging in every day situations at all. There is no cure for ASD, but treatment, including social services, can improve symptoms and the ability to function. 

Autism spectrum disorder statistics

In the United States, as of 2014, one out of every 59 children were diagnosed with ASD before age eight. That’s 1 in 37 boys and 1 in 151 girls. This is a 15 percent increase over 2012. Interestingly, the diagnosis rates vary significantly across the country. In areas where ASD researchers had good access to education records, they found an incidence of up to 1 in 34 children with ASD, while in other areas, the incidence was as low as 1 in 77. This means there’s a good chance doctors are missing ASD diagnoses in some children. 

In 2014, boys were four more times likely to be diagnosed with ASD than girls. That was down from 4.5 times more likely in 2012, indicating that autism spectrum disorder diagnosis in girls is occurring more frequently. 

White children are more likely to be diagnosed with ASD than children in minority groups, but the gap is narrowing. 

Most children are being diagnosed after the age of 4 despite the fact that ASD can usually be diagnosed by age 2. 

Thirty-one percent of children with ASD also have an intellectual disability.

Changes to the diagnosis of ASD

Autism spectrum disorder is a new DSM diagnosis that includes three sub-types of autism. Autistic disorder, Asperger’s syndrome, and pervasive developmental disorder not otherwise specified (PDD-NOS) are now included in a single diagnosis – autism spectrum disorder. While the official diagnosis has changed, many people, including some doctors, still use the terms Asperger’s syndrome, autism, and pervasive developmental disorder.

Signs and symptoms of autism

The severity of symptoms of ASD vary greatly, but there are some common signs and symptoms. 

  • Difficulty making eye contact, listening to others, and responding to being called or talked to 
  • Struggling with two-way conversation, talking excessively about a topic, or an unusual tone of voice
  • Facial expressions and movements that don’t seem to correspond with what’s happening around them or being said
  • Difficulty understanding points of view other than their own or predicting people’s behaviors
  • Repeating words or phrases or unusual behaviors
  • Having an intense interest in numbers, facts, or details
  • Being fascinated by objects
  • Difficulty adjusting to even slight changes in routine
  • Being overly sensitive to sensory stimulation, like light, sound, texture, taste, or temperature (some people may also be less sensitive than normal)
  • Having sleep problems
  • Being irritable

People with ASD often have great strengths as well. For example, they may excel at learning, especially when they have high interest, and they may be able to remember minute details and information quickly and for long periods of time. They may be outstanding musicians, mathematicians, scientists, and artists, calling upon their ability to remember facts and see things from different perspectives. 

Diagnosing autism

Doctors diagnose autism spectrum disorder in children by talking with parents about their child’s behavior and development. In most cases, specialized pediatricians can diagnose ASD by the time a child is two years old. And the sooner they diagnose it, the sooner treatment can begin.

The process of diagnosing ASD varies depending on the age of the child. The process for diagnosing young children happens in two stages – general developmental screening followed by further evaluations.

General developmental screening for ASD in young children

From infancy through the early toddler years, pediatricians conduct developmental screening during well-child visits to evaluate children for disorders like ASD. These screenings should occur at every child’s 9-, 18-, 24-, and 30-month check-ups. Autism-specific screenings should happen at both the 18- and 24-month visits. If your child is at greater risk for developing ASD, your pediatrician may want to perform additional screenings. 

If your child shows any early signs of autism during those visits, your child’s doctor will likely recommend further evaluation. 

Additional evaluation for ASD

The second stage of autism spectrum disorder evaluation involves a team of healthcare professionals who are experts at diagnosing and treating ASD. That team may include a developmental pediatrician, a child psychologist or psychiatrist, a neuropsychologist, and a speech-language pathologist. 

During the evaluation, the doctors will look at things like your child’s cognitive ability and thinking skills, language ability, and skills necessary to complete daily activities, like eating, getting dressed, and using the bathroom unassisted. This evaluation may also include blood tests and hearing tests to find out whether there are other potential causes for symptoms or developmental delays.

If the doctors believe your child has ASD, they will provide an official diagnosis and treatment recommendations.

Diagnosing ASD in older children

If an ASD diagnosis is missed during early childhood, symptoms may not be noticed until the school years. At that time, a school’s special education team may offer an evaluation for ASD and may recommend that a child be further evaluated by a pediatrician who specializes in diagnosing and treating ASD. 

Treating ASD

It’s important to begin treatment for ASD as early as possible. The younger a child is at diagnosis, the more effective treatment can be.

There is no one-size-fits-all ASD treatment. Your child’s treatment plan will be individualized to meet his or her needs. Treatment may include medication, therapy, and other support services.

Medication for ASD

When medication is used to treat ASD, it’s frequently prescribed to manage symptoms associated with the disorder, such as:

  • Irritability
  • Aggression
  • Attention problems
  • Hyperactivity
  • Repetitive behaviors
  • Anxiety 
  • Depression

Therapy for ASD

Therapy for ASD may be psychological, behavioral, or educational. Therapy programs tend to be highly structured, and they often involve family members, like parents, brothers, or sisters. Therapy can help with the skills needed to cope in everyday situations and may:

  • Teach life skills and independent living skills
  • Use behavior modification to reduce challenging behaviors
  • Help build upon existing strengths
  • Teach communication, language, and social skills

The Center for Human Development

The Center for Human Development (CHD) at Beaumont Children's is committed to using a multidisciplinary, evidence-based approach to diagnose and treat children and adolescents who experience developmental, behavioral, and learning challenges. Call either our Southfield location at 248-691-4744, or our Grosse Pointe location at 313-473-4730 to request an appointment. 

For more information on autism services at Beaumont, contact the Center for Exceptional Families in Dearborn at 313-996-1960 or the Ted Lindsay Foundation HOPE Center in Southfield at 248-691-4744.