Autism is a common complex neurobiological disorder with a wide spectrum of presentations, a strong familial genetic pattern and an uncertain cause. Family history is very important as is making sure there are no hearing or vision problems.
Published statistics for the prevalence of autism continue to increase. The most recent statistics suggest prevalence to be between 1 in 68 and 1 in 40 for school-aged children. The cause of this increase in prevalence is uncertain. Likely, an increased awareness about autism and improved diagnostic capabilities has led to the prevalence increases. Autism is a major global concern that is not limited by geography, culture or ethnicity. It is found much more commonly in boys than girls (5 times more common in boys than girls) but it is felt many girls with autism are underdiagnosed due to relative sparing of social and communication skills. Children from socio-economic groups who have limited access to medical, educational and developmental services also have a lower prevalence.
Children and adults with autism have core deficits in communication, social skills and typical behaviors. The reactivity and regulation difficulty that accompany these deficits often lead to behavioral challenges for both the individual with autism and the family.
About one-third of children and adults who are diagnosed with autism also have an intellectual disability. Two-thirds have normal to above average intellectual skills and very high functioning capabilities are seen in many individuals with autism.
Three primary deficit areas include social reciprocity, language and repetitive patterns of behavior, activity or interests. Patterns of interest include unique or unusual fascinations, excessive attachment to objects, sensory aversions to sounds, food and clothing and repetitive motor activity such as hand flapping or running or spinning in circles.
Skills that suggest your child does not have autism include reciprocal smiling by 2 months, laughing and giggling by 5 months and name response by 12 months. Reassuring social skills include eye contact during early infancy, playing peek-a-boo by age 9 months and the ability to copy your gestures such as waving, clapping and pointing by 12 months and waving bye-bye by 15 months of age. For toddlers an interest in imitating you is also a sign of normal development. The ability to share focus and attention by pointing at objects prior to 18 months is another reassuring skill. Remember, all infants and children are different and it is best to not over compare developmental milestones in children. If you have doubts about your child’s development you should talk to your pediatrician.
Autism traits vary with age. For infants and toddlers irritability and a lack of social interaction interests are common. Delays in language, shared gaze and interest or pleasure are the most common complaints. Excessive, unusual, unique, peculiar or repetitive behaviors, activities and interests are also common. For the school-aged child, a delayed ability to connect with others and a rigid and inflexible behavior pattern is the most common historical complaint. Social issues include being overly bossy, a lack of interest in being with people or preferring isolation. Language delay and abnormal language patterns such as word or phrase repetition, repetitive questioning and unusual speech tonality are the most common language difficulties. For teens and adults difficulty with social relationships, shared social interests, communication, rigidity, a lack of social cue awareness and executive function disturbances are the most common signs.