Autism Spectrum Disorder: A Helpful Guide Understanding the Basics
Autism spectrum disorder (ASD) is a neurological and developmental disorder that affects how people interact with others, communicate, learn, and behave. Although autism can be diagnosed at any age, it is described as a “developmental disorder” because symptoms generally appear in the first two years of life.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a guide created by the American Psychiatric Association that health care providers use to diagnose mental disorders, people with ASD often have:
Difficulty with communication and interaction with other people
Restricted interests and repetitive behaviors
Symptoms that affect their ability to function in school, work, and other areas of life
Autism is known as a “spectrum” disorder because there is wide variation in the type and severity of symptoms people experience.
People of all genders, races, ethnicities, and economic backgrounds can be diagnosed with ASD. Although ASD can be a lifelong disorder, treatments and services can improve a person’s symptoms and daily functioning. The American Academy of Pediatrics recommends that all children receive screening for autism. Caregivers should talk to their child’s health care provider about ASD screening or evaluation.
What are the signs and symptoms of ASD?
The list below gives some examples of common types of behaviors in people diagnosed with ASD. Not all people with ASD will have all behaviors, but most will have several of the behaviors listed below.
Social communication and social interaction behaviors may include:
Making little or inconsistent eye contact
Appearing not to look at or listen to people who are talking
Infrequently sharing interest, emotion, or enjoyment of objects or activities (including infrequently pointing at or showing things to others)
Not responding or being slow to respond to one’s name or to other verbal bids for attention
Having difficulties with the back and forth of conversation
Often talking at length about a favorite subject without noticing that others are not interested or without giving others a chance to respond
Displaying facial expressions, movements, and gestures that do not match what is being said
Having an unusual tone of voice that may sound sing-song or flat and robot-like
Having trouble understanding another person’s point of view or being unable to predict or understand other people’s actions
Difficulties adjusting behavior to different social situations
Difficulties sharing in imaginative play or in making friends
The Many Strengths of ASD
Attention to Detail: They can excel in tasks that require a high level of attention to detail and precision.
In-Depth Knowledge: Many individuals with autism have a deep knowledge of specific topics of interest.
Honesty and Integrity: They tend to be straightforward and honest in their communication.
Dedication: When they're passionate about something, they often exhibit strong dedication and perseverance.
Pattern Recognition: Some show exceptional abilities in recognizing patterns or solving complex puzzles.
Creativity: Many individuals with autism have a unique and creative perspective on the world.
Loyalty: They can be highly loyal and dependable in relationships and friendships.
Empathy: While it might be expressed differently, some individuals with autism can exhibit empathy and a genuine care for others.
Tech-Savviness: Some have a natural affinity for technology and excel in related fields.
Routine and Structure: They thrive in structured environments and can help establish routines.
Restrictive/repetitive behaviors may include:
Repeating certain behaviors or having unusual behaviors, such as repeating words or phrases (a behavior called echolalia)
Having a lasting intense interest in specific topics, such as numbers, details, or facts
Showing overly focused interests, such as with moving objects or with parts of objects
Becoming upset by slight changes in a routine and having difficulty with transitions
Being more sensitive or less sensitive than other people to sensory input, such as light, sound, clothing, or temperature
People with ASD also may experience sleep problems and irritability.
What are the causes and risk factors for ASD?
Researchers don’t know the primary causes of ASD, but studies suggest that a person’s genes can act together with aspects of their environment to affect development in ways that lead to ASD. Some factors that are associated with an increased likelihood of developing ASD include:
Having a sibling with ASD
Having older parents
Having certain genetic conditions (such as Down syndrome or Fragile X syndrome)
Having a very low birth weight
Not everyone who has these risk factors develops ASD.
Erie Psychiatry Offers ASD Diagnostics, Treatment and Support
Erie Psychiatry offers Autism Spectrum Disorder Evaluations, diagnostic assessments, treatment and medication management options. We can also provide referrals for Neuropsychological Evaluations once you’re an established patient, if interested. Please fill out the New Patient Inquiry Form on our website to get started!
How is ASD diagnosed?
Nurse Practitioners, Physician Assistants and Psychiatrists with specialized skill sets, experience and education can diagnose ASD by evaluating a person’s behavior and development and how this impacts their ability to function in our essential areas of life- social, work/school, and personal. ASD can usually be reliably diagnosed by the age of 2, but every individual is different in how their symptoms present and on what timeline. However, we believe it’s important to seek an evaluation as soon as possible given the advantages treatment provides. The earlier ASD is diagnosed, the sooner treatments and services can begin.
Diagnosis in Young Children
Diagnosis in young children is often a two-stage process.
Stage 1: General Developmental Screening During Well-Child Checkups
Every child should receive well-child checkups with a pediatrician or an early childhood health care provider. The American Academy of Pediatrics recommends that all children receive screening for developmental delays at their 9-, 18-, and 24- or 30-month well-child visits, with specific autism screenings at the 18- and 24-month well-child visits. A child may receive additional screenings if they are at high risk for ASD or developmental problems.
Considering caregivers’ experiences and concerns is an important part of the screening process for young children. The health care provider may ask questions about the child’s behaviors and evaluate those answers in combination with information from ASD screening tools and clinical observations of the child. To learn more about ASD screening tools, visit the Centers for Disease Control and Prevention (CDC) website.
If a child shows developmental differences in behavior or functioning during this screening process, the health care provider may refer the child for additional evaluation.
Stage 2: Additional Diagnostic Evaluation
It is important to accurately detect and diagnose children with ASD as early as possible, as this will shed light on their unique strengths and challenges. Early detection also can help caregivers determine which services, educational programs, and behavioral therapies are most likely to be helpful for their child.
A team of health care providers who have experience diagnosing ASD will conduct the diagnostic evaluation. This team may include child neurologists, developmental behavioral pediatricians, speech-language pathologists, child psychologists and psychiatric nurse practitioners, psychiatrists, educational specialists, and occupational therapists.
The diagnostic evaluation is likely to include:
Medical and neurological examinations
Assessment of the child’s cognitive abilities
Assessment of the child’s speech and language abilities
Observation of the child’s behavior
An in-depth conversation with the child’s caregivers about the child’s behavior and development
Assessment of age-appropriate skills needed to complete daily activities independently, such as eating, dressing, and toileting
Questions about the child’s family history
Because ASD is a complex disorder that sometimes occurs with other illnesses or learning disorders, the comprehensive evaluation may include blood tests and a hearing test.
The outcome of this evaluation may result in a formal diagnosis and recommendations for treatment.
Diagnosis in Older Children and Adolescents
Caregivers and teachers are often the first to recognize ASD symptoms in older children and adolescents who attend school. The school’s special education team may perform an initial evaluation and then recommend that a child undergo additional evaluation with their primary health care provider or a health care provider who specializes in ASD.
A child’s caregivers may talk with these health care providers about the child’s social difficulties, including problems with subtle communication. These subtle communication differences may include problems understanding tone of voice, facial expressions, or body language. Older children and adolescents may have trouble understanding figures of speech, humor, or sarcasm. They also may have trouble forming friendships with peers.
Diagnosis in Adults
Diagnosing ASD in adults is often more difficult than diagnosing ASD in children. In adults, some ASD symptoms can overlap with symptoms of other mental health disorders, such as an anxiety disorder or attention-deficit/hyperactivity disorder (ADHD).
Adults who notice signs and symptoms of ASD should talk with a health care provider and ask for a referral for an ASD evaluation. Although evaluation for ASD in adults is still being refined, adults can be referred to a neuropsychologist, psychologist, psychiatric nurse practitioner or psychiatrist who has experience with ASD.
The expert will ask about:
Social interaction and communication challenges
Sensory issues
Repetitive behaviors
Restricted interests
The evaluation also may include a conversation with caregivers and other family members to learn about the person’s early developmental history, which can help ensure an accurate diagnosis.
Obtaining a correct diagnosis of ASD as an adult can help people understand past challenges, identify personal strengths, and find the right kind of help. Studies are underway to determine the types of services and supports that are most helpful for improving the functioning and community integration of autistic transition-age youth and adults.
What treatment options are available for ASD?
Treatment for ASD should begin as soon as possible after diagnosis. Early treatment for ASD is important because proper care and services can reduce individuals’ difficulties while helping them learn new skills and build on their strengths.
People with ASD may face a wide range of issues, which means there is no single best treatment for ASD. Working closely with a health care provider is an important part of finding the right combination of treatments and services.
Medication
Your Nurse Practitioner or Psychiatrist may prescribe medication to treat specific symptoms. With medication, a person with ASD may have fewer problems with:
Irritability
Aggression
Repetitive behavior
Hyperactivity
Attention
Anxiety and depression
Read more about the latest medication warnings, patient medication guides, and information on newly approved medications on the U.S. Food and Drug Administration (FDA) website.
Behavioral, Psychological, and Educational Interventions
People with ASD may be referred to health care providers who specialize in providing behavioral, psychological, educational, or skill-building interventions. These programs are typically highly structured and intensive, and they may involve caregivers, siblings, and other family members. These programs may help people with ASD:
Learn social, communication, and language skills
Reduce behaviors that interfere with daily functioning
Increase or build on strengths
Learn life skills for living independently
Other Resources
Many services, programs, and other resources are available to help people with ASD. Here are some tips for finding these additional resources:
Contact us at Erie Psychiatry, we’ll help answer your questions about diagnoses, treatment options, medication, therapy, and resources for support. Send us an email at hello@eriepsychiatry.com or give us a call at 720-722-1584 to learn more.
Contact an autism advocacy group to learn about special programs or local resources with Weld and Boulder County.
Find an autism support group. Sharing information and experiences can help people with ASD and their caregivers learn about treatment options and ASD-related programs.
Keep copies of medical records, psychiatric records, academic evaluations, IEP and 504 plans, report cards, feedback from teachers, coaches and other important people within your life or your child’s life. This information may help people with ASD qualify for special programs.
If you’re interested in learning more about how Autism Spectrum Disorder (ASD) is diagnosed and treated by our team, please contact complete a New Patient Appointment Request on our website, to learn more.
Sources:
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES; National Institutes of Health NIH Publication No. 22-MH-8084]; National Institute of Mental Health (2021)
