About Autism

Autism Spectrum Disorder (ASD) is a neurobiological disorder that typically affects development within the first three years of life and is characterized by a triad of symptoms:

1. impaired social interaction,

2. impaired verbal and non-verbal communication, and

3. stereotyped and restricted behaviors, play, and/or interests (DSM-IV-TR, American Psychiatric Association, 2000; ICD-10, 1993).

For complete DSM-IV Criteria for Autistic Disorder, go to the Centers for Disease Control (CDC) website: CDC – Autism Sprectrum Disorders

In addition to the behavioral issues, which have been the primary means for diagnosing an ASD, more recent research has identified a higher incidence of medical, genetic, metabolic, immunologic, and neurologic problems in persons with ASD (Herbert, 2005). Consequently, ASD is no longer viewed as a strictly behavioral disorder, but a complex, neurobiological condition affecting multiple areas of a person’s overall functioning and learning capacity.

Autism versus ASD:

Autism Spectrum Disorder (ASD) is an “umbrella” term, which captures the broader range of functioning and presentation found in individuals with an ASD. Autism Spectrum Disorders include three diagnoses; Pervasive Developmental Disorder (PDD), Asperger’s Syndrome, and classic Autism. Individuals with classic Autism meet specific quantitative and qualitative criteria for the disorder to a greater extent than those with PDD (i.e., they have more of the autism features overall and these are present in greater frequency and intensity). Consequently, individuals with classic Autism will fall at the lowest functioning range of the spectrum. Individuals with PDD present with more criteria (and consequently, tend to be lower functioning) than those with Asperger’s.

Signs of Autism: Symptoms are characterized by a combination of symptoms in the following areas:

  • Impaired Communication Ability: may not: speak (or speak in non-functional way), use gestures (pointing, waving, etc.), babble, coo, or gesture by 12 months, use single words by 16 months, use two word phrases by 24 months, use normal rhythm, volume, or pitch in speech
  • Repetitive and/or Restricted Behaviors: stereotypical and intense focus on certain behaviors such as hand flapping, spinning, rocking, toe walking, or other repetitive (non-purposeful) movements with body, limited fine motor skills, overly focused on objects or parts of objects, may regularly line up toys or objects
  • Impaired Social Skills: may not: respond to name (appear deaf), search for hidden objects, share interests with others, have warm expressions, interact with other children or family (appears aloof), desire to be with others (prefers to be alone), make eye contact
  • Other Noted Symptoms: over or under sensory reaction (may bothered by light, smells, sounds, texture, or touch); may seem insensitive to pain, sleeping difficulties, behavior issues such as extreme tantrums (meltdowns), very routine-focused and may have emotional difficulty with change

If your child has any of the symptoms or combination of symptoms above, talk to your physician about your concern as soon as possible. Contact your local Early On® agency for possible eligibility for low or no-cost support services for your child and your family (which is based on your child or family meeting a need and is not based on income). You can also complete the survey: The Modified Checklist for Autism in Toddlers (M-CHAT); (Robins, Fein, & Barton, 1999). It is available for free download. You can complete it and take it to your physician for further review of your concerns. The MCHAT is a very brief, 23-question survey that can flag autism, or a developmental delay, and can be downloaded from the M-CHAT Information website. Your physician can evaluate the results and determine the best course of action. If you continue to have concerns, obtain a second opinion or contact Early On at 1-800-Earlyon.

Important! Research shows that symptoms of autism can be greatly reduced through early, intensive behavioral intervention. The sooner intervention starts, the more positive outcomes the child will likely experience in the home, community, and school.

Key Developmental Milestones

According to the American Academy of Pediatrics (AAP), there are key developmental milestones which children reach by certain ages. Access the AAP’s HealthyChildren.org site for all milestones by age (search on Developmental Milestones).

Although every child reaches milestones with some variation in age, the following are some key developmental milestones listed on the AAP’s HealthyChildren website as vital milestones that a child should reach by 12 Months:

Movement Milestones

  • Gets to sitting position without assistance
  • Crawls forward on belly by pulling with arms and pushing with legs
  • Assumes hands-and-knees position
  • Creeps on hands and knees supporting trunk on hands and knees
  • Gets from sitting to crawling or prone (lying on stomach) position
  • Pulls self-up to stand
  • Walks holding on to furniture
  • Stands momentarily without support
  • May walk two or three steps without support

Milestones in Hand and Finger Skills

  • Uses pincer grasp
  • Bangs two cubes together
  • Puts objects into container
  • Takes objects out of container
  • Lets objects go voluntarily
  • Pokes with index finger
  • Tries to imitate scribbling

Language Milestones

  • Pays increasing attention to speech
  • Responds to simple verbal requests
  • Responds to “no”
  • Uses simple gestures, such as shaking head for “no”
  • Babbles with inflection
  • Says “dada” and “mama”
  • Uses exclamations, such as “oh-oh!”
  • Tries to imitate words

Cognitive Milestones

  • Explores objects in many different ways (shaking, banging, throwing, dropping)
  • Finds hidden objects easily
  • Looks at correct picture when the image is named
  • Imitates gestures
  • Begins to use objects correctly (drinking from cup, brushing hair, dialing phone, listening to receiver)

Social and Emotional Milestones

  • Shy or anxious with strangers
  • Cries when mother or father leaves
  • Enjoys imitating people in play
  • Shows specific preferences for certain people and toys
  • Tests parental responses to his actions during feedings (What do you do when he refuses a food?)
  • Tests parental responses to his behavior (What do you do if he cries after you leave the room?)
  • May be fearful in some situations
  • Prefers mother and/or regular caregiver over all others
  • Repeats sounds or gestures for attention
  • Finger-feeds himself
  • Extends arm or leg to help when being dressed

Developmental Health Watch

Each baby develops in his own manner, so it’s impossible to tell exactly when your child will perfect a given skill. Although the developmental milestones listed in this book will give you a general idea of the changes you can expect as your child gets older, don’t be alarmed if his development takes a slightly different course. Alert your pediatrician if your baby displays any of the following signs of possible developmental delay in the eight-to twelve-month age range.

  • Does not crawl
  • Drags one side of body while crawling (for over one month)
  • Cannot stand when supported
  • Does not search for objects that are hidden while he watches
  • Says no single words (“mama” or “dada”)
  • Does not learn to use gestures, such as waving or shaking head
  • Does not point to objects or pictures

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