Autism Spectrum Disorder

Am Fam Physician. 2016;94(12):online

See related article on autism spectrum disorder

What is autism spectrum disorder?

Autism spectrum disorder (ASD) is a broad term used to describe problems with communication and behavior. ASD can range from mild to very severe.

What are the symptoms?

Symptoms of ASD often appear in young children. Some signs and symptoms are first seen between six and 12 months of age. The most noticeable symptoms are unusual behaviors and delayed talking. Some key signs and symptoms are:

Speech or communication delays
Repetitive movements or very few interests
Limited or no eye contact
Limited sharing of feelings or interests
Significant distress by change in routines
Failure to start and maintain conversations
Strong attachments to specific objects
Overreaction to sounds or visual signals
Lack of interest in making friends
Difficulty in imaginary play

What causes ASD?

There is no single cause of ASD. There may be a higher risk if other family members have ASD. Older age of the mother and father are risk factors. There is also a higher risk if the mother has diabetes, high blood pressure, obesity, infections, or is taking certain medicines (for example, valproate) or has had contact with pesticides.

Can vaccines cause ASD?

A large amount of research has shown that vaccines are safe and do not cause ASD.

How is it diagnosed?

ASD can be diagnosed in children by two years of age. Children as young as 18 months can be screened for ASD. If parents or clinicians think a child has ASD, the child should be evaluated by a trained professional. A team of medical professionals may be involved in making the diagnosis.

Are there conditions associated with ASD?

Children with ASD may have symptoms that overlap with other conditions, such as psychiatric conditions, physical disabilities, lower IQ, sleep problems, digestive problems, and epilepsy. The doctor or medical team will do a thorough evaluation to make the correct diagnosis and find out if the child has other conditions.

How is ASD treated?

There is no cure for ASD. Children with ASD usually have symptoms throughout their lives. One common treatment is called early intensive behavioral intervention. This can begin at the time of diagnosis in young children. The most well-studied method is applied behavior analysis therapy. This has been shown to improve mental ability, language, and social skills when used over a long period of time.

Medicines should be used only for treating coexisting medical conditions and behaviors that may not improve with behavioral therapy. The medicines used for treating ASD have serious side effects. They should be used only after the risks and possible benefits are considered.

Parents may learn about many complementary and alternative treatments for ASD, but not all of them are safe or effective. Melatonin is well studied and safe for treating sleep problems. Many other treatments have not been shown to help symptoms of ASD. Complementary and alternative treatments should be discussed with a doctor before using them.