Lack of pointing to direct others' attention to objects (occurs in the first 14 months of life) Does not adjust gaze to look at objects that others are looking at
Cannot start or sustain a social conversation
Develops language slowly or not at all
Repeats words or memorized passages, such as commercials
Does not refer to self correctly (for example, says "you want water" when the child means "I want water")
Uses nonsense rhyming Communicates with gestures instead of words
Shows a lack of empathy
Does not make friends
Prefers to spend time alone, rather than with others
May not respond to eye contact or smiles
May actually avoid eye contact
May treat others as if they are objects
Does not play interactive games
Response to sensory information
Has heightened or low senses of sight, hearing, touch, smell, or taste
Seems to have a heightened or low response to pain
May withdraw from physical contact because it is over stimulating or overwhelming
Does not startle at loud noises
May find normal noises painful and hold hands over ears
Rubs surfaces, mouths or licks objects
Shows little pretend or imaginative play
Doesn't imitate the actions of others
Prefers solitary or ritualistic play
Has a short attention span
Uses repetitive body movements
Shows a strong need for sameness
"Acts up" with intense tantrums
Has very narrow interests
Demonstrates preservation (gets stuck on a single topic or task)
Shows aggression to others or self
Is overactive or very passive
Signs and tests
All children should have routine developmental exams by their pediatrician. Further testing may be needed if there is concern on the part of the clinician or the parents. This is particularly true whenever a child fails to meet any of the following language milestones:
Babbling by 12 months
Gesturing (pointing, waving bye-bye) by 12 months
Single words by 16 months
Two-word spontaneous phrases by 24 months (not just echoing)
Loss of any language or social skills at any age.
The other pervasive developmental disorders include: An evaluation of autism will often include a complete physical and Neurological examination. It may also include a specific diagnostic screening tool, such as:
Autism Diagnostic Interview - Revised (ADI-R)
Autism Diagnostic Observation Schedule (ADOS)
Childhood Autism rating Scale (CARS)
Gilliam Autism Rating Scale
Pervasive Developmental Disorders Screening Test-Stage 3
Children with known or suspected autism will often have genetic testing (looking for chromosome abnormalities) and perhaps metabolic testing.
Autism encompasses a broad spectrum of symptoms. Therefore, a single, brief evaluation cannot predict a child's true abilities. Ideally, a team of different specialists will evaluate the child. They might evaluate speech, language, communication, thinking abilities, motor skills, success at school, and other factors.
Sometimes people are reluctant to have a child diagnosed because of concerns about labeling the child. However, failure to make a diagnosis can lead to failure to get the treatment and services the child needs.
An early, intensive, appropriate treatment program will greatly improve the outlook for most young children with autism. Most programs will build on the interests of the child in a highly structured schedule of constructive activities. Visual aids are often helpful.
Treatment is most successful when geared toward the child's particular needs. An experienced specialist or team should design the individualized program. A variety of effective therapies are available, including applied behavior analysis (ABA), speech-language therapy, medications, occupational therapy, and physical therapy. Sensory integration and vision therapy are also common, but there is little research supporting their effectiveness. The best treatment plan may use a combination of techniques.
Some children with autism appear to respond to a gluten free or a casein-free diet. Gluten is found in foods containing wheat, rye, and barley. Casein is found in milk, cheese, and other dairy products. Not all experts agree that dietary changes will make a difference, and not all reports studying this method have shown positive results.
Beware that there are widely publicized treatments for autism that do not have scientific support, and reports of "miracle cures" that do not live up to expectations. If your child has autism, it may be helpful to talk with other parents of children with autism, talk with autism specialists, and follow the progress of research in this area, which is rapidly developing.
At one time, there was enormous excitement about using secretin infusions. Now, after many studies have been conducted in many laboratories, it's possible that secretin is not effective after all, but research is.
Autism can be associated with other disorders that affect the brain, such as Tuberous Sclerosis, Mental retardation or Fragile X syndrome.
Some people with autism will develop Seizures.
The stresses of dealing with autism can lead to social and emotional complications for family and caregivers, as well as the person with autism.