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Autism Key Facts
What Is Autism?
Autism is a neurodevelopmental disorder diagnosed on the presence of three separate, but related criteria:
- Social challenges
- Communication deficits
- Repetitive behavior or behavior difficulties
While specific autism symptoms are different for each man, woman, and child, most, if not all cases of autism meet the above criteria.
In young children, beginning signs of autism may include lack of eye contact or poor eye contact, a significant speech delay or speech difficulties, a flat affect or tone, repetitive behaviors, and maladaptive or inappropriate social interaction with peers.
No two cases of autism are alike, and autism is considered to be on a spectrum. At one end, there are mild cases where the patient is said to be high-functioning, and the other end contains more severe cases of autism, which may be referred to as “low-functioning.”
Quick Facts at a Glance
- According to the Centers for Disease Control (CDC) statistics, 1 in 59 children are currently diagnosed with autism each year.
- Autism is four times more common in boys than in girls.
- Autism may also be comorbid (present) with other developmental disorders or medical problems, such as intellectual disability (ID), Down syndrome, cystic fibrosis, epilepsy, attention-deficit hyperactivity disorder (ADHD), and depression.
- Symptoms of autism present early and, as of 2019, children are often diagnosed between the ages of 2 and 3.
- Scientists and researchers have not pinpointed an exact cause of autism. Evidence points to both environmental and genetic factors.
- There is no “cure” for autism but with appropriate treatment, many of those on the spectrum lead happy, healthy, and fulfilling lives.
Screening and Diagnosis
Every child who participates in regular well-child visits at their pediatrician’s office will have an early screening test for autism, known as the Modified Checklist for Autism in Toddlers (M-CHAT). This is a short questionnaire, often verbally presented to parents, which attempts to gauge the toddler’s level of appropriate communication and social skills. If a toddler scores poorly on the M-CHAT, the pediatrician will likely put in a referral to Birth to 3 services.
Birth to 3 is an extension of the Individuals With Disabilities Education Act (IDEA). The agency provides needed services to children under the age of 3 who may have profound developmental or physical disabilities. Birth to 3 services provide early intervention to babies and toddlers of all needs, and are typically consulted when autism is suspected.
If autism is a concern, parents can ask for a referral for autism diagnostic testing through their pediatrician, or can opt for testing directly through the Birth to 3 platform. The gold standard for autism testing in younger children is the Autism Diagnostic Observation Schedule (ADOS), although other tests, such as speech-related diagnostic testing like the Mullen Scales of Early Learning, may be offered.
The ADOS or similar testing must be provided by a child neurologist, child psychologist, or developmental pediatrician in order to be valid. Only those who hold these licenses may officially diagnose autism. This is a medical diagnosis that holds weight. Parents may be wary of an “official diagnosis,” but this diagnosis holds the key to early intervention services, which have been shown to be paramount in positive autism outcomes.
Early Intervention and Services
Services for children on the autism spectrum are provided through the Birth to 3 system until the child turns 3; from there, services are provided by the school district in which the child lives. As each case of autism is different and may coexist with other disorders, every child’s need for services varies also. For example, some children may need physical therapy but not speech therapy, or the opposite. Some children will benefit from access to all of the available services. A comprehensive list is below.
Formal speech therapy is provided by a speech-language pathologist (SLP), who is trained in evaluating, recognizing, and treating an array of different speech disorders. Very often, autism-related language delay can coexist with other language difficulties, such as apraxia of speech. A qualified SLP can help children with everything from articulation to the very beginning of speech fundamentals. A speech therapist who treats children on the autism spectrum may also aid in other forms of communication, such as using fundamental American Sign Language (ASL), or operating an augmentative and alternative communication (AAC) device.
Occupational Therapy (OT)
Occupational therapy often gets confused with physical therapy; however, the two therapies are quite different. Occupational therapists essentially help with the tasks of daily living, so that children with autism can lead fully functional and integrated lives. Depending on the needs of the child, an OT may help with learning how to use utensils/feeding issues, self-care (such as dressing and toileting), fine motor skills (like writing one’s own name or using scissors), or gross motor skills like kicking a ball or dancing.
Physical Therapy (PT)
The tasks of a physical therapist and occupational therapist do often overlap. Physical therapists are trained to assist mobility issues as they relate to the developmental delays of autism. For example, a child on the spectrum may struggle with their gait, have strength issues, or have trouble with gross motor skills, such as throwing a ball. Physical therapy is meant to strengthen these areas of the body so these fundamental skills over time become second nature.
As behavior difficulties are one of the three tenets of an autism diagnosis, it is no surprise that behavioral therapy is often a cornerstone of early intervention autism treatment. Applied behavior analysis (ABA) therapy is the mainstay of treatment, as of 2019. Many ABA therapists come directly into the home and may provide up to 40 hours of services weekly for those with severe behavioral difficulties. ABA uses a lot of exposure techniques and while very successful, can be emotionally difficult on both parent and child. Parents should be aware that there are other behavioral treatments for autism, such as cognitive behavioral therapy (CBT), social skills groups, and the Denver model.
Questions and Myths
As with any time of medical or psychological condition, many people not familiar with autism have questions about it. While the internet is a great resource, there is a lot of misinformation available, particularly when it comes to autism. Below, see some answers to some of the most common questions asked about autism.
Do vaccines cause autism?
No. There is absolutely no scientific or medical evidence connecting vaccines to autism. The doctor (Dr. Andrew Wakefield) who first suggested a connection between the MMR vaccine and autism has since been discredited and lost his license to practice medicine. Large, cohort studies published as recently as 2019 further refute this claim, as well as the Centers for Disease Control and many authoritative sources.
Is there medication or a treatment for autism?
There is no one medication prescribed specifically for the treatment of autism. Risperidone is the only FDA-approved medication to treat some autism symptoms, such as behavioral problems. There are also other medications that are used off-label. Generally, first-line treatments for autism include either ABA (applied behavioral analysis) therapy or other types of therapy, such as CBT (cognitive behavioral therapy).
Is there a cure for autism?
Just as there is no medication prescribed to “treat” autism, there is no cure. Any medical professional or therapist that suggests such has no basis in fact or reality. One does not “recover” from autism; to suggest so is offensive to those who have autism spectrum disorder. However, many therapies exist to help those on the spectrum live happy, fulfilling lives.
Are Asperger’s syndrome and autism the same thing?
Yes and no. This is a complicated question with a complicated answer. Autism and related disorders are diagnosed based on what is written in the Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM-4 (fourth edition) had Asperger’s syndrome as a separate condition from autism. However, in the DSM-5, which is the most recent release, the category of Asperger’s syndrome was eliminated and professionals were instructed to diagnose those with Asperger’s as being on the autism spectrum. So, yes, Asperger’s is considered a form of autism, but some of the symptoms are wildly different of that than autism spectrum disorder. For example, those with Asperger’s may be extremely verbal, as opposed to nonverbal. They may also have extremely high IQs as opposed to many with ASD, who are comorbid with intellectual disability. However, many of the treatments for Asperger’s are the same for those with ASD, particularly in younger children.
Are those with autism intellectually disabled?
It is important to note that intellectual disability (ID) is completely separate than that of autism spectrum disorder. ID is often comorbid (present) with autism, and those with more severe cases of autism also have intellectual disabilities. However, many of those with ASD have extremely high IQs – they just need the proper therapies in order to help them express their intelligence by communicating efficiently.
What are the most common signs of autism in a child?
There are certain signs and symptoms of autism that are often seen even before a child’s second birthday. Delays in speech and communication often top the list. In addition, a child with autism may have trouble making eye contact, may not seem to respond to his/her name, may not interact with or notice peers, may line up toys or objects, may have repetitive movements or sounds, and may lack fundamental communication skills (child is unable to wave, point, clap, say “bye-bye,” etc.)
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