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Frequently Asked Questions

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1. What is autism?

Autism is a complex neurodevelopmental disorder associated with difficulties in social interaction, verbal and nonverbal communication, and repetitive behaviors or interests. Other characteristics can include unusual responses to sensory experiences, such as sensitivities to noises, textures, tastes, or the way certain objects look. It is part of a group of disorders called autism spectrum disorders (ASDs), so named because impairments range from mild to severe and vary with each individual.

The range of severity applies to each symptom of ASD. That is, some children may rarely use words to communicate, while others may hold extensive conversations and use rich language. Some children may not like to be hugged or touched, while others seek out and enjoy physical touch. ASDs are found in all ethnicities, races, and countries, and occurs in more boys than girls.

The autism spectrum disorders include autistic disorder, Asperger’s Disorder, and Pervasive Developmental Disorder not otherwise specified (PDD-NOS).

2. What causes autism/ASD?

Though autism research has come a long way in the past decade, the exact causes are not known in most cases. Only about 10-15% of cases have an identified primary genetic cause. (For example, we know that about one third of people with Fragile X syndrome also have ASD.) For the other 85-90% of cases, the precise cause is still not known. Research suggests, however, that genetics are strongly involved.

Sometimes ASD runs in families and there appears to be a significant genetic connection. In other cases, there is no family history or only subtle examples of ASD-like symptoms in a relative. Even in these cases, there is probably a strong genetic component, but the types of genetic influences likely differ.

Researchers believe that there are multiple and different risk genes that combine in various ways to cause ASD in any individual. Many of the risk genes seem to have only a small influence, and they require a specific combination of risk factors to cause ASDs. In most cases, though, it is apparent that genes cannot be the whole story -- genes are likely combining with other non-genetic (also known as environmental) sources of influence to cause ASDs.

There is very little understanding of what those other non-genetic causes might be. Researchers are hopeful that, once the genetic factors are discovered, the non-genetic sources of influence will be easier to identify. It is generally accepted, however, that ASDs do not occur because of psychological factors, and they are not the result of parenting behaviors or practices.

Research on causes is the most active area of autism research. Understanding the causes better will produce much more obvious roads to effective treatments.

3. Is there a cure for autism/ASD?

ASD is usually noticed in the first few years of a child’s life and lasts throughout a lifetime. While there is no definitive cure for autism, there are educational, behavioral, and therapeutic interventions and strategies for families and instructors to teach motor, cognitive, and social skills. These plans and programs are highly individualized, as the needs of each child with ASD are different. Treatment plans frequently include a cooperative team of speech and language, occupational, and physical therapists. Some families have found that other therapies like Applied Behavior Analysis (ABA), play therapy, medication, or certain dietary restrictions work well for them.

Generally speaking, the earlier a child with ASD receives services, the more these interventions will work to enhance a child's development and help to reduce challenging behaviors.

4. How do I know if my child has an autism spectrum disorder?

Although ASD presents as a range of severity of symptoms, there are three major categories of signs. The first set relates to problems with socialization. Individuals with ASDs have difficulty interacting with other people and often are uninterested in or have difficulty with common childhood social interactions (for example, cuddling or playing interactive games).

The second set of symptoms relates to problems with communication. For example, some individuals with ASDs use only a few words and have trouble learning more words. Others have incredible vocabularies but have a very literal interpretation of language and great difficulty maintaining conversation.

The third set of symptoms includes odd or repetitive behaviors. Children may insist on certain routines or patterns in everyday life or want to play with toys in atypical ways (for example, spinning the wheels of a toy car rather than “driving” it). Individuals with ASDs often have a great desire for predictability and consistency in their daily routines or the organization of their possessions. Some individuals with ASD may flap their hands or rock back and forth.

The American Psychiatric Association has proposed changes which will impact how autism is diagnosed. Click here to read a summary of these changes.

5. How is autism/ASD diagnosed?

It is important to remember that children develop at different rates. However, because autism is a "spectrum" disorder, meaning that difficulties range from mild to severe and vary with each individual, sometimes it may be difficult to diagnose.

ASD can only be formally diagnosed by a trained clinician after conducting formal diagnostic tests. The clinician may be a developmental pediatrician, psychiatrist, psychologist, or other trained and experienced professional.

Tools created for the purpose of diagnosing autism rely on observing the individual with suspected autism in structured and/or unstructured settings and asking questions of caregivers on the individual’s history and behavior. A clinician may also suggest a neurological evaluation or genetic, metabolic, and electrophysiologic testing. There is no definitive medical test for a diagnosis. Instead, a medical diagnosis of autism will be based on whether the individual meets the criteria set forth in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV).

The American Psychiatric Association has proposed changes to the DSM-IV,which will impact how autism is diagnosed. Click here to read a summary of these changes.

6. What is the prognosis for someone with an autism spectrum disorder?

Each individual with an ASD diagnosis is different, but all have positive characteristics that can be used to advantage. For example, most people on the spectrum are typically very honest and they rarely show bias or prejudice. Some have an excellent memory for details and facts and may have original problem-solving strategies. Many are extremely hard-working, loyal, and dependable. While some individuals with ASDs will have a job and even graduate from college, others will need intensive life-time care. Services for adult individuals on the spectrum and their families, while not as widely available as they need to be, are growing in number. They include social coaching, job training, and accommodated living arrangements in regular communities.

© 2014, The Children's Hospital of Philadelphia. All rights reserved.