What is Autism? Signs, Concerns and Diagnosis

Autism refers to a spectrum of disorders where the child presents with an impairment in social interaction skills, communication skills and demonstrates restricted or repetitive stereotypical type behaviors. Autism is a lifelong developmental disability which affects the child's ability to understand what he / she sees, hears and senses resulting in problems in social interaction, communication skills (and use of language) and unusual behavior and interests. Children with ASD do not follow the typical patterns of child development and their behaviors can range from mild to severe.

Early identification of Autism is ideal as early intervention and treatment has been directly linked with the best outcomes for children with autism. Babies are sociable beings. From early in life they turn towards familiar voices, gaze at their parents, smile and are comforted by hugs and touch. Many young children with autism experience difficulties in developing these skills and early forms of two-way interactions.

The causes of Autism are unclear however research supports a genetic component and then a disruption in normal brain development. There may be multiple factors or causes that lead to autism and only research will find these answers. Twin and family studies have suggested an underlying genetic vulnerability to autism and other studies have shown that a contributing cause for autism may be abnormal brain development beginning in the infant's first year of life.

Signs of Autism

* Communication Concerns
* Does not respond to his/her name
* Delayed language or no language
* Echolalia (repeats words heard, echo's words)
* Doesn't babble
* May develop language but uses it inappropriately
* Doesn't follow instructions
* Appears deaf at times
* Doesn't point or make meaningful gestures
* Doesn't wave goodbye
* Use to have words but appears to have 'lost' words / language
* Does not babble, point, or make meaningful gestures by 1 year of age
* Does not speak one word by 16 months
* Does not combine two words by 2 years

Social Concerns

* Doesn't smile socially
* Seems to prefer to play on their own
* Has poor eye contact
* Feels as though it is hard to emotionally / socially 'connect' with your child
* Not interested in other children

Behavioral Concerns

* Difficulties playing with toys eg. May line up toys or just play with the wheels of a toy
* Restricted interest in play / toys eg. Maybe attached to one toy.
* Tantrums
* Hyperactive / or uncooperative or oppositional
* Toe walking
* Strong sensory sensitivities eg. strong reaction to loud noises

How is Autism Diagnosed?

Ideally an autism diagnostic team will assess and diagnose autism. The team should be made up of clinicians specially trained in autism diagnosis and include a Pediatrician, Clinical Psychologist and Speech Therapist. A diagnosis is based on the child meeting a certain level of the below criteria from the DSM- IV manual:

1. Qualitative impairment in social interaction:
* marked impairment in nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction
* failure to develop peer relationships
* a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest)
* lack of social or emotional reciprocity

2. qualitative impairments in communication:
* delay in, or total lack of, the development of spoken language (no attempt to compensate through other methods of communication such as gesture)
* in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
* stereotyped and repetitive use of language or idiosyncratic language
* lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level

3. restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following:
* encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
* apparently inflexible adherence to specific, nonfunctional routines or rituals
* stereotyped and repetitive motor manners (e.g., hand or finger flapping or twisting, or complex whole-body movements)
* persistent preoccupation with parts of objects.

What to do?

If you are worrying about your child, please contact your family doctor to discuss available options. Since autism diagnosys is difficult, it is important to consult with multipe doctors for a second opinion.