Autism or autism spectrum disorder (ASD) is a developmental disorder that affects how people communicate and interact with their environment (physical and people). As of 2018, the CDC reports that 1 in 44 children have it. Dang! To give you an idea, when my son was diagnosed in 1999, it was 1 in 500.
There is no cure, BUT there IS hope and better understanding and accommodations for autistic persons today! Therapies such as ABA (Applied Behavior Analysis), speech therapy, occupational therapy, counseling, and special education have all been proven effective and helpful.
Autism is a spectrum which means that every single person with autism is unique, just like every freaking person in the world. There are some threads of similarities which is how a diagnosis can be given, but there is no magic checklist, no magic pill, no magic nothin'. And don't get confused by the word “spectrum.” It's not a linear “more” or “less.” It's more like a little bit of this and a little bit of that, and more of this, but less of that. Again, making autism unique and INTERESTING!
What are the main symptoms of autism?
As parents and loved ones (and providers!), this is basic information you might already know, but I thought I'd put it in one place for my readers!
There are three main characteristics of autism that are defined by the medical diagnosis (which you can find below). 1) Difficulties with social communication and social interactions, 2) Repetitive, restrictive patterns of behavior and interests, and 3) Symptoms present in the early years, impact daily life, and not better explained by another disability.
There are then three Levels 1) Requiring support, 2) Requiring substantial support, or 3) Requiring very substantial support.
Other common signs and symptoms of autism include:
- Delayed speech and language skills (e.g., not responding to name by 12 months, not following basic directions, limited babbling, not using words to communicate by 18 months)
- Limited or unnatural eye contact
- Need for rules and routines
- Being upset by change (even minor ones)
- Repetitive motor or vocal behavior (e.g., flapping hands, toe walking, hand wringing, repeating sounds and words)
- Under- or over-sensitive senses (e.g., hearing sight, taste, feeling, smelling)
- Difficulty understanding emotions of self and others and regulating own emotions
- Lack of pointing in the environment or other behaviors to share interest
Of course there are more, and I will include the actual diagnosis below, but that gives you an idea.
The Modified Checklist for Autism in Toddlers (M-CHAT)
If you are worried about your young child's development, don't sit on it! Early intervention is so important! Talk to your pediatrician, ask for a screening or evaluation. It'll be better to check and be told “No, it's nothing” than to wait and find out it IS something, and you lost some prime learning time!
The M-CHAT is an excellent quick screening you or your pediatrician can use if you are worried about your kiddo. You can either do it, yourself, and take it in to your pediatrician to discuss, or ask them to fill it out.
Autism in girls
You'd think it would be the same, right? It's not. Over the years of my interaction with boys and girls all over the spectrum, I've noticed some common differences. Girls, for some reason, are diagnosed with autism at a rate of 1:4 compared to boys. I can't say if there are truly that many fewer with autism or they just know how to mask it and fall through the cracks more. /shrug/
One weird thing I've noticed that probably has NO scientific backing is that girls often fall either on one side of the spectrum or the other, either need tremendous support and have limited independent skills or are able to mask their symptoms tremendously and present with mild symptoms. In addition, it seems like, as a whole group, autistic girls have higher social anxiety than the boys.
Here are some signs that a girl may have autism that may differentiate them from boys:
- Better understanding of basic emotions
- Higher level of acting out social scenarios they see in real life or shows
- More capable of making friends initially although may struggle to keep them over time
- Struggle with the nuances of social interactions
- Higher social anxiety and worry about what others think of them
- Social anxiety that prevents them from engaging in social situations they may be capable of doing
- High social media perseveration
- Higher level of “policing” (telling others what the rules are and that they should follow them)
- Higher likelihood of depression or eating disorders
What is the Diganostic Criteria for Autism
You can find the medical diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). But, to make it a little easier to understand, here it is in simple terms.
- Deficits in social communication and social interactions
- Social-emotional reciprocity: back-and-forth conversation, shared interests, understanding emotions of others, low social initiation and response.
- Non-verbal behavior: lack of eye contact, lack of understanding of gestures, body language, and facial expressions.
- Relationships: adjusting behavior to different situations, imaginative play, lack of age-appropriate making of friends, not interested in peers.
- Repetitive, restrictive patterns of behavior and interests
- Stereotypical or repetitive motor movements or vocalizations: flapping, toe-walking, spinning, vocal sounds like humming, grinding teeth, spinning or lining up objects, repeating words and phrases.
- Insistence on sameness: inflexible, strong adherence to routines, difficulty with transitions.
- Restricted and fixated interests: preoccupation with unusual objects or subjects, wanting to talk about or only do one thing.
- Hyper- or hypo-sensitivity to sensory input: indifference to pain, adverse to sunlight, seeking out spinning activities, excessive smelling or touching, visual preoccupations, limited food choices, seeks heavy blankets or weights to calm.
- Symptoms must be present in early development
- Symptoms have to impact the person in their daily life functioning.
- Symptoms not better explained by other disability (with the exception of intellectual disability; person can have both) or traumatic event.
- Diagnosis must include if there is an intellectual impairment, a language impairment, person has any other disorder, catatonia, or any other known genetic condition or environmental factor
Also, both Social Communication and Restrictive Behaviors need to be given a “Level.” These levels are independent of each other. In other words, a person can be a Level 1 Social Communication and a Level 3 Restrictive Behavior. Here is a synopsis of the levels:
If you're looking for thoughts on what it's like to parent an autistic adult (yes, it's still a thing!), see my 4-part post.