Autism spectrum disorders
Autism spectrum disorders (ASDs) are generally noticed in early childhood. Affected people have problems with social understanding, social behaviour and communication. The term ‘autistic spectrum disorders’ has replaced ‘autism’, as it has been increasingly recognised that this is a complex condition with a wide range of symptoms and varying degrees of severity. Many children affected by ASDs have much milder symptoms than the traditional image of a child with minimal language or communication skills leading an extremely isolated existence.
ASDs generally include:
- autistic disorder;
- Asperger syndrome (or Asperger's disorder); and
- pervasive developmental disorder not otherwise specified (PDD-NOS).
There is some debate as to whether Asperger syndrome represents a milder part of the autistic spectrum, or whether it is a distinct condition.
How common are ASDs?
ASDs are among the most common developmental disabilities, and the characteristics show themselves in the first 3 years of life. There are about 3 times as many males diagnosed with ASDs as females; however, girls who have the condition are likely to show more severe symptoms.
What problems do people with ASDs experience?
All children and adults with ASDs have problems in the areas of social interaction, social communication, and imagination. They may appear aloof and indifferent to other people and often cannot understand the meaning of gestures, facial expressions or tone of voice. Because of their limited capacity to understand other people’s feelings, they do not develop friendships easily.
ASDs are commonly associated with problems in the areas of emotional stability (e.g. tantrums), poor attention span, impulsiveness, and learning difficulties, either specific or general. However, in those with Asperger syndrome, intellectual abilities are likely to be normal or advanced. Many children with ASDs have strong reactions to sensory experiences — they may be either fascinated or afraid of particular sounds, textures or visual experiences, such as spinning tops or having things lined up.
People with ASDs don’t look any different from anyone else. They are not physically disabled, although they may have learning disabilities. The common factor that everyone with an ASD shares is a difficulty in making sense of their world, and in particular a difficulty in understanding the mental states of other people. Because of this, children with ASDs often appear to live in a world of their own, in some cases using a language or vocabulary only they understand.
Although ASDs are often associated with learning problems, not all people with these disorders are affected in this way. Indeed some people with ASDs have superior cognitive functioning and excellent memories. Every person with an ASD is affected differently and some live and work successfully in the community, having adjusted to the effects of their condition on their lives.
What are the symptoms of ASDs?
In children, symptoms include:
- delayed development, particularly of language skills;
- an inability to understand metaphor, sarcasm or irony;
- solitary play and withdrawal from others;
- lack of imaginative play;
- apathy toward other people’s attempts at communication;
- a short attention span;
- a dislike of physical affection;
- displays of temper towards the self or others;
- being able to learn one day, but not the next;
- difficulty with changes in routine;
- lack or absence of eye contact;
- inappropriate body language;
- repetitive and compulsive behaviour which, if interrupted, may provoke temper tantrums;
- repetitive movements;
- preoccupation with parts of objects;
- difficulty in learning;
- in some, extraordinary talent or brilliance in specific skills; and
- inflexible adherence to particular routines or rituals.
What causes ASDs?
The exact cause of ASDs has not yet been pinpointed, but doctors believe that some people are more likely to develop an ASD because of the genes they have inherited. Families with an affected child have a higher risk of a subsequent child having an autistic spectrum disorder than that of the general population. However, researchers think that several genes influence the development of ASDs, and that the cause is complex — possibly a combination of genetic and other factors.
In addition to this genetic predisposition, there is a failure of development of certain areas of the brain. This failure occurs either during development of the baby in the womb or at birth or soon afterwards.
When autism was first described in 1943, it was thought to be caused by poor attachment and bonding skills of the mother. This led to a great deal of pain and guilt on the part of parents of autistic children. Research has completely failed to support this view, and ASDs are now overwhelmingly regarded as an organic brain problem.
Associated disorders
There are a number of neurological disorders that have symptoms similar to those of ASDs, and ASDs can also be associated with many medical conditions including tuberous sclerosis (a rare genetic disorder causing tumours to develop in the brain and other organs), Tourette’s syndrome, Fragile X syndrome (a chromosomal abnormality, more common in boys, which causes mental retardation and heart problems) and some biochemical and metabolic disorders.
There is also an association between ASD and epilepsy. Seizures (fits) often start either in early childhood or in adolescence.
What your doctor can do for you
Your doctor can determine whether your child may be likely to have an ASD, and refer him or her to a specialist in ASDs or behavioural disorders for further tests, advice, treatment and education. In addition to the ASD itself, many children experience associated mood or anxiety disorders.
Since mid-2008, increased funding has been available in Australia through Medicare under the 'Helping Children with Autism' package. This improves access to speech pathologists, occupational therapists and psychologists, as well as paediatricians or psychiatrists for both assessment and treatment. To obtain this package, your child needs to be younger than 13 years at the time of initial assessment and referred to a psychiatrist or paediatrician for this service by your general practitioner (GP).
Last Reviewed: 23 November 2009
- 1. Helping Children with Autism [website]. Department of Health and Ageing [reviewed Dec 2009]. http://www.health.gov.au/internet/main/publishing.nsf/Content/autism-childern-factsheet (accessed Dec 2009).
2. Autism Spectrum Disorders: Pervasive Developmental Disorders [website]. The National Institute of Mental Health (NIMH) [reviewed July 2009]. Available from: http://www.nimh.nih.gov/health/publications/autism/complete-index.shtml (accessed Dec 2009).
3. Johnson CP, Myers SM, Council on Children With Disabilities. Identification and Evaluation of Children With Autism Spectrum Disorders. Pediatrics 2007; 120(5): 1183-215. Available from: http://aappolicy.aappublications.org/cgi/content/full/pediatrics;120/5/1183#SEC5 (accessed Dec 2009).
