Autism and the DSM-5
Autism Spectrum Disorders* are a range of complex developmental disorders that can cause problems with thinking, feeling, language, and the ability to relate to others. They are neurological disorders, which means they affect the functioning of the brain. How autism disorders affect a person and the severity of symptoms are different in each person.
Autism is usually first diagnosed in childhood. About 1 in 88 children is diagnosed with autism. Autism Spectrum Disorders are three to four times more common in boys than in girls.
It is a lifelong disorder in most cases, though there are more and more cases of children with ASD who are eventually function independently leading full lives. The information here focuses more on children and adolescents.
Autism differs from person to person in severity and
combinations of symptoms. There is a great range of abilities
and characteristics of children with autism spectrum
disorders—no two children appear or behave the same way.
Symptoms can range from mild to severe and often change
Characteristics of Autism Spectrum Disorders include:
Communication problems – difficulty using or understanding language.
Some children with autism focus their attention and conversation on a few
topic areas, some frequently repeat phrases, and some have very limited speech
Difficulty relating to people, things and events – trouble making friends
and interacting with people; , difficulty reading facial expressions, may not
make eye contact
Repetitive body movements or behaviors – hand flapping or repeating
sounds or phrases
Many children with autism are attentive to routines and sameness and have difficulty adjusting to to unfamiliar surroundings or changes in routine. Many people with autism have normal cognitive skills, while others have cognitive challenges. Some are at greater risk for some medical conditions – such as sleep problems and seizures.
Early diagnosis and treatment are important to reducing the symptoms of autism and improving the quality of life for people with autism and their families. There is no medical test for autism. It is diagnosed based on watching how the child talks and acts in comparison to other children of the same age. Trained professionals typically diagnose autism by talking with the child and asking questions of parents and other caregivers.
Under federal law, any child suspected of having a developmental disorder can get a free evaluation. The American Academy of Pediatrics recommends that children be screened for developmental disorders at well-child preventive visits before age three.
It is not clear exactly what causes of Autism Spectrum Disorders. Several factors probably contribute to autism, including genes a child is born with or perhaps something in the environment. The risk of autism is greater if there is a family member with autism. Research has shown that it is not caused by bad parenting, and it is not caused by vaccines.
While children are not typically cured and don’t outgrow autism, studies have shown that it can improve with early diagnosis and treatment. There is no single treatment for autism; treatments generally address behavioral and learning skills. Treatments can include intensive skill-building and teaching educational sessions, known as applied behavior analysis or ABA, and many recent more interactive, child-centered versions of behavior treatments. Treatment may also involve special training and support for parents, speech and language therapy, occupational therapy, and/or social skills training.
Also, some children and adults with ASD have other kinds of psychological difficulties at some point in their lives, such as anxiety, attention deficits and/or hyperactivity, disruptive behaviors, or depression. These difficulties can be treated with therapy or with medication. There are currently no medications that directly treat the core features of ASD.
In addition to treatment, regular and special education classrooms can be changed to help a student with autism. Many students with autism can function better if the day is consistent and predictable. It is also helpful if information is presented so the student can learn by seeing as well as hearing, and if students get to play and learn with nondisabled peers. A federal law — the Individuals with Disabilities Education Act, or IDEA — requires that special services be available to children identified with a disability. The services can include early intervention, support for birth through 3 years, and special education for ages 3 through 21.
Use of complementary and alternative treatments is common among children with autism, for example, special nutritional supplements and diets. To date, there is little good scientific evidence that such treatments are effective and sometimes they have negative consequences to it is important to talk to your doctor before trying them.
- Learn as much as possible
- Provide consistent structure and routine
- Connect with other parents of children with autism
- Seek professional help
- Take time for yourself and other family members
Having a child with autism affects the whole family. It can be stressful, time-consuming, and expensive. Paying attention to the physical and emotional health of the whole family is important. Many national and local advocacy organizations provide information, resources and support to individuals with autism spectrum disorders and their families. A few are listed below.
Autism Society of America
American Academy of Pedicatrics
CDC (Centers for Disease Control and Prevention)
NICHCY - Link to state resources
*ASD includes autism, PDD-NOS (pervasive developmental disorder not otherwise specified), and Asperger syndrome (the three most common). Asperger Syndrome falls within the autism spectrum but is characterized by fluent language and no intellectual disability and is usually used to describe children who are fully included in school. PDD-NOS has sometimes been used as a “working diagnosis” with young children, or children with milder forms of autism or children with less obvious repetitive behaviors. Proposed changes in the DSM (Diagnosic and Statistical Manual of Mental Disorders) would include the currently separate categories of autistic disorder (autism), Asperger’s disorder, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified.