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Autism Essay | Essay on Autism for Students and Children in English

February 13, 2024 by Prasanna

Autism Essay:  Autism, also known as autism spectrum disorder (ASD), is a neurodevelopmental disorder. Problems with communications and social interactions, along with repetitive and restricted behaviour, are common in autism. The associated factors of autism include genetics and specific environmental influences.

Autism includes a wide range of disorders of which, Asperger syndrome, childhood disintegrative disorder and pervasive developmental disorders have been added recently. The symptoms of autism occur before three years in a child, as observed by doctors.

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Long and Short Essays on Autism for Students and Kids in English

We provide students with essay samples on a long essay of 500 words and a short essay of 150 words on the topic Autism for reference.

Long Essay on Autism 500 Words in English

Long Essay on Autism is usually given to classes 7, 8, 9, and 10.

Autism is a complex neurodevelopmental disorder and affects a person’s responsive and interactive behaviour. It requires sensitivity and a certain intensity of the traits that affect social development for diagnosis. Autism includes persistent deficits in social communication and interactions. People who have autism also face difficulties in social and emotional reciprocity and a reduced interest in sharing emotions or feelings and often fail to respond to social interactions. Autistic people often face difficulties in maintaining, developing, or understanding relationships. They exhibit poorly integrative verbal or non-verbal communications and abnormalities in making eye-contacts and body language.

Autism is characterized by stereotypical and repetitive movements, phrases and words, and reactions along with inflexible adherence to a particular routine. The abnormal intensity of attachment with unusual objects is often seen in autistic people, and they are hypersensitive to small changes around them. The symptoms of autism result from changes related to maturation in different brain systems. The mechanisms of autism can be divided into two ways. The pathophysiology of the brain structure and associated processes regulates the behavioural characteristics. There are individual neurophysiological connections between the brain and behaviours also.

Autism is a significant form of Pervasive developmental disorders (PDD) and is also classified as syndromal and non-syndromal. The extent of non-syndromal autism is unclear, but syndromal autism includes an intellectual disability or congenital syndromes. Diagnosed reports suggest some children lose their language and social skills at 15-30 months. Researches have been restricted due to identification problems in traditional boundaries between the subgroups and disciplines like psychiatry, neurology, paediatrics, and psychology.

According to doctors, very few people suffering from autism exhibit savant syndrome. A person starts to exhibit extraordinary skills and abilities in a specific field, like, calculating complicated sums at a very high speed, reading two books simultaneously, memorizing things quickly, etc. The exact causes leading to autism are still not known. It just occurs due to a different functioning of the brain and is often believed to be genetic, as the doctors found pieces of evidence. Autistic people experience changes in the significant areas of the brain that affect their speech and behaviour. In cases of twins, a strong correlation between them has also been observed in terms of autism. Environmental factors also cause autistic disorders. The risk factors during pregnancy, including rubella, toxins, autoimmune diseases, fetal growth restrictions, and air pollution, also play a vital role.

Autism results in low tolerance and perseverance levels in distinctive individuals. Autistic people often suffer from regular panic attacks and societal trauma which causes anxiety, self-esteem issues, depression, obsessive-compulsive disorders, epilepsy, and sleep disturbances. This trauma adversely affects their development. There is no such proven treatment for curing autism, but proper therapies and strategies can manage mental health issues. Treatment interventions are beneficial in autism cases. Applied behaviour analysis (ABA) increases desirable behaviour, reduces harmful isolation from others, and might improve memory-focus, academic performance, and communications. Other interventions include Early Start Denver Model (ESDM), Occupational Therapy (OT), Pivotal Response Treatment (PRT), Speech Therapy, Relationship Development Intervention (RDI), Verbal Behaviour Therapy (VBT), and TEACCH.

Short Essay on Autism 150 Words in English

Short Essay on Autism is usually given to classes 1, 2, 3, 4, 5, and 6.

Autism is a neurodevelopmental disability that occurs at the age of three years. It affects the social, behavioural and communicative skills. The characteristics of autism vary from person to person. Parents start to notice the autistics characteristics in their child when he/she avoids social interactions, has behavioural issues and speech problems.

One of the important behavioural characteristics of an autistic child is aggressiveness or self-harming behaviour, either active or passive. They exhibit odd behaviours and have a resistance to change regular routines. However, in many cases, extraordinary talents and skills are observed in autistic people. The symptoms of autism first appear during infancy or early childhood days. Autistic people have specific impairments which include problems in social interactions, communications, repetitive behaviour. Atypical eating habits are also common.

The causes of autism have not been discovered yet, but genetics play an essential role along with significant risk factors during the time of pregnancy. It is a disorder and not a disease and is not curable. Medications, therapies and strategies help to improve the conditions, physically and mentally, and people need to get more aware and careful while dealing with autistic children.

10 Lines on Autism in English

• Autism is a neurodevelopmental disorder and not an illness.
• Genetics, environmental factors and risk factors at the time of pregnancy play a vital role in cases of autism.
• The first signs and symptoms of autism are seen during infancy and early childhood days.
• Autistic people face difficulties in communication and interactions and often suffer from mental health issues.
• Autistic people often have repetitive behaviour and may have speech problems.
• In some cases of autism, the person may exhibit unique talents and extraordinary skills in specific fields.
• Autism is a resultant form of differential performing of the brain.
• Autism is the most common form of Pervasive developmental disorders (PDD).
• Autistic people face issues related to the senses, memory and understanding verbal instructions.
• There is no cure for autism though medicines and therapies improve the mental health of the child.

FAQ’s on Autism Essay

Question 1.  What causes autism?

Answer:  There is no exact known cause of autism, but genetics and environmental often affect in cases of autism.

Question 2. What does ‘spectrum’ mean in autism cases?

Answer:  Autism does not come with a single disorder. It has a range of conditions related to behaviour, speech, communication and memory, and hence it is often called Autism Spectrum Disorder (ASD).

Question 3.  How to understand if a child is autistic?

Answer:  The signs of autism are identified in early childhood when the child isolates themselves or faces speech difficulties or have a tendency of repetitive behaviour or phrases.

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Autism Spectrum Disorder

What is asd.

Autism spectrum disorder (ASD) is a neurological and developmental disorder that affects how people interact with others, communicate, learn, and behave. Although autism can be diagnosed at any age, it is described as a “developmental disorder” because symptoms generally appear in the first 2 years of life.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) , a guide created by the American Psychiatric Association that health care providers use to diagnose mental disorders, people with ASD often have:

• Difficulty with communication and interaction with other people
• Restricted interests and repetitive behaviors
• Symptoms that affect their ability to function in school, work, and other areas of life

Autism is known as a “spectrum” disorder because there is wide variation in the type and severity of symptoms people experience.

People of all genders, races, ethnicities, and economic backgrounds can be diagnosed with ASD. Although ASD can be a lifelong disorder, treatments and services can improve a person’s symptoms and daily functioning. The American Academy of Pediatrics recommends that all children receive screening for autism. Caregivers should talk to their child’s health care provider about ASD screening or evaluation.

What are the signs and symptoms of ASD?

The list below gives some examples of common types of behaviors in people diagnosed with ASD. Not all people with ASD will have all behaviors, but most will have several of the behaviors listed below.

Social communication / interaction behaviors may include:

• Making little or inconsistent eye contact
• Appearing not to look at or listen to people who are talking
• Infrequently sharing interest, emotion, or enjoyment of objects or activities (including infrequent pointing at or showing things to others)
• Not responding or being slow to respond to one’s name or to other verbal bids for attention
• Having difficulties with the back and forth of conversation
• Often talking at length about a favorite subject without noticing that others are not interested or without giving others a chance to respond
• Displaying facial expressions, movements, and gestures that do not match what is being said
• Having an unusual tone of voice that may sound sing-song or flat and robot-like
• Having trouble understanding another person’s point of view or being unable to predict or understand other people’s actions
• Difficulties adjusting behaviors to social situations
• Difficulties sharing in imaginative play or in making friends

Restrictive / repetitive behaviors may include:

• Repeating certain behaviors or having unusual behaviors, such as repeating words or phrases (a behavior called echolalia)
• Having a lasting intense interest in specific topics, such as numbers, details, or facts
• Showing overly focused interests, such as with moving objects or parts of objects
• Becoming upset by slight changes in a routine and having difficulty with transitions
• Being more sensitive or less sensitive than other people to sensory input, such as light, sound, clothing, or temperature

People with ASD may also experience sleep problems and irritability.

People on the autism spectrum also may have many strengths, including:

• Being able to learn things in detail and remember information for long periods of time
• Being strong visual and auditory learners
• Excelling in math, science, music, or art

What are the causes and risk factors for ASD?

Researchers don’t know the primary causes of ASD, but studies suggest that a person’s genes can act together with aspects of their environment to affect development in ways that lead to ASD. Some factors that are associated with an increased likelihood of developing ASD include:

• Having a sibling with ASD
• Having older parents
• Having certain genetic conditions (such as Down syndrome or Fragile X syndrome)
• Having a very low birth weight

How is ASD diagnosed?

Health care providers diagnose ASD by evaluating a person’s behavior and development. ASD can usually be reliably diagnosed by age 2. It is important to seek an evaluation as soon as possible. The earlier ASD is diagnosed, the sooner treatments and services can begin.

Diagnosis in young children

Diagnosis in young children is often a two-stage process.

Stage 1: General developmental screening during well-child checkups

Every child should receive well-child check-ups with a pediatrician or an early childhood health care provider. The American Academy of Pediatrics recommends that all children receive screening for developmental delays at their 9-, 18-, and 24- or 30-month well-child visits, with specific autism screenings at their 18- and 24-month well-child visits. A child may receive additional screening if they have a higher likelihood of ASD or developmental problems. Children with a higher likelihood of ASD include those who have a family member with ASD, show some behaviors that are typical of ASD, have older parents, have certain genetic conditions, or who had a very low birth weight.

Considering caregivers’ experiences and concerns is an important part of the screening process for young children. The health care provider may ask questions about the child’s behaviors and evaluate those answers in combination with information from ASD screening tools and clinical observations of the child. Read more about screening instruments   on the Centers for Disease Control and Prevention (CDC) website.

If a child shows developmental differences in behavior or functioning during this screening process, the health care provider may refer the child for additional evaluation.

Stage 2: Additional diagnostic evaluation

It is important to accurately detect and diagnose children with ASD as early as possible, as this will shed light on their unique strengths and challenges. Early detection also can help caregivers determine which services, educational programs, and behavioral therapies are most likely to be helpful for their child.

A team of health care providers who have experience diagnosing ASD will conduct the diagnostic evaluation. This team may include child neurologists, developmental pediatricians, speech-language pathologists, child psychologists and psychiatrists, educational specialists, and occupational therapists.

The diagnostic evaluation is likely to include:

• Medical and neurological examinations
• Assessment of the child’s cognitive abilities
• Assessment of the child’s language abilities
• Observation of the child’s behavior
• An in-depth conversation with the child’s caregivers about the child’s behavior and development
• Assessment of age-appropriate skills needed to complete daily activities independently, such as eating, dressing, and toileting

Because ASD is a complex disorder that sometimes occurs with other illnesses or learning disorders, the comprehensive evaluation may include:

• Blood tests
• Hearing test

The evaluation may lead to a formal diagnosis and recommendations for treatment.

Diagnosis in older children and adolescents

Caregivers and teachers are often the first to recognize ASD symptoms in older children and adolescents who attend school. The school’s special education team may perform an initial evaluation and then recommend that a child undergo additional evaluation with their primary health care provider or a health care provider who specialize in ASD.

A child’s caregivers may talk with these health care providers about their child’s social difficulties, including problems with subtle communication. For example, some children may have problems understanding tone of voice, facial expressions, or body language. Older children and adolescents may have trouble understanding figures of speech, humor, or sarcasm. They also may have trouble forming friendships with peers.

Diagnosis in adults

Diagnosing ASD in adults is often more difficult than diagnosing ASD in children. In adults, some ASD symptoms can overlap with symptoms of other mental health disorders, such as anxiety disorder or attention-deficit/hyperactivity disorder (ADHD).

Adults who notice signs of ASD should talk with a health care provider and ask for a referral for an ASD evaluation. Although evaluation for ASD in adults is still being refined, adults may be referred to a neuropsychologist, psychologist, or psychiatrist who has experience with ASD. The expert will ask about:

• Social interaction and communication challenges
• Sensory issues
• Repetitive behaviors
• Restricted interests

The evaluation also may include a conversation with caregivers or other family members to learn about the person’s early developmental history, which can help ensure an accurate diagnosis.

Receiving a correct diagnosis of ASD as an adult can help a person understand past challenges, identify personal strengths, and find the right kind of help. Studies are underway to determine the types of services and supports that are most helpful for improving the functioning and community integration of autistic transition-age youth and adults.

What treatment options are available for ASD?

Treatment for ASD should begin as soon as possible after diagnosis. Early treatment for ASD is important as proper care and services can reduce individuals’ difficulties while helping them build on their strengths and learn new skills.

People with ASD may face a wide range of issues, which means that there is no single best treatment for ASD. Working closely with a health care provider is an important part of finding the right combination of treatment and services.

A health care provider may prescribe medication to treat specific symptoms. With medication, a person with ASD may have fewer problems with:

• Irritability
• Repetitive behavior
• Hyperactivity
• Attention problems
• Anxiety and depression

Read more about the latest medication warnings, patient medication guides, and information on newly approved medications at the Food and Drug Administration (FDA) website  .

Behavioral, psychological, and educational interventions

People with ASD may be referred to a health care provider who specializes in providing behavioral, psychological, educational, or skill-building interventions. These programs are often highly structured and intensive, and they may involve caregivers, siblings, and other family members. These programs may help people with ASD:

• Learn social, communication, and language skills
• Reduce behaviors that interfere with daily functioning
• Increase or build upon strengths
• Learn life skills for living independently

Other resources

Many services, programs, and other resources are available to help people with ASD. Here are some tips for finding these additional services:

• Contact your health care provider, local health department, school, or autism advocacy group to learn about special programs or local resources.
• Find an autism support group. Sharing information and experiences can help people with ASD and their caregivers learn about treatment options and ASD-related programs.
• Record conversations and meetings with health care providers and teachers. This information may help when it’s time to decide which programs and services are appropriate.
• Keep copies of health care reports and evaluations. This information may help people with ASD qualify for special programs.

How can I find a clinical trial for ASD?

Clinical trials are research studies that look at new ways to prevent, detect, or treat diseases and conditions. The goal of clinical trials is to determine if a new test or treatment works and is safe. Although individuals may benefit from being part of a clinical trial, participants should be aware that the primary purpose of a clinical trial is to gain new scientific knowledge so that others may be better helped in the future.

Researchers at NIMH and around the country conduct many studies with patients and healthy volunteers. We have new and better treatment options today because of what clinical trials uncovered years ago. Be part of tomorrow’s medical breakthroughs. Talk to your health care provider about clinical trials, their benefits and risks, and whether one is right for you.

To learn more or find a study, visit:

• NIMH’s Clinical Trials webpage : Information about participating in clinical trials
• Clinicaltrials.gov: Current Studies on ASD  : List of clinical trials funded by the National Institutes of Health (NIH) being conducted across the country

Where can I learn more about ASD?

Free brochures and shareable resources.

• Autism Spectrum Disorder : This brochure provides information about the symptoms, diagnosis, and treatment of ASD. Also available  en español .
• Digital Shareables on Autism Spectrum Disorder : Help support ASD awareness and education in your community. Use these digital resources, including graphics and messages, to spread the word about ASD.

Federal resources

• Eunice Kennedy Shriver National Institute of Child Health and Human Development  
• National Institute of Neurological Disorders and Stroke  
• National Institute on Deafness and Other Communication Disorders  
• Centers for Disease Control and Prevention   (CDC)
• Interagency Autism Coordinating Committee  
• MedlinePlus   (also available en español  )

Research and statistics

• Science News About Autism Spectrum Disorder : This NIMH webpage provides press releases and announcements about ASD.
• Research Program on Autism Spectrum Disorders : This NIMH program supports research focused on the characterization, pathophysiology, treatment, and outcomes of ASD and related disorders.
• Statistics: Autism Spectrum Disorder : This NIMH webpage provides information on the prevalence of ASD in the U.S.
• Data & Statistics on Autism Spectrum Disorder   : This CDC webpage provides data, statistics, and tools about prevalence and demographic characteristics of ASD.
• Autism and Developmental Disabilities Monitoring (ADDM) Network   : This CDC-funded program collects data to better understand the population of children with ASD.
• Biomarkers Consortium - The Autism Biomarkers Consortium for Clinical Trials (ABC-CT)   : This Foundation for the National Institutes of Health project seeks to establish biomarkers to improve treatments for children with ASD.

Last Reviewed:  February 2024

Unless otherwise specified, the information on our website and in our publications is in the public domain and may be reused or copied without permission. However, you may not reuse or copy images. Please cite the National Institute of Mental Health as the source. Read our copyright policy to learn more about our guidelines for reusing NIMH content.

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• Fact sheets /
• Autism – also referred to as autism spectrum disorder ̶ constitutes a diverse group of conditions related to development of the brain.
• About 1 in 100 children has autism.
• Characteristics may be detected in early childhood, but autism is often not diagnosed until much later.
• The abilities and needs of autistic people vary and can evolve over time. While some people with autism can live independently, others have severe disabilities and require life-long care and support.
• Evidence-based psychosocial interventions can improve communication and social skills, with a positive impact on the well-being and quality of life of both autistic people and their caregivers.
• Care for people with autism needs to be accompanied by actions at community and societal levels for greater accessibility, inclusivity and support.

Autism spectrum disorders (ASD) are a diverse group of conditions. They are characterized by some degree of difficulty with social interaction and communication. Other characteristics are atypical patterns of activities and behaviours, such as difficulty with transition from one activity to another, a focus on details and unusual reactions to sensations.

The abilities and needs of autistic people vary and can evolve over time. While some people with autism can live independently, others have severe disabilities and require life-long care and support. Autism often has an impact on education and employment opportunities. In addition, the demands on families providing care and support can be significant. Societal attitudes and the level of support provided by local and national authorities are important factors determining the quality of life of people with autism.

Characteristics of autism may be detected in early childhood, but autism is often not diagnosed until much later.

People with autism often have co-occurring conditions, including epilepsy, depression, anxiety and attention deficit hyperactivity disorder as well as challenging behaviours such as difficulty sleeping and self-injury. The level of intellectual functioning among autistic people varies widely, extending from profound impairment to superior levels.

Epidemiology

It is estimated that worldwide about 1 in 100 children has autism (1) . This estimate represents an average figure, and reported prevalence varies substantially across studies. Some well-controlled studies have, however, reported figures that are substantially higher. The prevalence of autism in many low- and middle-income countries is unknown.

Available scientific evidence suggests that there are probably many factors that make a child more likely to have autism, including environmental and genetic factors.

Extensive research using a variety of different methods and conducted over many years has demonstrated that the measles, mumps and rubella vaccine does not cause autism. Studies that were interpreted as indicating any such link were flawed, and some of the authors had undeclared biases that influenced what they reported about their research  (2,3,4) .

Evidence also shows that other childhood vaccines do not increase the risk of autism. Extensive research into the preservative thiomersal and the additive aluminium that are contained in some inactivated vaccines strongly concluded that these constituents in childhood vaccines do not increase the risk of autism.

Assessment and care

A broad range of interventions, from early childhood and across the life span, can optimize the development, health, well-being and quality of life of autistic people. Timely access to early evidence-based psychosocial interventions can improve the ability of autistic children to communicate effectively and interact socially. The monitoring of child development as part of routine maternal and child health care is recommended.

It is important that, once autism has been diagnosed, children, adolescents and adults with autism and their carers are offered relevant information, services, referrals, and practical support, in accordance with their individual and evolving needs and preferences.

The health-care needs of people with autism are complex and require a range of integrated services, that include health promotion, care and rehabilitation. Collaboration between the health sector and other sectors, particularly education, employment and social care, is important.

Interventions for people with autism and other developmental disabilities need to be designed and delivered with the participation of people living with these conditions. Care needs to be accompanied by actions at community and societal levels for greater accessibility, inclusivity and support.

Human rights

All people, including people with autism, have the right to the enjoyment of the highest attainable standard of physical and mental health.

And yet, autistic people are often subject to stigma and discrimination, including unjust deprivation of health care, education and opportunities to engage and participate in their communities.

People with autism have the same health problems as the general population. However, they may, in addition, have specific health-care needs related to autism or other co-occurring conditions. They may be more vulnerable to developing chronic noncommunicable conditions because of behavioural risk factors such as physical inactivity and poor dietary preferences, and are at greater risk of violence, injury and abuse.

People with autism require accessible health services for general health-care needs like the rest of the population, including promotive and preventive services and treatment of acute and chronic illness. Nevertheless, autistic people have higher rates of unmet health-care needs compared with the general population. They are also more vulnerable during humanitarian emergencies. A common barrier is created by health-care providers’ inadequate knowledge and understanding of autism.

WHO resolution on autism spectrum disorders 

In May 2014, the Sixty-seventh World Health Assembly adopted a resolution entitled  Comprehensive and coordinated efforts for the management of autism spectrum disorders , which was supported by more than 60 countries.

The resolution urges WHO to collaborate with Member States and partner agencies to strengthen national capacities to address ASD and other developmental disabilities.

WHO response

WHO and partners recognize the need to strengthen countries' abilities to promote the optimal health and well-being of all people with autism. WHO's efforts focus on:

• increasing the commitment of governments to taking action to improve the quality of life of people with autism;
• providing guidance on policies and action plans that address autism within the broader framework of health, mental and brain health and disabilities;
• contributing to strengthening the ability of the health workforce to provide appropriate and effective care and promote optimal standards of health and well-being for people with autism; and
• promoting inclusive and enabling environments for people with autism and other developmental disabilities and providing support to their caregivers.

WHO Comprehensive mental health action plan 2013–2030 and World Health Assembly Resolution WHA73.10 for “global actions on epilepsy and other neurological disorders” calls on countries to address the current significant gaps in early detection, care, treatment and rehabilitation for mental and neurodevelopmental conditions, which include autism. It also calls for counties to address the social, economic, educational and inclusion needs of people living with mental and neurological disorders, and their families, and to improve surveillance and relevant research.

1 . Global prevalence of autism: A systematic review update. Zeidan J et al. Autism Research 2022 March.

2. Wakefield's affair: 12 years of uncertainty whereas no link between autism and MMR vaccine has been proved. Maisonneuve H, Floret D. Presse Med. 2012 Sep; French ( https://www.ncbi.nlm.nih.gov/pubmed/22748860 ).

3. Lancet retracts Wakefield’s MMR paper. Dyer C. BMJ 2010;340:c696. 2 February 2010 (https://pubmed.ncbi.nlm.nih.gov/20124366/)

4. Kmietowicz Z. Wakefield is struck off for the “serious and wide-ranging findings against him” BMJ 2010; 340 :c2803 doi:10.1136/bmj.c2803 ( https://www.bmj.com/content/340/bmj.c2803 )

Training for caregivers of children with development delays and disabilities

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Article Contents

Introduction, increase in prevalence of autism spectrum disorder, clinical presentation, dsm-5 changes in autism spectrum criteria, implications of changes in dsm-5 diagnostic criteria for autism spectrum disorder, gender related differences in autism presentation, aetiology of asd, controversial risk factors, controversial treatments and interventions, early diagnosis and intervention, future directions, conclusions, conflict of interest statement.

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Autism spectrum disorder

• Article contents
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Lisa Campisi, Nazish Imran, Ahsan Nazeer, Norbert Skokauskas, Muhammad Waqar Azeem, Autism spectrum disorder, British Medical Bulletin , Volume 127, Issue 1, September 2018, Pages 91–100, https://doi.org/10.1093/bmb/ldy026

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This article is based on key recent published literature including international guidelines and relevant reviews and meta-analyses. Authors have also supplemented this material with their own clinical experience.

There is an agreement that autism spectrum disorder (ASD) have a strong hereditary component. There is also a consensus that the reported prevalence estimates have increased in the last 5 years. There is strong support for using the broader spectrum disorder conceptualization of the DSM-5.

Higher public awareness of ASD has generated several controversial theories of causation. We review a number of environmental risk factors receiving media attention including: vaccines, mercury, heavy metal exposure and Selective Serotonin Uptake Inhibitors (SSRIs). Popular yet controversial treatment interventions are discussed. Early diagnostic screening tools are also addressed.

There is increasing scientific interest in identifying biomarkers of autism with potential for early diagnosis, prognostic indicators and predictive treatment responses. We review evidence from genetics, neuroimaging and eye tracking as candidate biomarkers.

Family studies point to a strong hereditary component in the aetiology of autism. However these studies have not established 100% concordance rates, suggesting a role for environmental factors. The gene–environment interplay has not received enough attention in scientific research. This represents an important new avenue for research in ASD.

Autism spectrum disorder (ASD) is one the most common neurodevelopmental disorders, 1 characterized by persistent impairment in reciprocal communication and social interactions as well as restricted repetitive pattern of behaviours, interests or activities. 2 Kanner 3 wrote the first published description of autism in 1943 and after one year, Hans Asperger, a paediatrician from University of Vienna wrote about a group of children with almost similar pattern of behaviours as Kanner’s. The disorder is evident in all racial, ethnic and socioeconomic groups. 4 The diagnostic process of ASD is complex and recent changes in diagnostic criteria and how the disorder is conceptualized has initiated a discussion among professionals, policy makers as well as patients and their families. 5 In order to ensure best standards of care for these individuals, it is important for clinicians to have a better understanding of the disorder. This review provides a broader understanding of research findings, highlights current areas of agreement and controversies, clinical implications as well as critical issues for the research.

There has been a dramatic increase in the prevalence of autism spectrum disorders, with current estimates of 1 in 68 children in the United States having ASD. 4 This figure is ~30% higher than what was reported in 2012 by the Center for Disease Control as 1 in 88 children having autism. However, it is unclear whether these numbers represent a true increase in prevalence, or are the result of increased awareness, differences in study methodology, or inclusion of subthreshold cases.

Autism is currently conceptualized as a spectrum disorder with significant variations in patients’ social, communicative and intellectual abilities. Symptoms lead to significant impairment in multiple domains of adaptive functioning. Individuals suffering from ASD need varying levels of psychosocial support to achieve relative independence, and in some cases, may need continuous care.

Social communication

Depending on age and intellectual abilities, children diagnosed with autism have a varying degree of communication deficits. These deficits range from speech delays, monotonous speech, echolalia, pronoun reversal, poor comprehension to a complete lack of spoken language. Nonverbal communication is also impaired and may include poor eye contact, difficulties in understanding facial expressions and descriptive gestures, to name a few.

Another important feature of individuals with ASD is deficits in socio-emotional reciprocity. These individuals are less likely to initiate conversation, show less interest in peer interactions and overall find it difficult to adjust their behaviour according to different social situations.

Restricted repetitive behaviours

Individuals with ASD have a varying presentation of restricted and repetitive behaviours. Repetitive behaviours may include simple stereotypical motor behaviour (e.g. hand flapping, finger flicking), repetitive use of objects (e.g. lining up toys), or repetitive speech (echolalia). Restricted behaviours may present as resistance to change or highly restricted fixated interests, which are abnormal in intensity or focus. Further, some children with ASD my present hyper and hyposensitivity to various sensory stimuli, presenting an extreme response to various sounds, lights or smells, or a decreased reaction to pain.

Associated clinical features

Individuals with ASD often have comorbid intellectual disability and also are prone to emotional difficulties such as anxiety or depression.

Comparison of changes in DSM-5 with DSM IV-TR in the diagnostic criteria of autism spectrum disorder

Differences in DSM-5 criteria for ASD in comparison to DSM-IV 6 have led to debates regarding the impact on the prevalence of the disorder, as well as the diagnosis, and subsequently clinical practice.

The DSM-5 taxonomy offers more stringent criteria for a diagnosis of ASD. 7 The literature raises concern that individuals who used to get the diagnosis of Asperger’s disorder, or Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS) under DSM-IV, are now less likely to meet criteria for the ASD diagnosis by using DSM-5 and therefore will not be eligible for services. 8 Studies also support the notion that young children and females 9 may be at higher risk of being underdiagnosed according to the DSM-5 criteria. 10 – 12 These results are of concern as children who are less impaired are more likely to benefit from early intervention, may now be least likely to qualify for such services.

It is however important to note before the publication of DSM-5, there was a growing consensus among clinicians that subcategories of pervasive developmental disorders in DSM IV cannot be reliably diagnosed. 9 , 13 Thus, despite the concerns of being a stringent criteria, efforts to conceptualize autism as a broad spectrum of disorders in the DSM-5 had met with less criticism by professionals. Several groups investigating the validity of shifting from a triadic model to a two-factor model (integration of impaired social interaction and limited social communication into one category) have also yielded support for it. 9 , 14

There are no significant differences in ASD core symptomatology between males and females. However, research consistently shows that females tend to have more severe symptoms, more associated intellectual disability, as well as higher risk of comorbid psychiatric problems. 15

There is a consensus in the literature that autism is caused by both genetic and environmental factors. Although family studies support a strong genetic component in the aetiology of idiopathic autism, concordance rates are not 100%, indicating that environmental factors also contribute to ASD. 16

Unproven risk factors cited in the literature

Measles, mumps and rubella

Few subjects in the field of autism have garnered greater attention and controversy than that of vaccines and their potential causal link to autism. The issue was first brought forward in 1998 after an article published in the Lancet 20 in which authors postulated a causal association between the measles, mumps and rubella (MMR) vaccine and the development of autism. The study involved a group of 12 children with a prior diagnosis of autism who had also received the MMR vaccine before being diagnosed with autism. In their investigation, the authors concluded that the children were found to have an unrecognized form of inflammatory bowel disease along with small traces of the measles virus that matched the strain of measles in the vaccine. These findings led to the interpretation that the MMR vaccine, which contains a live virus, had caused a measles infection in the gastrointestinal system which in turn led to a ‘leaky gut.’ Autism was hypothesized to be the result of toxins entering the blood stream via the gut and affecting the nervous system.

The outcome of this publication gained significant media attention, however an overwhelming body of scientific evidence has since been put forth refuting a relationship between ASD and MMR, 21 , 22 yet the issue remains controversial. The initial article published in Lancet on this topic was retracted in 2010 citing that ‘several elements’ of 1998 paper ‘are incorrect, contrary to the findings of an earlier investigation’.

Mercury and thimerosal

Another issue that added fuel to the vaccination controversy was thimerosal. Thimerosal, a mercury-based vaccine preservative is frequently found in combined vaccines, including diphtheria-tetanus-pertussis (DTP). Thimerosal contains 50% ethyl mercury, which is similar to methylmercury, which at high doses can be toxic to humans. 23 The controversy with thimerosal was not related to the MMR vaccine, given this vaccine never contained ethyl mercury. However, public scepticism with vaccination led to the viewpoint that high levels of thimerosal could lead to autism in children. A vast amount of scientific data on the topic has overwhelmingly disproven this claim. 24 Despite the lack of evidence and steps taken by public health officials to counteract these claims, this controversy has had significant consequences on childhood immunity and infectious disease control.

Heavy metal exposure

One meta-analyses 25 has examined metal concentrations in children with ASD. The heavy metals most commonly studied in this population have been cadmium, lead, arsenic and aluminium. There is little evidence to support a link between aluminium and ASD, whereas the evidence concerning the others is conflicting. The authors conclude that while there is evidence suggesting heavy metal exposure as a risk factor for the development of autism, data to conclusively support these claims is still lacking.

Air pollution is speculated to have neurological consequences including inflammation and oxidative damage in the brain that, in turn, leads to abnormal neural development. There is also some research suggesting that residing near a freeway or highway during the latter stages of pregnancy could increase the risk of a child developing autism. 26 Again, conclusive evidence supporting this claim is lacking.

Selective serotonin reuptake inhibitors

The evidence for a link between prenatal maternal selective serotonin reuptake inhibitors (SSRI) antidepressants exposure and ASD is relatively new and controversial and mainly relies on animal and preclinical studies. 27

The challenge of developing a universal theory on the aetiology of autism, along with variations in the developmental trajectory are some of the factors that account for the wide range of interventions proposed to, and endorsed by, families of children with ASD. At times, families sometimes turn to interventions which lack empirical validity or have even been found to be harmful to the child development. 28

In recent years, dietary interventions including gluten-free or casein-free diets (GFCF) have received a significant amount of interest from parents and researchers alike. In Europe, according to one report, 13.5% of families of children with ASD 28 have tried this dietary restriction. The rationale for this approach appears to stem from the ‘Opioid-Excess Theory’, 20 , 29 according to which some individuals do not produce sufficient gluten- and casein-related digestive enzymes. Without enough of these enzymes, gluten and casein-related peptides do not get adequately metabolized and cross the brain–blood barrier. Symptoms of ASD are believed to be the result of these peptides attaching to opioid neuro-receptors, which in turn disrupts the central nervous system. However, support for this theory, the underlying mechanism, and method of treatment is limited.

The ScanBrit study 30 examined the effects of a GFCF diet in Danish children and found positive changes in symptom presentation following this intervention. However, there were several limitations to this study, including the lack of a placebo group and a high attrition rate. In contrast, two recent systematic reviews 31 , 32 have since shown no significant differences in symptom relief in children with ASD following a GFCF diet.

Dietary supplements are another popular nutritional approach considered by parents and caregivers of children with ASD. These include mineral supplementation (e.g. calcium, zinc, iron), as well as folic acid. Vitamin D supplementation has received significant attention because of its impact on neural developmental, anti-inflammatory properties and effects on detoxification pathways. However, evidence supporting dietary and vitamin D supplementation is again limited and inconsistent. 33 , 34

Hyperbaric oxygen

Hyperbaric oxygen therapy (HBOT) provides a higher concentration of oxygen by delivering oxygen to a chamber with elevated atmospheric pressure. The rationale for HBOT in individuals with autism includes its potential to heighten cerebral perfusion, reduce inflammation and oxidative stress. 35 Advocates of HBOT believe that improvements in these underlying pathophysiological mechanisms will lead to improvements in autistic symptoms. Evidence supporting its effectiveness in relieving symptoms of ASD is mixed at best. The few randomized controlled studies 36 that have been conducted have shown no evidence to support the benefit of HBOT in children with ASD, with some identifying adverse events in the hyperbaric oxygen group (minor-grade ear barotrauma). The United States Food and Drug Administration (USFDA) 37 has published a warning for parents cautioning them against the use of HBOT in treating symptoms of ASD.

Chelation therapy

Chelation therapy involves the administration of several chemical substances to bind and then remove specific metals from the person’s body. It is estimated that between 7% and 8% of children with ASD in the United States 38 and 1–3% of children with ASD in Europe 28 undergo this form of therapy. However, one randomized clinical trial comparing multiple doses of chelating agents have found no evidence to suggest that oral chelating agents had any effect on ASD symptomatology. 39 Moreover, serious adverse side effects have been reported including hypocalcaemia and impaired renal function in individuals undergoing chelation therapy.

Pharmacological treatments

Medications are sometime needed to treat the comorbid symptoms of irritability, aggression, and hyperactivity in individuals of ASD. The FDA has approved two atypical antipsychotic medications, risperidone and aripiprazole for this purpose. 40 , 41 Although evidence has suggested short-term improvements in the behaviour of children with ASD, long-term benefits and pros and cons of this strategy are still being debated.

SSRIs are also often prescribed to treat comorbid symptoms in ASD, but clinical trials have yet to demonstrate their effectiveness. A review of nine randomized controlled-trials assessed various SSRIs including fluoxetine and citalopram 42 but failed to show a positive result in symptoms reduction.

Autism is a clinical diagnosis, made on the presentation and history of the individual and in spite of a very active hunt for biomarkers, no laboratory test has been found. The literature on early diagnosis and treatment is in agreement that there is an inverse relationship between age at diagnosis and a positive prognosis, which makes early detection by health care providers critical. A 10-year study spanning from 2004 to 2014 examined diagnostic trends in the UK 43 and found no statistical change in improving early detection during this period, with the average age at diagnosis remaining at 55 months. This was despite parents noting their first concern about their child development much earlier than the time when the child was diagnosed with ASD.

The American Academy of Pediatrics 44 , 45 has recommended that paediatricians use autism screening tools, such as the Modified Checklist for Autism in Toddlers (M-CHAT) and the Social Communication Questionnaire (SCQ) at the 18 and 24-month check-up visits. A newer, improved two-step revision of the M-CHAT with Follow-up Interview (M-CHAT/F), has been developed, and is reliable and sensitive in identifying toddlers at high, medium and low risk for ASD. 46 Data are still lacking to determine if an early detection has in fact improved following its implementation.

Early detection has a positive impact on prognosis, in large part due to the fact that those children are able to benefit from early intervention. A substantial amount of scientific literature is derived from data looking at the efficacy of Applied Behaviour Analysis (ABA). ABA is an intensive treatment programme, developed in the 1960s, based on using learning principles, such as positive reinforcement to help children develop appropriate behaviours. Over the last five decades, there has been accruing evidence documenting the effectiveness of ABA in treating ASD. 47 There is also evidence that those children who received earlier and more intensive ABA therapy, were more likely to have a positive prognosis in later childhood and adulthood. 48

Biological markers or biomarkers are defined as ‘biological variables associated with the disease of interest and measurable directly in a given patient or his/her biomaterials using sensitive and reliable quantitative procedures’. 49 The identification of early biomarkers of autism is important as it can be used in providing earlier, more reliable diagnoses, and helps to predict prognosis and response to specific interventions.

As noted earlier, there is strong support for a hereditary component to the presentation of ASD with higher concordance rates of autism in monozygotic twins than dizygotic twins. Some studies are also finding higher rates in families with two or more children diagnosed with autism, with rates approaching 50% affected. However, to date, no consistent genetic variant has been identified. Moreover, given its varied clinical and behavioural manifestations, it has been estimated that there are over 500 distinct genetic variants that may be related to ASD, 50 which makes it difficult to identify the target genes accurately.

Neuroimaging

Head circumference and grey matter thickness is under investigation as a relevant diagnostic indicator, given findings of accelerated brain growth and brain size in ASD children. Whereas newer neuroimaging techniques have helped to elucidate findings on the pathophysiology of ASD, the current scientific evidence on the subject is not adequate to establish reliable neuroimaging biomarkers. 51

Eye tracking

One promising technique is using the eye-tracking technology under the assumption that infants and toddlers with ASD prefer geometric images as compared to social images. One such study 52 examined a subset of children with ASD who fixated on the geometric images and concluded that visual preference might potentially be used as an early indicator in identifying subtypes with more severe symptoms and likely negative prognosis.

A common feature of autism research is that studies mostly consist of small samples and do not portray the full heterogeneity that is present in ASD. Given the various pathophysiological pathways that have been proposed to account for the development of this disorder, it is doubtful that a single biomarker is responsible for ASD. Furthermore, the heterogeneous features of ASD mean that different ASD patients have different requirements when it comes to treatments and interventions.

One large scale investigation aiming to address this issue is the EU‑AIMS Longitudinal European Autism Project (LEAP). LEAP is a worldwide, multidisciplinary study 52 that will include ASD and control participants across childhood and into adulthood collecting data on genomics, prenatal environmental risk factors, magnetic resonance imaging (MRI), functional MRI (fMRI), electroencephalogram (EEG) and biochemical biomarkers. The study holds promise not only in its potential to identify markers of autism but also to provide clinicians with predictive value in determining symptom progress and treatment response, which will also open up the possibility of targeted treatments.

As noted earlier, while there is a strong hereditary component thought to be involved in the aetiology of autism, environmental factors are also believed to play a role in its development. Some of the processes thought to be involved includes metabolic processes such as oxidative stress, immune function and inflammation. These processes are believed to be derived from environmental influences such as the parent’s immune functioning, pollutants, diet and other risk factors as listed above. The gene–environment interaction has received less attention than basic genetics, but future research using a developmental framework and taking into account the interplay between genes and their environment represents yet another scientific approach.

ASD is a complex and heterogeneous neurodevelopmental disorder. In the last decades, there has been a steep rise in public awareness on ASD that has also coincided with a rise in prevalence. Whether the rising prevalence is a true reflection of an increase in rates of ASD or due to other confounding factors, these findings highlight the need for further research into ASD, particularly with regards to its aetiology, treatments and interventions. Evidence from biomarker studies offers promising insight into early identification and targeted treatments, but research is still in its infancy. Supporting and empowering families with children diagnosed with ASD and helping highlight their children’s strengths can also help make a difference in these families’ lives. 53

The authors have no potential conflicts of interest.

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• neuroimaging
• environmental factors
• autistic disorder
• biological markers
• metals, heavy
• selective serotonin re-uptake inhibitors
• diagnostic and statistical manual
• autism spectrum disorder
• early diagnosis
• eye-tracking

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Jackie Schuld Art Therapy Blog

• Feb 17, 2023

The Great List of Autistic Essays

I’m a late-identified autistic who loves writing about autism. How much do I love it? I’ve written over 150 essays on it in the past six months alone.

How do I think of so many autistic topics to write about? I’m an art therapist who specializes in late-identified autistic adults. That means I not only have my personal experience to draw from, but also the hundreds of hours spent listening to my clients.

I share most of my essays here on Medium, which means it has now become quite the library. In an effort to make my essays more accessible to those wanting clear, relatable information about late-identified autism in adults, I’ve sorted my essays into topics below. While I wish I could provide a link to each of them for you… I’ve got to prioritize my time and energy. So if a specific essay interests you, just pop it into the search and it’ll come up

Autism in a Neurotypical World

What Would a World Designed by Autistic People Be Like

The Harm in "They're a Little Autistic"

Autism Does Not Directly Cause Socializing Problems

Please Trust My Lived Autistic Experience

Can Someone Please Create a Neurodivergent Intentional Living Community

What if I Accept that Most Neurotypicals Won't Like Me

How Neuro-Bias Shows Up in Professional Testing

Your Autistic Experience Sounds Just LIke my Neurotypical One

Neurotypical Words that Don't Work for Autistics: Overachiever

But Neurotypicals Experience That, Too!

Neurotypical Norms That Don’t Work for Autistics: Hustle Goals

The Fear of Being a Hypocritical Autistic

Neurodiversity: Us vs Them?

How to Meet an Autistic Adult Exactly Where They're At

Autism Characteristics

The Autistic Mind Loves to Take Detours

4 Reasons Why Autism Symptoms Lists are Confusing

My Autistic Brain: Sunshine and Detours

The Joys of Being Autistic: Part 1

Stop Saying Autistic People Can't Empathize

Redefining Fun for Autistic Adults

9 Reasons Why Autism Looks So Similar to CPTSD

We Need More Depictions of the Interior Experience of Autism

Clarity is What my Autistic Mind Craves

How Trauma and Autism Can be a Confusing Mix to Decipher

Why am I like This? Understanding the Autistic Brain

My Autistic Mind Does What it Wants

The Dissociated Autistic Performance State

The Joys of Being Autistic: Increased Creativity and Innovation

My Autistic Memory Is Not the Same as Others

The Firehouse Dilemma: Autism and Infodumping

The Variability of the Autistic Sensory System

5 Reasons Autistics are Especially Hard on Themselves

The Shame That Often Accompanies Autism

Knowing You’re Different as an Autistic Adult

3 Reasons Autism is Worse After You Learn You're Autistic

Disability and Internalized Ableism

I Had to Dismantle My Fear of Autistic People

Is Autism a Disability?

I’m Ok With Saying I have a Disability, Right?

Dog Training

The Difficulties of Adjusting to a New Dog When You're Autistic

Tips for Adjusting to a New Dog When You're Autistic

5 Tips to Integrate a Dog into Your Autistic Life

Defining and Explaining Autism

What I Wish Others Knew About Autism

Let’s Drop the “Disorder” From Autism Spectrum Disorder

How Low and High Autism Labels are Misleading

We Need All the Autism Theories and Models

Autism Can Be a Murky Thing To Understand

How I Explain Autism to Someone Unfamiliar With It

What is Late Identified Autism

Autistic Statistics are Not Accurate for Late-Identified Autistics

I'm Here for the Autistic Awakening

How It Helps to Know You’re Autistic

Why It Matters to Know You're Neurodivergent

What is Neurodiversity and Why Does it Matter

How Neurodivergent Acceptance Can Improve Our Lived Experiences

How Unidentified Autistics are Taught to Socially Camouflage and Mask

Is There a World Where I can Be Unmasked?

The False Dichotomy of Masked and Unmasked Autism

6 Reasons Why UnMasking Is Harder Than it Sounds

What if You have to Mask Everywhere?

My Personal Experience as an Autistic

Hating Cooking as an Autistic Adult

I Make Giant Lists About Autism for Fun

The Challenges of Writing Publically About Autism

The Risk of Sharing my Autistic Passions with Others

I'm Reclaiming Weird for My Autistic Self

I Expand and Then I Contract

I Stopped Seeing Myself As Broken When I learned I was Autistic

Respecting my Limits as an Autistic Business Owner

I Need to Lessen the Pressure on my Autistic Self

My Autistic Brain Doesn’t Want to Watch TV Right Now

Embracing Who I am as an Autistic Adult

I Used to be a Very Judgemental When I Didn’t Know I was Autistic

A Letter from An Autistic Adult to Trust

Don’t Get So Upset: A Line that Doesn’t Work for This Autist

Why This Autistic Writer Didn't Respond to Your Comment

Relationships

Is Dating Worth it as an Autistic Adult?

Is it Possible to be Happily Partnered as an Autistic Adult?

Not Liking People as an Autistic Adult

Self-Identification

So You Think You Might Be Autistic

Dearly Newly Identified Autistic Person

Am I Actually Autistic?

Dearest Smart, Weird, and Caring Autistic

I Am Deeply Unsure About Autism

How to Self Identify Autism as an Adult

When the Past Makes Sense after a Late-Identification of Autism

Where to Start When You First Learn You’re Autistic

6 Strategies to Harness the Hyperfocus Power of an Autistic Mind

Leave the Gremlin In the Cave: Self-Isolation as a Necessary Autistic Tool

No Plans Days as an Autistic Tool

Making Accommodations for Myself as an Autistic Adult

How Many Accommodations Can We Ask for as Autistic Adults?

Using Art to Help Your Autistic Mind

Dissociation as an Autistic Tool

The Power of the Home Environment for Autistics

Is It Ok to Honor My Autistic Needs?

Recognizing When It's Not Time to Make Decisions as an Autistic

Therapy for Autistics

Dearest Autistic Client of Mine

8 Ways Therapy Can Help With Late Identified Autism

Gaslighting the Autistic Experience

Dearest Therapist Who Knows Barely Anything About Autism

I'm an Autistic Therapist: Sometimes It's Easier Than Everyday Life

Does Your Therapist Know Enough About Autism to Help You?

Questions to Ask a Potential Therapist When You're Autistic

How I Work with Newly Identified Autistic People

What to Ask When You're Seeking Therapy for Late-Identified Autism

12 Ways Therapy Can Enhance Life for Late Identified Autistic Adults

Therapy is Not for Fixing Autism

The Harm I Caused When I Didn't Know about Autism

A Newly Identified Autistic Therapist Working with Newly Identified Autistics

Common Therapy Advice That is Counterproductive for Autistics

A Therapist Told Me Treating Autism is Like Treating Depression

Who Can Diagnose Autism in Adults?

Autistic Adults Deserve Better from the Mental Health Field

Undiagnosed Autism

The Correlation Between Intelligence and Undiagnosed Autism

10 Consequences of a Life with Unidentified Autism

The Gap Between “Diagnosable Autism” and a Lifetime of Unidentified Autism

Autism Diagnosis Criteria are Limiting for Men Too

No Autistic Should Receive a Diagnosis Letter Like Mine

Identifying Autism in Undiagnosed Women Abstract

How I Identify Autism in Undiagnosed Women

Autistic Stereotypes Block People From Knowing They're Autistic

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165 Autism Essay Topic Ideas & Examples

Struggle with writing a research paper topics on autism? We’ve got your back covered! Below, you will find a list of 147 topics about autism as well as autism research paper examples!

🏆 Best Research Autism Topics & Essay Examples

👍 good autism essay topics, 💡 psychology research autism topics to write about, ⭐ simple & easy autism essay titles, ❓ research questions about autism.

• Autism Spectrum Disorder (ASD) Autism is a serious disorder that has the potential to disrupt the success of people living with it. This is to mean that the theory of causation regarding autism is not complete as yet.
• Exploring Autism in the Drama Film Rain Man Charlie Babbitt, the brother to Raymond, is the actor who portrays Raymond’s autism on the way to Los Angeles to secure his fair share in the Babbitt’s $3 million fortunes in form of inheritance.
• Analysis of Children Autism in “The Black Balloon” It is imperative to note that Charlie’s emotions are not regulated and as such, manifest in immature behaviors such as flapping of his hands.
• Autism: Characteristics, Prevalence and Interventions The symptoms of autism are noticeable in the early years of childhood. Occupational therapy is one of the non-educational interventions used to assist kids with autism.
• How Does Having a Child With Autism Affects Parents’ Lifestyle? The creation of a system of psychological, pedagogical and social support can reduce the risk of a complete family life dedication to a child with autism.
• Autism. Child and Family Assessment The other common disorder associated with autism is that of mutism whereby it also lies under the category of speech disorder and in many cases it is difficult to be diagnosed and at the same […]
• Bright Not Broken: Gifted Kids, ADHD, and Autism It is possible to state that the book provides rather a high-quality review of the issues about the identification, education, and upbringing of the 2e children.
• Critical Analysis of Published Articles: Autism It was therefore the goal of the research to find out if the negative attitude of people towards autistic children can be altered to the benefit of the parents.
• “Let Me Hear Your Voice: A Family’s Triumph Over Autism” by Catherine Maurice The book was published in 1994, and it was a success as parents of autistic children were waiting for someone to prove that autism was not an incurable disorder.
• Inclusion Curriculum for Children With Autism In the given paper, the issue of children autism, the developmental issues that autism triggers and the educational prospects for children with autism are going to be considered.
• Applied Behavior Analysis and Autism The primary subject of this study is applied behavior analysis while the secondary subject is applied behavior analysis and its effects on autism in children.
• One-To-One Programs: Supporting Autistic Children The purpose of conducting this essay will be to examine the educational intervention of one-to-one support programs during normal school times within a mainstream classroom and also to discuss the challenges faced by teachers and […]
• Autism Spectrum Disorder and Interventions However, the negative side of it is that such an intervention is limited to those patients who are verbal and have limited vocabulary.
• Impact of Autism Disorder on Adolescents This essay discusses the impact of autism disorder on adolescents in the community and a nursing intervention that can be used to assist adolescents in becoming prominent society members.
• Progression of Reading Ability in a Child Diagnosed With Autism The battery of assessments and interviews with parents on the participant’s socialization and early reading ability indicates the study applied the Psychometric and Social Contextual approaches.
• Analysis of Behavior of Preschool Age Child With Autism The child’s behavior in the video differs from that of a mentally healthy child, and these differences lie in the child’s other emotional state and degree of interest in talking to people.
• Autism and Disability Advocacy People with autism can contribute to the diversity of disability culture by expanding understanding of what disability is and how it can be accepted.
• Autism Spectrum Disorder Diagnosis According to DSM-5, to fit the diagnostic criteria for ASD, a child must have evident deficits in three major areas of social communication as well as 2 out of the 4 restricted or repetitive behaviors.
• Thinking in Pictures: Autism and Sensory Problems The chapter “The Squeeze Machine: Sensory Problems in Autism” in Grandin’s Thinking in Pictures presents a series of life perspectives of various individuals, including her own, regarding the sensory problems they experienced. They postulated that […]
• Therapeutic Programs for Children With Autism in K-12 Institutions In the paper, the gaps in the research of effective treatments for children with ASD are explored, after which the efficacy of a multi-system aquatic therapy and standardized equine-assisted therapy program is argued.
• Societal Issue Research Project: Autism Spectrum Disorder The first factor is the significant risk that the genetics of siblings who had ASD diagnosis will increase the chance of the disorder.
• Child-Centered Play Therapy and Autism The purpose of the discussed research was to investigate the effects of CCPT on the sample of children with autism, establishing and describing the connection between CCPT and social and emotional growth.
• Children With Autism Spectrum Disorder: The Training Program for Caregivers The latter means that many caregivers take care of children with ASD, hence the importance of equipping them with the necessary skills for effective and smooth parenting and coping with various difficulties.
• Autism Spectrum Disorder’s Impact on Child’s Learning In regards to the public-school setting, standardized testing demands youngsters to grasp and react to spoken as well as written communication at an anticipated pace and level.
• Laboratory Diagnosis of Autism Spectrum Disorders The purpose of my study is to discover which of these methods is more accurate, with the reason being the importance of early diagnosis of ASD, which leads to better treatment outcomes.
• Autism and Related Cognitive Concepts It has been suggested that children with autism show a general deficit of cognitive skills in multilevel planning and in the regulation of behavior.
• Bullying and Autism Spectrum Disorder In fact, bullying as a social phenomenon can be characterized as a social and interaction issue; therefore, it is possible to analyze the connection between autism and acts of bullying and inappropriate behavior.
• Face Emotion Recognition in Autism Phenotype One critical aspect of social communication is the capability to apprehend the emotions and intentions of another person. In conclusion, Autism Spectrum Disorder makes the interpretation of facial expressions difficult.
• Misrepresentation of Autism in the ‘Music’ Film While the film was not centered on the topic of autism as its message, the stereotype-heavy portrayal and a lack of research make it a harmful piece of media.
• Autism Spectrum Disorder Prevalence and Impact in Society It has therefore been impossible to determine the level of increase in autism cases that is as a result of improved diagnostic measures and that which can be attributed to the real increase in autism […]
• Autism Spectrum Disorder: Diagnosis, Impact, Treatment The main diagnostic element for ASD is the evidence of difficulties, either in the present or past, which are different across the age groups.
• Autism and Vaccination Refusal Management Among Somalian Parents Somalian parents in their community in Minnesota refuse from their children being vaccinated, as they believe that vaccination causes autism.
• Everyone Has the Power to Effect Positive Change Within the Autism Community This paper presents what is autism, how every one reacts to the problem, what is the difference between the rich and the poor in their response towards the problem.”Autism is one of five developmental disorders […]
• Reducing Off-Task Behaviors Using a Token Economy System in Children With Autism Token economy is a strategy of positive reinforcement that can be provided to children in the form of tokens for completing the assigned tasks.
• Autism Spectrum Disorder: Key Points The requirement to meet these needs is supported by the fact that the rate of students with ASD is high: according to the Australian Institute of Health and Welfare, more than 83 per cent of […]
• “Theoretical Aspects of Autism” by Helen Ratajczak On the whole, it is possible to say that the standards set by Austin Hill cannot be always met, in part because the physiological aspects of this disease have not been fully investigated.
• Dr. Temple Grandin’s Argument on Visual Thinking and Autism A more in-depth analysis of visual activities can reveal the all imagery can be mentally processed and modified by children so that images are rotated and analyzed to make the brain map expand.
• Intellectual Disability: Autism In their adulthood, and because of the communication issues that most individuals with autism tend to have, they will naturally have difficulty in finding and keeping jobs.
• Hyperbaric Oxygen Therapy for Children With Autism On the positive side, it fastens the production of different types of reactive oxygen used in the body. It is arguable that the size of the samples used in the study was small.
• Occupational Therapy for Children With Autism The main reason for the appearance of autism is the disturbance of the development of the patients brain which results in the appearance of various symptoms.
• The Mitochondria and Autism – Results and Main Function The results are important in health because children with autism were more probable to have dysfunctions and abnormalities of the mitochondria such as over replication and deletion of mitochondrial DNA compared to those without the […]
• Autism Etiology, Symptoms, Beliefs, and Management To date, debate on the cause or etiology of autism still remains divided, with extant literature demonstrating that “although many hypotheses have been proposed, a singular or specific combination of causes has yet to be […]
• Quantitative Assessment of Neuromotor Function in Adolescents With High Functioning Autism: Critique The study authors did not give the benefits and/or risks associated with the study participation. The authors indicated that the ZNA was appropriate for collecting the data because it could measure the 11 parameters of […]
• Critical Appraisal on the Impact of Autism Spectrum Disorders on the Family: A Qualitative Study of Mothers’ Perspectives The study researchers established the significance of the study by outlining the social and financial implications of taking care of children with ASD.
• Autism: External Forces, Causes and Treatment The increasing prevalence of Autism in the United States and across the world is attracting great attention from the healthcare sector to design critical programs tailored to stem the disorder in terms of prevention, treatment, […]
• The Importance of Services for Children With Autism The plea of the majority of Americans for the reverse of healthcare budget allocation is well because it is wrong to interfere with services offered to children with autism. With childcare initiative in place, the […]
• Autism: General Information and Treatment She argues that the treatment of autism is through scientific proven medication that aids in controlling aggressive behaviors and that Trisperidone is the commonly used antipsychotic.
• The Issue of Autism: Task-Group Project The role of B.N.in the meeting can be seen as a summarizer, providing a summary of the minutes of the previous meeting.
• Concepts of Autism and Williams Syndrome The disorder manifests itself in the early years of a child’s life, with long-lasting effects that are not curable but controllable and easy to deal with on condition that, the concerned parties take the necessary […]
• Autism Programs to Enhance Students’ Outcomes In addition to social and behavioral challenges, ASD typically hinders a learner’s ability to gain and process the necessary academic information.
• Autism Program’s Impact Across Contexts In other words, a detailed overview of the issues that administrators face when designing the program and which the teachers have to deal with when addressing the needs of children with autism must be carried […]
• Autism: Teaching Plan for Taking All the Features Into Account For the first child, caregiver training was done at child’s bedroom, and for the second child it was done at living room, and for the third child with severe mental retardation it was carried out […]
• Education Considerations for Students With Autism Two articles under consideration consider the opposite views regarding the education of students with autism; on the basis of the information obtained from these articles, it can be stated that none of the perspectives is […]
• Developmental Psychology: Autism and Vaccination Vaccination of infants is widely used today as the pattern of endemic diseases can be explained in terms of interplay of social, physical and biological factors in an area that is conducive to a continuous […]
• Social Work Methods to Treat the Child Who Is Suffering From Autism This is a clear indicator that alcohol intake by the family is costing the members and it is an issue that needs to be looked into.
• Autism and Immunization: Vaccines and the Changing Epidemiology The interest and attention invoked by this paper were largely due to the fact that it appeared to provide a biological means through which MMR vaccine resulted in autism.
• The Autism-Vaccine Debate, Arguments, and Research Autism is defined by the Autism Society of America as ” a complex developmental disability that typically appears during the first 3 years of life and is the result of a neurological disorder that affects […]
• Autism and False Belief in Psychology The theories are found to be covering the deficits of an individuals’ mind and factors relating to autism, research further indicates that a child’s behavior may be influenced by the executive functions this, therefore, brings […]
• Autism: Symptoms, Forms, Diagnostic Instruments Autism is basically a developmental disorder of the human brain that its first symptoms are initially manifested in infancy and it follows a steady cause without relapse.
• Autism Spectrum Disorder Features in Children One of the causes for the appearance of these issues is an inborn disability that might presuppose the need for specific methods to educate a child and guarantee a chance for integration with society.
• Autism Occurrence by Measles Vaccine Status The organization of information in the text follows a logical format by introducing the background for the vaccine, incorporating the issue of ASD connection, and leading up to the primary research question.
• Parental Report of Vaccine Receipt in Children With Autism Spectrum Disorder In the introduction, which is the first section, the study’s research problems and their significance to nursing are stated. The discussion section covers how the authors relate the findings to the research objective and the […]
• Teenagers With Autism Disorder Autism is seen as a spectrum disorder since its severity and symptoms vary greatly among affected individuals – from mild and occasional to persistent and interfering with all aspects of life.
• Impact of Autism Spectrum Disorders on Life However, between the ages of two and three, his lack of verbal activity and inability to “echo” simple sounds and syllables were found to be very concerning by the family.
• Autism Should Not Be Viewed as a Disability A good example is that the treatment of autism as a mental disorder makes it possible for pharmaceutical companies and clinics to invent new health systems or procedures that will meet the needs of the […]
• Autist Student’s Behavior and Remedial Plan In the process of reading, I would pay attention to the student’s concentration and ability to integrate what she was reading. She also took long in doing this and did not want to stop the […]
• Autism Treatment, Its Methods and Results It was appropriate to focus on the use of the DSE intervention and examine if addressed most of the challenges facing many ASD patients.
• Autism Spectrum Disorder: Programs Effectiveness The purpose of this PE, therefore, is to evaluate and analyze the efficiency of the programs implemented by the Day Support Services.
• Students With Autism Spectrum Disorders The main goal of this paper is to present a review of relevant literature addressing the issue of helping college students with ASD prepare for workforce readiness and job placement.
• Autism Treatment Network in the PEACE Program In order to use these resources in PEACE, it is necessary to establish a budget that will cover expenditures on training courses for specialists involved in the program, educational materials, seminars, and individual counseling.
• Association Between Vaccination and Autism The study examined whether there is a link between the toxic effects of exposure to thimerosal-containing vaccines and the risk of developing ASD.
• Olfaction and Autism Spectrum Disorder Relationship These findings reveal that the sniff test can reveal both the presence and severity of ASD in young children. The link between ASD and olfaction can be used in diagnosing young children with autism.
• Abu Dhabi Autism Center The Abu Dhabi Autism Center has to operate within the laws and regulations of the Zayed Higher Organization for Humanitarian Care and Special Needs.
• Applied Behavior Analysis Treatment for Autism It is the most commonly applied autism treatment remedy in the United States and several other countries in the world and the major method that schools and therapists embrace and use.
• Involving Adults With Autism Plus Learning Disability Since the method is interviewing, a particular aspect of the study that should be addressed with attention is the researchers’ perspective.
• Inclusive Education: Child With Autism and Spina Bifida It is worth mentioning that Ted’s mother is willing to cooperate with teachers, and her participation can be of great assistance to the teacher.
• Children With Autism’ Communication in Saudi Arabia Parents of children with autism in Saudi Arabia have complained that the government has neglected the needs of autistic children by failing to finance their education and research to detect the effectiveness of the digital […]
• Autism Spectrum Disorders: Testing and Measurement It will begin with the rationale that explain why the issues are critical, followed by the reasons for unavailability of the solutions to the issues and the consequences of the issues.
• Autism Spectrum Disorders and Educational Interventions From this point, this paper aims to discuss the definition of Autism Spectrum Disorders, examine the etiology and incidence of the disorder, focus on the prevalence of autism, and analyze the effectiveness of the DTT […]
• Autism Expressed: Branding Strategy and Marketing The promise that the brand offers to the public should be in line with the desires of the clients. This firm will need to prepare this branding strategy in a way that will meet its […]
• Vaccines and Autism: Separating Facts From Fiction The advocacy groups say that thimerosal, a preservative used in vaccines, is toxic to the central nervous system and responsible for an alarming rise in rates of autism among children in the United States and […]
• Lesson for Learners With Autism: Reflection Observation The essay identifies the instructional methods used by the teacher during the exercise. The teacher also guided the learners to solve the mathematical problems using different visual objects.
• Autism Spectrum Disorder Concept Besides, Temple often explores her own experiences and attempts to understand the feelings of others that are unavailable to her by visualizing herself as other creatures people and animals.
• Dubai Autism Center’ Quality Management TQM employs strategies and effective communication within the organization to incorporate the quality principles into the culture and activities of the organization to ensure that all the activities are geared towards satisfying the customers.
• Vaccination and Autism in Children The problem with this case is that while it may be true that the cause for the development of autism in children have yet to be fully determined, the fact remains that there have been […]
• Video Modeling for Individuals With Autism The video model will be developed according to the needs of autistic children, with the focus on the role of visual and auditory stimuli in the teaching process.
• The Effects of Vaccines on Autism From their study, the findings demonstrate that the presence of thimerosal is one of the causes of the disorder. It is imperative to state that they have used many studies that have indicated that there […]
• Vaccination as a Cause Autism This paper borrows on the arguments of Monica Prasad and Washington and Haydn when they argue that the belief about vaccinations as a primary cause of autism stems from emotional, psychological, and behavioral barriers, as […]
• Youth With Autism Disorder: Education and Employment This includes the communication patterns of the teenager, the extent of social relations and the unusual behavioral characteristics of the teenager in the environment.
• Autism Children Education Inclusion Policy in Private Schools: Compulsory Enrollment Policy 2011 The following are the main areas will be addressed by the policy: Prohibited Private schools will be prohibited from ignoring the needs of children suffering from autism; they will be compelled by the act to […]
• Autism: Pathogenesis and Intervention Similarly, a person with autism has to be trained on the process of communicating normally and forming a relationship with objects, events and people in their lives.
• The Real Causes of Autism However, the main problem is that this association or correlation does not imply that autism is triggered by a vaccine. This is the main argument that can be put forward.
• Autism. Sensory Integration. Tactile Desensitization The poor development that is recorded at the early stages in life is likely to affect the development of different skills by the individuals even in the adult stages The signs that are associated with […]
• Autism Effect on Children It is crucial to understand the behavior of children with autism in the school set up in order to understand how autism affects children and their social interactions. It is up to the teacher to […]
• Autism and Its Effects on Social Interaction The article “Social Impairment in Children with Autism Spectrum Disorder” identifies the major challenges facing many people with autism. The authors wanted to examine the social problems and difficulties encountered by individuals with Autism Spectrum […]
• Older Dads More Likely to Have Kids With Autism The author highlights autism as one of the main outcomes of late fatherhood following the release of the results of a study involving the counting of the mutations corresponding to a father’s age at the […]
• Evidenced-Based Practice: Autism Management in Children Autism largely is connected to communication abilities of a child, a situation that later results into the child experiencing disability problems in effectively encoding and decoding communicative messages.
• Miami Dance Project for Autistic Children For me, what the Miami dance project represents is in line with what is known as the concept of confidence building wherein through the development of certain talents children with autism will begin to have […]
• Autism Spectrum Disorders and Family Impact One of the greatest fears of a parent with such a child is the fact that such a child would be taken care of until the advanced stages of their lives.
• Program Models in Autism The DTT technique has been designed in such a way as to target the individual behavior of an autistic child using the available curriculum.
• Autism Spectrum Disorder in Relation to Education Attending to students having ASD in the regular classrooms requires specialized teachers and supplementary staff in order to aid in the realization of the needs of the students having ASD.
• Autism in Saudi Arabia This support may come in the form of modification of the curriculum to cater for the special needs of the autistic children.
• Analysis of Autism Disorder This disorder affects the brain of the child during growth so that it does not develop in the right way thus affecting the social and communication skills of the child. This is especially to the […]
• Psychological Disorders and Their Treatment: An Overview of the Recent Progress and the Current Challenges in Treating Autism in Children In the given paper, the issue of psychological disorders is being addressed in reference to the ideas expressed in Chapter 11 “Psychological Disorders” in Carole Wade and Carol Tavris’s Invitation to Psychology.
• Early Intervention for Young Adults With Autism This is due to unavailability of information on children development stages and the importance of early detection and intervention in the case of autism.
• Different Behaviors in Children With Autism The purpose is to find out whether the co morbidity changes with the environment, and assess the influence that the environment has on the behavior of an autistic child.
• Diagnosis and Treatment for Autism Disorder Children with autism are therefore able to reason and even interpret the feelings of other people but the challenge is to communicate the response to other people.
• Autism: Qualitative Research Design Golafshani continues to argue that the use of the term “dependability” in qualitative studies is a close match to the idea of “reliability” in quantitative research.
• Autism Spectrum Disorder However, the reality is that the number of children with autism and having high intelligence is insignificant. It is apparent that, in autism, a disorder is found in the structure of the brain.
• Vaccines and Autism: A Critical Analysis of Thimerosal in Relation to Measles, Mumps, and Rubella The safety and efficacy of vaccines has been the subject of many studies in the medical field. The disorder was observed in one participant from each of the cohorts in the experiment.
• How to Recognize and Teach Students With Autism If these groups of students have to be given directions that are more than three steps, the directions have to be written down due to their inability to remember sequences.
• Autism and Visual Thought Suprisingly the quality of visual thinking according to Bogdashina is dependent on other factors like time and the state the autistic person is in.
• Autism and Educational Process Owing to these adverse effects that can stem from autism and the shear prevalence of the condition in the country’s population, a lot of research effort has been dedicated to the early diagnosis and treatment […]
• Do Vaccines Cause Autism? Thimerosal is alleged to increase the exposure of mercury in the vaccine to a substantiated high amount. In fact, the amount of antigens between children with autism and without is the same irrespective of the […]
• Language Development Problems in Children: An Indicative Characteristic of Autism This is because it is a time when it is expected that a majority of the kids should be able to talk.
• The Disease of Autism Origin The disorder is one of the new diagnoses of the autism. Other effects of the disorder are constipation and growth failures that may be a problem to the lives of the individual.
• Autism Spectrum Disorder in Children and Its Impact on the Family Manning, Wainwright and Bennet argue that children with autism are faced with a big challenge because of the nature of the symptoms the disorder.
• Autism’s Teaching Tips for Children and Adults The present description is concerned with the role of teacher in the better management of Autism in children. Further, assessment of the interactive and developmental skills is on of the important component in the teacher […]
• How Christopher’s Autism Affect His Life In spite of the fact that the issue of autism is not clearly explained in the story, the condition of the narrator is referred to as high-functioning autism or Aspersers Syndrome on the cover of […]
• What Are Autism Spectrum Disorders?
• How Does Autism Affect the Person With It and Those Around Them?
• What Are the Barriers of Learning for a Learner With Autism/Aspergers in Performing Arts?
• Does Gluten Effect Children With Autism?
• What Are the Causes of Autism?
• How Does Autism Affect a Child’s Educational Performance?
• What Can Autism Look Like and Things You Can Do to Spot It?
• Can Children With Autism Develop a Theory of Mind?
• Which Interventions Reduce Anxiety in Autistic People?
• What Influence Has the Development of Autism Had on a Diagnosed Individual?
• How Does Autism Affect the Development of a Child?
• Are Huddles the Missing Piece of the Puzzle in Implementing Clinical Innovation for the Eating Disorder and Autism Comorbidity?
• How Does Autism Start?
• Can Mouse Imaging Studies Bring Order to Autism Connectivity Chaos?
• How Does ‘Fake News’ Affect Autism Policy?
• Are There Any Relationships Between Latent Toxoplasma Gondii Infection, Testosterone Elevation, and Risk of Autism Spectrum Disorder?
• How Do People With Autism Experience the World?
• Can Robotic Systems Promote Self-Disclosure in Adolescents With Autism Spectrum Disorder?
• How Did the Media Perpetuate the Autism-Vaccine Scare?
• Are There Cultural Differences in Parental Interest in Early Diagnosis and Genetic Risk Assessment for Autism Spectrum Disorder?
• How Can the Therapist Help Autism Children?
• Can Vaccinations Cause Autism?
• Does Autism Spectrum Disorder Affect People All Around the World?
• Is There a Correlation Between Epigenetics and Autism Spectrum Disorder?
• How Does Autism Affect Regular Brain Functions as Well as Socialization Skills?
• What Can Responses to Music in Autism Tell Us About the Nature of Musical Emotions?
• Why Has the Incidence Rate of Autism Increased?
• What Are the Most Effective Ways to Support/Provide Social Care For Autistic Adults?
• Which Interventions Are Effective in the Development of Communication/Language Skills in Autism?
• How Can Parents and Family Members Be Supported/Educated to Care For and Better Understand an Autistic Relative?
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Home — Essay Samples — Nursing & Health — Autism — The Definition and Characteristics of Autism spectrum disorder (ASD)

The Definition and Characteristics of Autism Spectrum Disorder (asd)

• Categories: Autism

About this sample

Words: 3683 |

19 min read

Published: Oct 17, 2018

Words: 3683 | Pages: 8 | 19 min read

Table of contents

Onset and population of asd, history of autism – introducing the pioneers, asperger’s syndrome and high functioning autism (hfa), pervasive developmental disorders (pdd), suspecting asd and seeking support immediately (sassi), solutions for cognitive problems, solutions for social problems, solutions for behavioral problems, recommendations for disabled students.

• Myth: poor eye contact by people who are faced ASD
• Fact: they express their personality in a different way more or less than a typical child’s
• Myth: people with ASD have a preference to be lonely
• Fact: another way they may be interrelated with others but they not have social abilities to do so efficiently
• Myth: they do not have feelings and care about others
• Fact: They progression their mindset in a different and or tricky way and People with ASD do in fact have emotional feelings but they do not have the ability to unexpectedly attach and build up a connection.

The Autism Spectrum Disorders

• Asperger’s syndrome and High Functioning Autism
• Pervasive Developmental Disorders
• Pervasive Developmental Disorder Not Otherwise Specified
• Atypical Autism

Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS) and Atypical

Seek support services, conduct lead screening, perform formal auditory assessments, conduct autism screening.

• Demonstrate/model/act out instructions; use hand signals
• Put instructions in the same place always.
• Complete the first examples with students.
• Replicate instructions after allowing 10 seconds for processing time; speak gradually and clearly, modify tone and pace.
• Give extra time and resources.
• Simplify; analyze tasks and break them into small steps
• Involve students in presentations.
• Teams teach.

Applied Behavior Analysis (ABA)

Teacch (treatment and education of autistic and related communication handicapped children).

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• Patient Care & Health Information
• Diseases & Conditions
• Autism spectrum disorder

Autism spectrum disorder is a condition related to brain development that impacts how a person perceives and socializes with others, causing problems in social interaction and communication. The disorder also includes limited and repetitive patterns of behavior. The term "spectrum" in autism spectrum disorder refers to the wide range of symptoms and severity.

Autism spectrum disorder includes conditions that were previously considered separate — autism, Asperger's syndrome, childhood disintegrative disorder and an unspecified form of pervasive developmental disorder. Some people still use the term "Asperger's syndrome," which is generally thought to be at the mild end of autism spectrum disorder.

Autism spectrum disorder begins in early childhood and eventually causes problems functioning in society — socially, in school and at work, for example. Often children show symptoms of autism within the first year. A small number of children appear to develop normally in the first year, and then go through a period of regression between 18 and 24 months of age when they develop autism symptoms.

While there is no cure for autism spectrum disorder, intensive, early treatment can make a big difference in the lives of many children.

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Some children show signs of autism spectrum disorder in early infancy, such as reduced eye contact, lack of response to their name or indifference to caregivers. Other children may develop normally for the first few months or years of life, but then suddenly become withdrawn or aggressive or lose language skills they've already acquired. Signs usually are seen by age 2 years.

Each child with autism spectrum disorder is likely to have a unique pattern of behavior and level of severity — from low functioning to high functioning.

Some children with autism spectrum disorder have difficulty learning, and some have signs of lower than normal intelligence. Other children with the disorder have normal to high intelligence — they learn quickly, yet have trouble communicating and applying what they know in everyday life and adjusting to social situations.

Because of the unique mixture of symptoms in each child, severity can sometimes be difficult to determine. It's generally based on the level of impairments and how they impact the ability to function.

Below are some common signs shown by people who have autism spectrum disorder.

Social communication and interaction

A child or adult with autism spectrum disorder may have problems with social interaction and communication skills, including any of these signs:

• Fails to respond to his or her name or appears not to hear you at times
• Resists cuddling and holding, and seems to prefer playing alone, retreating into his or her own world
• Has poor eye contact and lacks facial expression
• Doesn't speak or has delayed speech, or loses previous ability to say words or sentences
• Can't start a conversation or keep one going, or only starts one to make requests or label items
• Speaks with an abnormal tone or rhythm and may use a singsong voice or robot-like speech
• Repeats words or phrases verbatim, but doesn't understand how to use them
• Doesn't appear to understand simple questions or directions
• Doesn't express emotions or feelings and appears unaware of others' feelings
• Doesn't point at or bring objects to share interest
• Inappropriately approaches a social interaction by being passive, aggressive or disruptive
• Has difficulty recognizing nonverbal cues, such as interpreting other people's facial expressions, body postures or tone of voice

Patterns of behavior

A child or adult with autism spectrum disorder may have limited, repetitive patterns of behavior, interests or activities, including any of these signs:

• Performs repetitive movements, such as rocking, spinning or hand flapping
• Performs activities that could cause self-harm, such as biting or head-banging
• Develops specific routines or rituals and becomes disturbed at the slightest change
• Has problems with coordination or has odd movement patterns, such as clumsiness or walking on toes, and has odd, stiff or exaggerated body language
• Is fascinated by details of an object, such as the spinning wheels of a toy car, but doesn't understand the overall purpose or function of the object
• Is unusually sensitive to light, sound or touch, yet may be indifferent to pain or temperature
• Doesn't engage in imitative or make-believe play
• Fixates on an object or activity with abnormal intensity or focus
• Has specific food preferences, such as eating only a few foods, or refusing foods with a certain texture

As they mature, some children with autism spectrum disorder become more engaged with others and show fewer disturbances in behavior. Some, usually those with the least severe problems, eventually may lead normal or near-normal lives. Others, however, continue to have difficulty with language or social skills, and the teen years can bring worse behavioral and emotional problems.

When to see a doctor

Babies develop at their own pace, and many don't follow exact timelines found in some parenting books. But children with autism spectrum disorder usually show some signs of delayed development before age 2 years.

If you're concerned about your child's development or you suspect that your child may have autism spectrum disorder, discuss your concerns with your doctor. The symptoms associated with the disorder can also be linked with other developmental disorders.

Signs of autism spectrum disorder often appear early in development when there are obvious delays in language skills and social interactions. Your doctor may recommend developmental tests to identify if your child has delays in cognitive, language and social skills, if your child:

• Doesn't respond with a smile or happy expression by 6 months
• Doesn't mimic sounds or facial expressions by 9 months
• Doesn't babble or coo by 12 months
• Doesn't gesture — such as point or wave — by 14 months
• Doesn't say single words by 16 months
• Doesn't play "make-believe" or pretend by 18 months
• Doesn't say two-word phrases by 24 months
• Loses language skills or social skills at any age

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Autism spectrum disorder has no single known cause. Given the complexity of the disorder, and the fact that symptoms and severity vary, there are probably many causes. Both genetics and environment may play a role.

• Genetics. Several different genes appear to be involved in autism spectrum disorder. For some children, autism spectrum disorder can be associated with a genetic disorder, such as Rett syndrome or fragile X syndrome. For other children, genetic changes (mutations) may increase the risk of autism spectrum disorder. Still other genes may affect brain development or the way that brain cells communicate, or they may determine the severity of symptoms. Some genetic mutations seem to be inherited, while others occur spontaneously.
• Environmental factors. Researchers are currently exploring whether factors such as viral infections, medications or complications during pregnancy, or air pollutants play a role in triggering autism spectrum disorder.

No link between vaccines and autism spectrum disorder

One of the greatest controversies in autism spectrum disorder centers on whether a link exists between the disorder and childhood vaccines. Despite extensive research, no reliable study has shown a link between autism spectrum disorder and any vaccines. In fact, the original study that ignited the debate years ago has been retracted due to poor design and questionable research methods.

Avoiding childhood vaccinations can place your child and others in danger of catching and spreading serious diseases, including whooping cough (pertussis), measles or mumps.

Risk factors

The number of children diagnosed with autism spectrum disorder is rising. It's not clear whether this is due to better detection and reporting or a real increase in the number of cases, or both.

Autism spectrum disorder affects children of all races and nationalities, but certain factors increase a child's risk. These may include:

• Your child's sex. Boys are about four times more likely to develop autism spectrum disorder than girls are.
• Family history. Families who have one child with autism spectrum disorder have an increased risk of having another child with the disorder. It's also not uncommon for parents or relatives of a child with autism spectrum disorder to have minor problems with social or communication skills themselves or to engage in certain behaviors typical of the disorder.
• Other disorders. Children with certain medical conditions have a higher than normal risk of autism spectrum disorder or autism-like symptoms. Examples include fragile X syndrome, an inherited disorder that causes intellectual problems; tuberous sclerosis, a condition in which benign tumors develop in the brain; and Rett syndrome, a genetic condition occurring almost exclusively in girls, which causes slowing of head growth, intellectual disability and loss of purposeful hand use.
• Extremely preterm babies. Babies born before 26 weeks of gestation may have a greater risk of autism spectrum disorder.
• Parents' ages. There may be a connection between children born to older parents and autism spectrum disorder, but more research is necessary to establish this link.

Complications

Problems with social interactions, communication and behavior can lead to:

• Problems in school and with successful learning
• Employment problems
• Inability to live independently
• Social isolation
• Stress within the family
• Victimization and being bullied

More Information

• Autism spectrum disorder and digestive symptoms

There's no way to prevent autism spectrum disorder, but there are treatment options. Early diagnosis and intervention is most helpful and can improve behavior, skills and language development. However, intervention is helpful at any age. Though children usually don't outgrow autism spectrum disorder symptoms, they may learn to function well.

• Autism spectrum disorder (ASD). Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/autism/facts.html. Accessed April 4, 2017.
• Uno Y, et al. Early exposure to the combined measles-mumps-rubella vaccine and thimerosal-containing vaccines and risk of autism spectrum disorder. Vaccine. 2015;33:2511.
• Taylor LE, et al. Vaccines are not associated with autism: An evidence-based meta-analysis of case-control and cohort studies. Vaccine. 2014;32:3623.
• Weissman L, et al. Autism spectrum disorder in children and adolescents: Overview of management. https://www.uptodate.com/home. Accessed April 4, 2017.
• Autism spectrum disorder. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://dsm.psychiatryonline.org. Accessed April 4, 2017.
• Weissman L, et al. Autism spectrum disorder in children and adolescents: Complementary and alternative therapies. https://www.uptodate.com/home. Accessed April 4, 2017.
• Augustyn M. Autism spectrum disorder: Terminology, epidemiology, and pathogenesis. https://www.uptodate.com/home. Accessed April 4, 2017.
• Bridgemohan C. Autism spectrum disorder: Surveillance and screening in primary care. https://www.uptodate.com/home. Accessed April 4, 2017.
• Levy SE, et al. Complementary and alternative medicine treatments for children with autism spectrum disorder. Child and Adolescent Psychiatric Clinics of North America. 2015;24:117.
• Brondino N, et al. Complementary and alternative therapies for autism spectrum disorder. Evidence-Based Complementary and Alternative Medicine. http://dx.doi.org/10.1155/2015/258589. Accessed April 4, 2017.
• Volkmar F, et al. Practice parameter for the assessment and treatment of children and adolescents with autism spectrum disorder. Journal of the American Academy of Child and Adolescent Psychiatry. 2014;53:237.
• Autism spectrum disorder (ASD). Eunice Kennedy Shriver National Institute of Child Health and Human Development. https://www.nichd.nih.gov/health/topics/autism/Pages/default.aspx. Accessed April 4, 2017.
• American Academy of Pediatrics policy statement: Sensory integration therapies for children with developmental and behavioral disorders. Pediatrics. 2012;129:1186.
• James S, et al. Chelation for autism spectrum disorder (ASD). Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD010766.pub2/abstract;jsessionid=9467860F2028507DFC5B69615F622F78.f04t02. Accessed April 4, 2017.
• Van Schalkwyk GI, et al. Autism spectrum disorders: Challenges and opportunities for transition to adulthood. Child and Adolescent Psychiatric Clinics of North America. 2017;26:329.
• Autism. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed April 4, 2017.
• Autism: Beware of potentially dangerous therapies and products. U.S. Food and Drug Administration. https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm394757.htm?source=govdelivery&utm_medium=email&utm_source=govdelivery. Accessed May 19, 2017.
• Drutz JE. Autism spectrum disorder and chronic disease: No evidence for vaccines or thimerosal as a contributing factor. https://www.uptodate.com/home. Accessed May 19, 2017.
• Weissman L, et al. Autism spectrum disorder in children and adolescents: Behavioral and educational interventions. https://www.uptodate.com/home. Accessed May 19, 2017.
• Huebner AR (expert opinion). Mayo Clinic, Rochester, Minn. June 7, 2017.

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Autism Spectrum Disorder

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Autism: Characteristics, Diagnosis, and Understanding

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The prevalence of Autism Spectrum Disorder has nearly doubled in recent years, and the numbers are staggering: nearly 1 in every 59 children are diagnosed with autism in the United States alone. Yet, there are so many questions surrounding the complexity and increase in diagnoses of this condition that affects so many in such diverse ways. (Autism Speaks) How autism originates in the first place and its impact on communication, both verbal and nonverbal, are questions that need to be continually scrutinized in order to better accommodate those who are affected, and, in turn, educate those who interact with the disorder in the most meaningful ways.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), “people with Autism Spectrum Disorder have difficulty with communication and interaction with other people, restricted interests and repetitive behaviors, and symptoms that hurt the person’s ability to function properly in school, work, and other areas of life.” (National Institute of Mental Health) Although autistic characteristics can manifest themselves in so many different ways, concern surrounding communication reverberates as the trademark characteristic of ASD, with symptoms of the disorder, such as “difficulty with social communication and interaction, restricted interests, and repetitive behaviors” usually showing by the age of two or three. (Autism Speaks) For instance, a child might not understand how to work cooperatively in a group or look someone in the eye and make an introduction. Children with autism also often have trouble understanding the point of view of others, matching facial expression with what is being communicated, and having an “unusual tone of voice” that often sounds flat. (National Institute of Mental Health) Although symptoms of autism “must be present in the early developmental period,” often, understandably, many of these symptoms do not make themselves evident until a child is placed in situations that require more complex use of these skills, such as a school or another educational setting. (Autism Speaks)

In order to begin to delve into the impact of ASD symptoms on modes of communication, it is vital to understand the complexity and uncertainty around the anatomical origin of autism in the first place. While there is no known specific biological cause, one of the strongest cases is for a genetic link, with “research suggest[ing] that genes can act together with influences from the environment to affect development in ways that lead to ASD.” (National Institute of Mental Health) This, in turn, influences how neurons, the specialized cells that are responsible for transmitting nerve signals, “connect and communicate with each other in the brain.” (Bhandari, Tamara) In reference to this statement, a study conducted at The University of Washington School of Medicine in St. Louis found that rats that lacked the gene absent in many of those with ASD in turn displayed an overabundance of connections between brain neurons, and this, in turn, influenced their basic ability to learn (Bhandari, Tamara). According to Azad Bonni, the head of the Department of Neuroscience at Washington, “This study raises the possibility that there may be too many synapses in the brains of patients with Autism.” (Bhandari, Tamara) According to Bonni, this overabundance of synapses and “miscommunication among neurons in the developing brain, correlates with impairments in learning, although we don’t know how.” (Bhandari, Tamara) There are six genes, called ‘ubiquitin ligases,’ which “attach a molecular tag called ubiquitin to proteins” at the focus of this study. (Bhandari, Tamara) These genes tell the brain which proteins should be kept and which should be thrown out. The same study looked specifically at one of these six genes: RNF8, the gene that is believed to mutate in those with ASD. This gene was removed from neurons in the cerebellum of mice, and “researchers found that neurons that lacked the RNF8 protein formed about 50 percent more synapses than those with the gene.” (Bhandari, Tamara) Although the mice walked normally, associated with motor function of the cerebellum, they were unable to learn new motor movements, a key symptom of ASD. Those with autism often display difficulty building social skills and simple skills like eye contact, bouncing a ball, or gauging how much energy to exert when lifting or pushing. (National Institute of Mental Health) The mice without an RNF8 gene were also unable to pick up a basic new skill, learning to close their eyes when a puff of air was blown at them: closing their eyes only ? of the time compared to those with a functioning gene closing their eyes ? of the time, a delayed and misunderstood reaction. (Bhandari, Tamara) Those with autism often can’t focus on one task for too long, or become consumed with a task, such as trying to put a puzzle together or sort objects. The study also reverberates the importance of the cerebellum “in higher cognitive functions such as language and attention, both of which are affected in autism.” (Bhandari, Tamara) While it would be thought that an increase in neural connections would increase brain function, it actually leads to a repetitive and remediated nature of thought and action. Two trademarks of Autism are language delays and intense attachment to specific objects, both of which directly correlate with some lack of higher level thinking skills. (Bhandari, Tamara)

Another study at Columbia University Medical Center adds more meaning to these findings, by associating this overabundance of synapses in the brain with a “slowdown in a normal pruning process during development.” (Gudsnuk, Kathryn, et al) Normally, “a burst of synapse formation occurs in infancy, particularly in the cortex, a region involved in autistic behaviors.” (Gudsnuk, Kathryn, et al) Normally, pruning takes out about half of the synapses, but, in the study, which looked at brains of those with autism who died from another cause, the pruning process had not done its job to the extent that it does in most brain cortexes. (Gudsnuk, Kathryn, et al) While this is just a correlation between a few studies, the new light it is shedding on brain formation and ASD is vital.

It is also worth examining the function of the superior temporal sulcus in those with autism, which controls processing of visual information, and its role in “inability to interpret body language, facial expression, and gestures.” (Driver, Janine) Those with ASD often mistake gestures or do not realize the significance of what body language is communicating. This symptom of ASD was put to the test in research conducted by the University of Durham in 2009. The study presented autistic individuals with cartoon pictures showing specific emotions (happy, sad, angry), directions, and gestures without the use of faces or language.The participants had to rely solely on body language, such as skipping or clapping to come to a conclusion about how the figure was feeling. The study concluded that “participants had a tremendously difficult time reading the emotion and/or deciphering the direction of movement,” which is believed to be related to the gene mutation referenced earlier which directly affects social ability. (Driver, Janine) According to Janine Driver, a contributor to Psychology Today, “These individuals are unable to decipher the communication cues bombarding them; resulting in not only a diminished capacity to properly communicate their wants to others, but an inability to feel empathy or socially relate to those around them.” (Driver, Janine) It doesn’t necessarily mean that they aren’t feeling, they are just unable to show it the way most people do. For example, during a pep rally, a student with ASD may misassociate cheering and noise as scary sounds, rather than excitement and become nervous. There isn’t a same mechanism present for decoding these sensory signals and reacting accordingly.

There is also a spectrum in relation to what communication capability children with autism have. Some students are able to learn vocabulary related to things that are meaningful to them very quickly, while others may struggle. According to The National Institute on Deafness and Other Communication Disorders, language development can be uneven, with some children being “able to read words before age five, but not comprehend[ing] what they have read.” (The National Institute of Deafness and Other Communication Disorders) Others may not even be able to respond to their names or basic speech. Children with autism may also repeat back questions that are asked to them or “repeat words heard at an earlier time.” (NIDCD) Without being able to properly comprehend body language and form higher level thoughts, it can often be difficult to carry on conversations.

Another study conducted by Dr. David Matsumoto interestingly examined body language of Olympic athletes. He saw a trend in how these people reacted to feeling certain emotions. While this doesn’t seem revolutionary, some of his subjects were blind, and yet still responded with basic physical movements and gestures representational of the emotion they were feeling. He therefore came to the conclusion that “it is reasonable to conclude that many of the behaviors, gestures and expressions we use to convey our feelings are deeply imbedded in our distinctly human code.” (Driver, Janine) This provides evidence that although there may be environmental risk factors for developing ASD, a genetic link cannot be ignored.

While autism is not exclusionary to a specific race, gender, or socioeconomic class, there are some possible environmental risk factors associated with ASD, such as having a sibling with the disorder or older parents, having certain genetic conditions such as Down Syndrome, and a very low weight at birth. (National Institute of Mental Health) Some risk factors have also been debated more than others. According to Autism Speaks, “prenatal exposure to the chemicals thalidomide and valproic acid has been linked to increased risk of autism.” (Autism Speaks) Other possible environmental factors include deadly viruses or infections, such as rubella, and childhood immunizations. While none of these risk factors are completely inclusionary of those with Autism, many factors alongside observation of behavior are used in diagnosing ASD.

After taking into account some of the possible biological causes and environmental risk factors associated with autism, it is also important to acknowledge a more individualized aspect of ASD: the environment that is created around the individual. As a special education teacher, I witness, everyday, the effects that educational and social influences can have on those with ASD and their communication skills. I have one student, in particular, who reminds me every day that genetics don’t paint the entire picture of what he is capable of. He is a freshman in high school, nonverbal, and speaks in only short phrases, characteristic of ASD, and often speaks in a repetitive nature. This is called echolalia, and is a “repeating of words or phrases.”(National Institute of Mental Health) If his social worker is coming after school, I usually hear about it intermittently throughout the entire day: it’s what he’s thinking about. Another trademark characteristic of Autism that he exhibits is a narrow scope of topic and interest, but, nevertheless, there’s a brain process going on there. We affirm his thinking because it gives us a window into what is going on inside his head, and he is often excited when something he says is repeated back to him or if someone makes a connection to a movie he references. At the beginning of the year, he knew where Wisconsin was on a map. We learned two states every day, and he now knows forty-three states and counting and can put a map of the United States together by memory. I am reminded everyday that although his brain processes may be inhibited and limited, the science says so, and he he can’t have conversations with the depth that most can, there are a lot of processes occuring in his head, and I need to be cognizant of that. He has an amazing memory: almost photographic in some ways. He, and so may others, are capable of learning and thinking for themselves, we just need to give them the avenues to do so within their abilities. Autism Spectrum Disorder does not fit a specific mold, and small victories look different for every child.

This specific student comes from a home of extremely low socioeconomic status, and I have reason to believe that most of his interaction and opportunity to communicate comes from interaction with social workers and school personnel. I have seen, first hand, how surrounding a child with caregivers and teachers who support a child with ASD in positive and meaningful ways can make all the difference in the student’s ability to be emotive and communicate.

Students make a concentrated effort to interact with my freshman student with autism. They play sports with him and give him high-fives in the hallway. He will often laugh when someone says something he thinks is funny and he can point to objects he wants or doesn’t want. He can communicate, as basic as the interactions may be, he just has to be given the opportunity to do so.

I witness everyday the bombardment of stimuli he tries to take in on a daily basis. He often covers his ears during lunch if there are too many discussions going on around him. He used to scream. I learn more every day about what it means to accommodate a student with ASD. Early intervention, creating a loving and supporting environment, and providing opportunities to communicate using an array of available modes, including talkboards, pictures, flashcards etc., are vital in supporting someone with ASD in and out of the classroom. One method of interaction, coined by Melanie Nind and Dave Hewett, authors of “Access to Communication,” is called Intensive Interaction. This practice “makes use of the range of interactive games that have been shown to occur in interactions between infants and their primary caregivers.” (Nind, Melanie & Hewett, Dave) It takes into account the gap in basic ability to communicate present in those affected by ASD, and “incorporate[s] interactive play into…daily routines in school.” (Nind, Melanie & Hewett, Dave) One example that is given is using changing clothes, or “dressing situations,” such as putting on a jacket and boots, often a “non-personal and stressful routine” into a playful game, allowing for a more meaningful connection. (Nind, Melanie & Hewett, Dave) This connection allows the student the opportunity to respond in a non-risk environment, creating a more enjoyable experience. Nind and Hewett found that, by using what they call “free-flowing interactive play,” that was integrated into a daily schedule, they were able to better gain the attention of the students and allow them opportunities to express themselves. I see, everyday, the importance of showing my students with autism that although they may not be able to completely express their emotions to me, I validate them and can still reciprocate the emotions I know they are feeling. It is important to be adaptable, modifying tasks, jobs, and communication modes so that they are accessible.

The student I referenced earlier was, for the first time, given a talk board app loaded onto an iPad this year. I watched his face light up as he was able to use technology, something he loves, to point to movies he likes and to talk about or foods he is making in class that day. The words are repeated back to him through headphones. I have to remind myself on a daily basis to give him my all, because he deserves it. I don’t think, even with all of the research out there, that there is any replacement for that dedication.  

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What is autism?

Autism is a lifelong developmental disability which affects how people communicate and interact with the world. More than one in 100 people are on the autism spectrum and there are around 700,000 autistic adults and children in the UK. 

Find out more about autism by watching our film narrated by Alan Gardner, the Autistic Gardener

Being autistic

Autism is a spectrum condition and affects people in different ways. Like all people, autistic people have their own strengths and weaknesses. Below is a list of difficulties autistic people may share, including the two key difficulties required for a diagnosis. Click on the plus sign for more information.

Social communication and social interaction challenges

Social communication

Autistic people have difficulties with interpreting both verbal and non-verbal language like gestures or tone of voice. Some autistic people are unable to speak or have limited speech while other autistic people have very good language skills but struggle to understand sarcasm or tone of voice. Other challenges include:

• taking things literally and not understanding abstract concepts
• needing extra time to process information or answer questions
• repeating what others say to them (this is called echolalia)

Social interaction

Autistic people often have difficulty 'reading' other people - recognising or understanding others' feelings and intentions - and expressing their own emotions. This can make it very hard to navigate the social world. Autistic people may:

• appear to be insensitive
• seek out time alone when overloaded by other people
• not seek comfort from other people
• appear to behave 'strangely' or in a way thought to be socially inappropriate
• find it hard to form friendships.

Read more about  social communication and social interaction challenges here

Repetitive and restrictive behaviour

With its unwritten rules, the world can seem a very unpredictable and confusing place to autistic people. This is why they often prefer to have routines so that they know what is going to happen. They may want to travel the same way to and from school or work, wear the same clothes or eat exactly the same food for breakfast. 

Autistic people may also repeat movements such as hand flapping, rocking or the repetitive use of an object such as twirling a pen or opening and closing a door. Autistic people often engage in these behaviours to help calm themselves when they are stressed or anxious, but many autistic people do it because they find it enjoyable. 

Change to routine can also be very distressing for autistic people and make them very anxious. It could be having to adjust to big events like Christmas or changing schools, facing uncertainty at work, or something simpler like a bus detour that can trigger their anxiety. 

Read more about repetitive behaviours and dealing with change here

Over- or under-sensitivity to light, sound, taste or touch

Autistic people may experience over- or under-sensitivity to sounds, touch, tastes, smells, light, colours, temperatures or pain. For example, they may find certain background sounds like music in a restaurant, which other people ignore or block out, unbearably loud or distracting. This can cause anxiety or even physical pain. Many autistic people prefer not to hug due to discomfort, which can be misinterpreted as being cold and aloof.

Many autistic people avoid everyday situations because of their sensitivity issues. Schools, workplaces and shopping centres can be particularly overwhelming and cause sensory overload. There are many simple adjustments that can be made to make environments more autism-friendly. 

Read more about sensory differences here

Highly focused interests or hobbies

Many autistic people have intense and highly focused interests, often from a fairly young age. These can change over time or be lifelong. Autistic people can become experts in their special interests and often like to share their knowledge. A stereotypical example is trains but that is one of many. Greta Thunberg's intense interest, for example, is protecting the environment.

Like all people, autistic people gain huge amounts of pleasure from pursuing their interests and see them as fundamental to their wellbeing and happiness.

Being highly focused helps many autistic people do well academically and in the workplace but they can also become so engrossed in particular topics or activities that they neglect other aspects of their lives. 

Take a look at the Spectrum magazine, written for and by autistic people

Extreme anxiety

Anxiety is a real difficulty for many autistic adults, particularly in social situations or when facing change. It can affect a person psychologically and physically and impact quality of life for autistic people and their families.  

It is very important that autistic people learn to recognise their triggers and find coping mechanisms to help reduce their anxiety. However, many autistic people have difficulty recognising and regulating their emotions. Over one third of autistic people have serious mental health issues and too many autistic people are being failed by mental health services. 

Read more about anxiety and mental health

Meltdowns and shutdowns

When everything becomes too much for an autistic person, they can go into meltdown or shutdown. These are very intense and exhausting experiences. A meltdown happens when someone becomes completely overwhelmed by their current situation and temporarily loses behavioural control.  This loss of control can be verbal (eg shouting, screaming, crying) or physical (eg kicking, lashing out, biting) or both. Meltdowns in children are often mistaken for temper tantrums and parents and their autistic children often experience hurtful comments and judgmental stares from less understanding members of the public.  A shutdown appears less intense to the outside world but can be equally debilitating. Shutdowns are also a response to being overwhelmed, but may appear more passive - eg an autistic person going quiet or 'switching off'. One autistic woman described having a shutdown as: 'just as frustrating as a meltdown, because of not being able to figure out how to react how I want to, or not being able to react at all; there isn’t any ‘figuring out’ because the mind feels like it is past a state of being able to interpret.'

Get advice and guidance on meltdowns and shutdowns

"The greatest discomfort for autistic people can be the social one. For me, I was confused by the way people behaved." Chris Packham, CBE and National Autistic Society Ambassador

Think you or someone you know could be autistic?

Ever-changing definition .

The definition of autism has changed over the decades and could change in future years as we understand more. Some people feel the spectrum is too broad, arguing an autistic person with 24/7 support needs cannot be compared with a person who finds supermarket lights too bright. We often find that autistic people and their families with different support needs share many of the same challenges, whether that’s getting enough support from mental health, education and social care services or being misunderstood by people close to them. We will continue to fight to make society work for autistic people.

How many people are autistic

It is important to know how many autistic people there are for several reasons, including helping to provide support, as well as showing the sheer number and diversity of autistic people. This is also called “autism prevalence”. It is an estimate of how many autistic people there are in the UK. It is not the same as the number of autistic people who have a diagnosis and many autistic people might not have been identified or even know yet themselves. As autism understanding has grown, the estimated prevalence has also changed. 

Government prevalence surveys last estimated that around one in 100 people are autistic. However, because these are estimates this is not definite. Other surveys and international estimates have come up with different prevalence estimates. Most of them suggest autism prevalence is higher. The National Autistic Society thinks the UK governments should do more research into autism prevalence to find an updated figure. Until that research is done, we believe that more than one in 100 people are autistic, which means more than 700,000 people in the UK.

Having an accurate prevalence figure is vital. We all need to know this to improve support and understanding, and to create a society that works for autistic people.

More about autism

Varying support needs

Autistic people have varying and complex needs from 24-hour care to simply needing clearer communication and a little longer to do things.

Autistic women and girls

More men and boys are currently diagnosed with autism than women and girls. The most up-to-date ratio is 3:1. There are various theories to explain this.

Autism and BAME people

Our 2014 report, Diverse Perspectives, suggests it can be even harder for people from Black, Asian and minority ethnic groups to get a diagnosis and support.

Autism and gender identity

We look at the connection between autism and gender identity, and hear stories from non-binary and transgender autistic people.

The causes of autism

There is strong evidence to suggest that autism can be caused by a variety of physical factors that affect brain development and genetic factors.

The history of autism

It is more than 40 years since Lorna Wing and Judith Gould coined the term autism spectrum and introduced the idea of the triad of impairments.

Ways to get involved

Help us support as many autistic people and their families as possible.

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Join us and help create a society that works for autistic people. 

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• Neuropsychiatr Dis Treat

Language and Speech Characteristics in Autism

Ioannis vogindroukas.

1 New Bulgarian University, Sofia, Bulgaria

Margarita Stankova

Evripidis-nikolaos chelas.

2 Research and Education Institute of Speech Therapy, Ioannina, Greece

Alexandros Proedrou

The aim of this paper is to provide information regarding diversity in speech and language profiles of individuals with Autism Spectrum Disorders (ASD) and try to classify these profiles according to the combination of the communication difficulties. Research findings confirm the existence of heterogeneity of communication challenges in ASD across the lifespan. A lot of children with ASD experience communication challenges and strengths across all language sub-systems including pragmatics, grammar, semantics, syntax, phonology, and morphology in both oral and written language, while some children with autism demonstrate exceptional language abilities incl. linguistic creativity. Communication issues vary on a continuum of severity so that some children may be verbal, whereas others remain non-verbal or minimally-verbal. The diversity of profiles in speech and language development stem from either the presence of comorbid factors, as a core symptom of autistic behavior without comorbidity or both, with the development of complex clinical symptoms. Difficulties with the semantic aspect of language affect the individual’s skills in abstract thinking, multiple meanings of words, concept categorization, and so on. Finally, the coexistence of ASD with other communication difficulties such as a Language Disorder, Apraxia of Speech, Speech Sound Disorders or/and other neurodevelopmental disorders raises the need for examining more carefully the emergence of new clinical profiles and clinical markers useful in performing differential diagnosis and different intervention.

Introduction

Willingness and ability for interaction with a communicative partner emerges early in human evolution as a step in social development and before language acquisition or the use of language. Joint attention, imitation and play are the first aspects of sociability that have been related to the development of language and communication skills, either in children demonstrating typical development (TD) or in children with developmental disabilities. In TD children, joint attention usually emerges around the age of 9 months and it is well developed when the child reaches the age of 12 months, 1 , 2 a crucial factor in the development of joint attention is considered to be the interactions with stable and available adults. Relevant research data show that this skill increases gradually as the number of interactions increase. 3 According to researchers Charman et al, 4 joint attention skills observed in the second year of life are closely linked to higher social skills in the future. Joint attention skills hailed as a milestone of socialization by showing us how a human being transforms into an advanced social being. 5 Research has highlighted the importance of developing joint attention skills and imitation in the development of language production, 6 and other research 7 suggests that children with well-developed joint attention skills end up in having better language skills by age 3–4 years. Imitation skills of motor patterns also influence the development of sociability and socialization, and has been linked to the development of language skills later in children’s lives. 8

The connection between social skills and speech and language development are strong and seems that language and speech development is a result of social developmental processes in the first year of life. One of the most common symptoms in the majority of ASD children is issues they face in social communication and the manifestation of difficulties in the integration of verbal and nonverbal communication. That particular communication impairment is a core feature of autism and one of the most frequent reasons for referral among children who are later diagnosed with autism spectrum disorder has been the focus of numerous studies. Moreover, the increasing number of evidence from longitudinal studies of young children with and without an ASD indicates that those with impairments in verbal skills are at increased risk for less favourable outcomes later in life. Early language abilities and their development predict social functioning, academic achievement, and psychiatric outcome in late childhood and adulthood 9–11

Moreover, the importance of social and communication challenges in ASD was recognized as a core ASD symptom under the heading “Social Communication Difficulties and Interaction” in the Diagnostic Statistical Manual, 5th Edition (DSM 5) of the American Psychiatric Association (APA). 12 In fact, it was determined as an obligatory core symptom to receive a diagnosis of ASD.

The importance of language use in defining clinical subtypes of ASD is also noted in the International Classification of Diseases (ICD), 11th edition of World Health Organization, with the presence or absence of functional language taking center stage. 13 ICD 11 categorizes ASD in five different types, a) ASD with disorder of intellectual development and with impaired functional language, b) ASD with disorder of intellectual development and with absence of functional language, c) ASD without disorder of intellectual development and with mild or no impairment of functional language, d) ASD with disorder of intellectual development and with mild or no impairment of functional language and e) ASD without disorder of intellectual development and with impaired functional language. The method of categorization relates to the existence or absence of disorder of intellectual development and to the existence or absence of functional language. The use of term functional language in ICD 11 and the description of symptom of social communication difficulty in DSM 5 helps the clinicians to focus not on the existence of speech and language availability, but on the appropriate use of speech and language for functional and social communication. Additionally, clinicians focus on the presence of social communication difficulties, beyond language and speech and pinpoint the communication difficulties in ASD as related to the social aspect of communication mainly, which serves as a good differentiation between language impairment and ASD with the presence of language impairment /specifier “With or without accompanying language impairment”/.

Although the hypothesis of influence of social development is a crucial cause for the language and speech difficulties in ASD children, there are other conditions which may affect speech and language development. Comorbidity conditions of ASD children with other developmental disorders such as Developmental Language Disorder (DLD), Apraxia of Speech (AS) or low Intelligent Quotient (IQ) level 14 also influence language and speech abilities in ASD because development is generally seen on a continuum.

Research and knowledge about ASD in recent years has provided data that have resulted in better understanding of language specifics of children with autism. One of these concerns the widely used 15 , 16 at present classification of children with autism into two large groups in terms of their language development: Normal Language development (ASD-LN) and Language Impaired (ASD-LI). ASD children with LI profile seems to experience difficulties in language development. Following the same logic, it is observed in the literature that a sub classification of the group of children with autism with typical language development is used, dividing them into children with Low Language Abilities (ASD-LL) and children with High Language Abilities (ASD-HL). 17 This categorization is usually related with the scores of ASD children in standardized language tests.

The purpose of this paper is to provide information on diversity in the speech and language profiles of people with ASD. We offer a discussion of the existence of language profiles identified in individuals with ASD and a categorical approach to support ongoing diagnostic and intervention efforts.

Language and Autism Spectrum Disorder

ASD is a neurological and developmental condition characterized by lasting and important difficulties in communication and social interaction in multiple contexts. The description of the condition includes problems in social interaction and communication, as well as a restricted repertoire of interests and behaviors, difficulties in the communication abilities and difficulties in daily tasks and activities. The individuals with ASD often present limited interests, follow stereotyped behaviors and adhere to repetitive rituals. 14

Nevertheless, because ASD has very broad diagnostic criteria, different ASD individuals show markedly different characteristics. Specifically, ASD children have very diverse developmental backgrounds and differ significantly in the extent to which they master, vocalize and express, language in the form of grammar and vocabulary. 16 Overall, 3 out of 4 ASD children show some impaired language abilities by the time they enter kindergarten, which may be mild or extreme while 1 in 4 autistic children show typical or even exceptional language abilities by the age of 5. 18

Although difficulties in the functional language are important indicator of ASD in early life, difficulties in speaking and communicating through language are not at all uniform, and this fact means that providing a prognosis and devising interventions can be particularly challenging. 19 However, the level of language skills and abilities in childhood significantly predict the future outcomes of people with ASD, like academic success and living as an independent adult. 20 , 21 Thus, it is particularly important for researchers to gain insight into the variables that affect and cause the heterogeneous levels of language attainment in children with ASD. 22

This research offers an extensive discussion on a list of variables such as semantics, pragmatics, phonology and morpho syntax and are discussed thoroughly in the next sections.

Communicating with other people, verbally or not, means that the individuals know how to produce and understand morphemes with a particular meaning. Semantics is the study of how languages organize and express meanings. Semantics is also the main factor in terms of mastering the language adequately both as difficulty in understanding or/and using the language that can lead in Developmental Language Disorder.

Studies that examine the breadth of vocabulary developed in ASD children, with measures at particular points in time, find that their operating vocabulary is usually smaller than the vocabulary of same-aged TD children. 23–25 On the other hand, there is conflicting research which has found that the development of language in young individuals with ASD does not differ from that found in TD children and adolescents. 26–28

Conflicting outcomes can mislead between using words in a spoken language and capability of fully understanding language in context. Following studies help us understand in a better way substantial differences in the development of semantics between ASD and TD children. Goodwin et al 27 for example, found that young ASD children had comparable size of expressive vocabulary with TD children. Henderson et al 28 found that adolescents with autism were not significantly different in word comprehension from TD adolescents.

ASD children also tend to use nonsensical or idiosyncratic colloquialisms; they may name objects abnormally or inappropriately and use nonsensical nomenclature alternatively to common sense terms. One explanation is that the abnormal or nonsense discourse could signify that ASD individuals are unable to mentally represent the actual meaning they want to communicate, or they may be unsure, or lack confidence, regarding how to respond. 15

In a recent study, Viglioco et al 29 investigated the way children with ASD learn concepts and words in an abstract way, and how this can be a predictor for coexisting language impairment. Researchers tried to assess whether the social/emotional difficulties identified in children with ASD are associated with the existence of an uneven difficulty in their knowledge of abstract words, or whether, instead they would score as their TD peers, once language impairment is accounted for. The same pattern of generalized vocabulary impairment for concrete and abstract words is reported for language impaired children who presented comorbidity with ASD. However, children with ASD do not show abnormal performance with abstract or with valence words in this study. The researchers conclude that, these reports may be a result of different mechanisms underlining the social and emotional difficulties in ASD as well as the social communicative interactions considered to be substantial in abstract development. Nevertheless, on the basis of these findings only, they cannot exclude that emotional bootstrapping might not be the primary or main mechanism for abstract vocabulary acquisition.

In this vein, Taylor et al 30 in a large study with 6000 twin siblings, concluded that as a process, language development is independent from the development of other traits and characteristics of ASD – the development of language was neither observationally nor genetically related to the severity of autistic symptoms. Findings like the above illustrate that the independent way in which language and autistic traits develop underlie the conflicting research findings, and, importantly, drive the wide-ranging and diverse language developmental pathways that characterize autistic individuals.

However, thus far no single research hypothesis has been able to adequately explain all the features and difficulties found in individuals with autistic spectrum disorder, under different contexts, with varying levels of symptom severity. Nevertheless, different parts of different theories have been shown to be useful in determining the nature of different ASD language peculiarities. 31

As a result of the brief analysis of the semantic features of language functions in children with ASD, the following can be concluded: semantic abilities can vary from very good to limited without being necessarily related to the severity of RAS; probably other aspects of ASD also affect semantic language performance; probably in some individuals there is an overlap of the manifestation of language disorders and ASD; there is a group of children with exceptional language abilities, incl. semantic abilities.

Nowadays it is accepted that there is a cognitive background involved in autism spectrum disorders. 32 Most relevant psychological theories attempt to explain autism in terms of neurological and cognitive factors based on theory of mind, or their executive functions, but not in terms of language and the proper use of it. Difficulties with language, like pragmatic difficulties, very often characterize individuals with ASD, 32 however these are conceptualized as a type of second-order effect of the first-order difficulties in cognition, often social, non-linguistic cognition. Pragmatic language impairment is an inability to determine the types of language that are appropriate for use during different types of social situations; difficulties like these can compound social relationships and lead to social anxiety. According to the review of Moby, Belliveau 22 children with ASD exhibit inappropriate language behavior in social situations, eg, they rarely provide comments or ask for information, and this reinforces the observation of the crucial relationship that exists between linguistic and social difficulties. 22

It is not yet known whether pragmatic speech can predict the capacity of individuals with ASD and developed language abilities as well as those with TD to decode incoming messages and comprehend read material. 33 Still, regarding the organization of language, many theorists and researchers have adopted a “modular” point of view which regards cognition and language as discrete and separate entities; language organization is said to be defined by the relatively independent operation of phonological, syntactic, semantic, and pragmatic components. 29

Individuals with ASD also present a number of languages untypicalities such as echolalia, pedantic speech, misunderstanding of figurative language and more, due to pragmatic impairment.

Echolalia, or the repetition of words or phrases of others speech, is evident in children with ASD as well as in typical developed peers. In the case of ASD, echolalia happens more frequently and lasts longer. For some children, echolalia comprises a large part of their spoken discourse. 15 While more insight is needed concerning the nature and function of echolalia, one of the main reasons for its existence is to facilitate communication. For instance, echolalia can be used when the child is unsure how to respond during verbal interactions, and repeats what has been said in order to understand what was meant or to figure out how to respond. 15

Furthermore, individuals with ASD have distinctive styles of speaking which feature particular suprasegmental characteristics – relating to stress, tone, pitch, or juncture that is overlaid onto the consonants and vowels during speech. For instance, they may speak too softly, too loudly, too emotionlessly, or too hoarsely, while other aspects of speaking are conversely understated. ASD individuals’ verbal discourse also often includes formal words, unusual sentences, and neologisms, or words and expressions that they themselves have created. 15 Also, ASD individuals often find it difficult to speak because their interpretation of others’ statements is too literal – they may not understand metaphors, or humor, and they may also find it difficult to tell stories. 34

Individuals with ASD, perhaps because they are likely to use words which are not appropriate in particular contexts, may resort to pedantic speech, or speaking in such ways so as to impress others. 15 Pedantic speech could be expressed by informal prosody in speech and/or by verbal content that can be strange, philosophical and pompous. 35 The characteristics of this kind of speech are a) hyper- information which is not necessary, b) vocabulary and grammar used in written speech and not in oral speech, c) repetitions and corrections that are not necessary. 36

Finally, the tendency of children with ASD to develop special language skills in languages not apparent in the family and school environment has often been observed in recent years. A typical example is the use of the English language by Greek children with Greek as their mother tongue. This behavior results from the acquisition of the second language by computer programs, which are considered the main source of exposure of the child with ASD in the second language. Possible explanation is the difficulties in sociability, which lead the child to learn a language from a mechanistic environment, highlighting the difficulty of learning a language being part of the social environment. This field has not been researched much and systematically, among the few researches are those of Kissine 37 and Francis. 38 Findings of Kissine 37 concludes that the children of the sample acquired the Common New Arabic from a non-interactive social source, driven by the social and pragmatic difficulty observed in ASD children.

Respectively, research by Francis 38 studies the importance of this phenomenon in distinguishing children belonging to ASD from other TD children. The results of the first phase of the survey showed that 61.5% of children who used the official Arabic language rather than their family version in their daily lives were diagnosed with ASD.

Regardless of whether they are related to difficulties in other components of language, pragmatic difficulties in children with ASD are also related to other difficulties in social performance. They could be presented together with a general difficulty in the language development, in cooperation with good skills in the other components of the language and even on the basis of very good intellectual abilities without disorders in semantics and grammar.

Phonology related to sound structure in individual languages: the way distinctions in sound are used to differentiate linguistic items, and the ways in which the sound structure of the same element varies as a result of the other sounds in its context. Phonology studies the ways in which sounds are distributed and deployed within particular languages.

The remarkable prevalence of Speech Sound Disorders (SSD) identified in ASD speech profiles led to extensive study of phonological and articulatory skills over the past few years. More specifically, reports indicate that the prevalence of ASD comorbidity with SSD ranged between 15% and 20%. 39 However the existence, characteristics, and severity of SSD remain unclear within children with ASD. Although older reports on development of phonetics, phonological awareness and prosody reported age-appropriate speech profiles, 40 recent reports on younger children with autism revealed atypical speech patterns. The immature structure of syllables, restricted variety of phonetics, speech sound deformations, inconsistent production of words, inconsistent use of phonological process, late development of meaningful expressive vocabulary, and restricted use of phonological contrasts were the characteristics of these atypical speech patterns. 41

Phonological processing involves the cognitive processes that are based on the phonological, or sounded, structures of language. Phonological processing is comprised of phonological awareness, or the meta-cognitive skill (being aware of one’s thinking); phonological memory, or the ability to temporarily preserve information in working memory; and rapid naming, or the ability to swiftly connect visual and verbal information. On the other hand, some studies have found that individuals with good intellectual abilities and ASD exhibit persistent difficulties with phonological processing. Earlier research has proposed that ASD is connected to impairments in phonological processing and syntactic ability, since syntax and phonology, as well as semantic and pragmatic ability, are related. 42 Furthermore, persistent difficulties with phonological processing have been found only in children who exhibit syntactic and semantic impairments. 43 However, more recent research questioned this assumption.

Phonological disorders will most often be seen in the context of general language impairment with and without intellectual impairment. It is highly likely that there is a group of children with ASD who would also have mild phonological disorders that are isolated and some of them could result in temporary difficulties in articulation and written language. 41

Morphosyntax

Morphosyntax refers to the study of the morphological and syntactic properties of linguistic or grammatical units, the rules that determine the relation between one linguistic form and another, defined by morphological and syntactic criteria.

ASD children with language impairment involve marked difficulty with morphological aspects of language, like non-word repetition and verbal inflection. 44

In recent years a growing body of research has begun to study the morphosyntax of children with ASD with some initial studies revealing that certain aspects of it are not as intact as first believed. Roberts et al 45 investigated the production of tense morphology in children aged 5 to 15 years old with ASD. The study showed that the children with ASD who had low scores on general language tasks were identified as language impaired and more specifically had difficulties in tense inflection because of the high rates shown in omission of tense morphemes. On the other hand, these results were not identified in children with ASD who were not language impaired. Perovic et al 46 investigated “he” citation of personal object pronouns as well as reflexive pronouns in children with ASD aged 6 to 18 years old. This study concluded that children with ASD with language impaired also presented difficulties in the interpretation of reflexive pronouns. Terzi et al 47 assess in their study the use of clitics and the corresponding noun phrases and they conclude that children with ASD without language impairments do not perform as well as TD children only in two sections assessed: 1) in the condition of asking to produce a simple pronominal direct object clitic, and 2) in the condition of a focused structure where they have to produce a noun phrase. Errors identified in the first condition suggest that they have difficulties acknowledging the prominent item in the discourse, whereas errors identified in the second condition suggest difficulties in associating a particular intonation with a particular discourse interpretation excluding clitics. They suggest that while seems to be a morphosyntactic difficulty, it is actually generated by its position at the interface of morphology-syntax, prosody, and pragmatics.

We assume that morphosyntactic disorders in children with ASD will mainly occur in the presence of a general language disorder with and without intellectual disorders. However, some morphosyntactic errors would result from general social difficulties and discourse comprehension, without underlying language impairment.

Speech and Autism Spectrum Disorder

Speech is a way of communication which includes articulation, voice and fluency. Speech motor planning is the ability to come up with an idea, plan how to say or express that idea and then finally say it. Muscle tone refers to the muscles and strength needed to move the jaw, tongue and other muscles needed to speak.

Speech symptoms in ASD children are quite common. These symptoms refer to difficulties regarding speech production, oral movement, fluency and speech programing.

Disordered prosody as a difficulty in communication, refers primarily to suprasegmental features of speech such as phrasing, intonation, and rhythm have been addressed since early research on ASD. Clinical reports have variously referred to the speech of individuals with ASD as “monotone”, “robotic”, “staccato”, “jerky”, and “sing-songy” and inconsistent prosody has been described as among the first identifiable characteristics that can create an impression of “oddness” among children with ASD. 48 Acoustic studies have confirmed such impressions, demonstrating that individuals with ASD show generally slower speech rate, greater intonational range as well as differences in prosodic phrasing and stress regarding durational cues. 49

Motor function plays substantial role for broader aspects of development, including language, social interaction, and learning. 50 Skilled motor abilities of the body and speech production area, demand a greater rate of motor dexterity and not only basic motor control. These skilled motor abilities may form a potential difficulty in ASD as well as they are shabbily imitated by participants with ASD compared to TDs. As a result, throughout the time of imitation tasks, skilled motor gestures were once suggested to form a core difficulty in ASD, along with their relation to mirror neuron theory. 51 Furthermore, one of the difficulties in some cases of autism, regarding the use of language, is the absence of communicative speech, but at least in a subpopulation may instead come from motor and oral motor issues. Clinical reports between receptive and expressive speech/language abilities are closely linked with speech production addressed such a hypothesis. 52 An association between speech fluency and oral motor movements including lips has been highlighted in ASD children as well as similar measures reported to be distinguishing factors for TD children with some ASD behaviors. Belmonte 52 in her research indicated that many ASD children showed difficulties in gross motor, fine motor, and oral motor skills leading to substantial motor difficulties. In the majority of ASD children oral motor skills, in particular, are tightly linked to speech and language acquisition. Moreover, poor oral motor skills are correlated with the lack of expressive language skills or speech in particular, whereas receptive language skills are relatively better. To sum up, results from this research indicate that motor difficulties present a high correlation with the level of speech-language acquisition, but in addition the more severe the oral motor issues could be displayed, the more considerable challenge could be the acquisition of speech and the overall rate of learning. 52

Adams 53 indicates that ASD children had difficulty performing oral movement

and complex syllable production task which is to be included in the research profile. In particular, ASD children had difficulty to elevate their tongue as well as to alternate between a lip spread and pucker. 53 Most and first of all, results highlight the clinical heterogeneity of people with ASD in terms of motor function and ability to produce speech. Additionally clinical, basic researchers and therapists should be prompted to reject a one-size-fits-all approach to ASD: both therapeutic intervention and basic science must consider seriously the variability between phenotypes. 52

An issue that many ASD individuals experience regarding their language is linguistic fluency. Difficulties in linguistic fluency may be related to working memory. Some types of dysfluencies found in ASD individuals include stuttering, cluttering, other non-stuttering dysfluencies, as well as other atypical dysfluencies like word-final dysfluencies that involve abrupt stops in speech that affect the latter part of a word. 53 Research has found that stuttering, non-stuttering and atypical dysfluent behaviors occur in ASD individuals, while cluttering is usually characteristic of older ASD children. 54

The non-stuttering types of dysfluent discourse are often observed in ASD 53 and take place when an individual forgets what he or she was going to say next, and it can involve exclamations and self-corrections. 53 People who experience this often have difficulty with fluent speaking during conversation. One possibility is that excessive non-stuttering dysfluencies, which are a characteristic of cluttering, 55 are related to difficulties with working memory in autism. 56

All speech difficulties in individuals with ASD can be observed with the presence of language impairments and intellectual disorders; with the presence of language disorders without intellectual disabilities; without language disorders; and probably as primary impairments related to motor functions, which may secondarily lead to a delay in mastering the language, due to difficulties in practicing it.

Synthesizing Findings: Considerations for Language Profiles

Recent research on the language and speech characteristics of ASD individuals strongly suggests that developmental difficulties in language and speech attainment are frequent, but not absolute.

Also, there is a tendency for categorization of different language profiles in ASD as mentioned in the introduction. The language profile categorization may help for better differential diagnosis, but also help to better the understanding of the therapeutic needs of ASD individuals and leads in the appropriate intervention programs.

A possible categorization of different language profiles in ASD could be structured in 4 types:

Type 1: ASD with pragmatics language impairments without any other language difficulties. Difficulties in the development of language pragmatics are related to the manifestations of difficulties in social functioning, they are not an element of developmental language disorder and/or comorbidity. This group would also include individuals with very good and exceptional language abilities, but difficulties in the so-called functional language, and/or non-verbal behavior related to communication, and who would only have difficulty using language for social needs.

Type 2: ASD in comorbidity with DLD and other developmental disorders like SSD, or/and AS. These children will demonstrate disorders in social functioning and stereotyped behaviors together with a disorder in language and speech development.

Type 3. ASD in comorbidity with intellectual disability with a global lag in language and general intelligence. IQ has a strong influence on language development in ASD children and most of the children who do not develop phrase speech also have nonverbal IQ below 70. 57

Type 4. ASD with severe difficulties in the development of social communication and social interaction and secondary language difficulties as a result of nonuse of language as a communication tool.

This category is debatable, due to the difficulties of proving secondary language delay as a result of other factors that are related to the development of social functions and the environment, included the extreme cases of neglect as in orphanage situations or child abuse and overuse of electronic devices. We assume, however, that in the developmental process, if there are no enough opportunities to practice a skill, we can expect some delays in its development. Supporting this category is the fact that language stimulation has a positive effect in ASD therapy. 58

If we refer to the first type from the above categorization ASD with language pragmatics impairments without other language disorders, it becomes obvious that is different from the new category in the DSM-5 - Social (pragmatic) communication disorder (SPCD) and different from the pragmatic disorders in DLD as a results of language difficulties. In this case, language pragmatics will be disrupted as a result of difficulties in social functioning and the approach to interventions would be different from that of DLD. 59 Interventions would focus on understanding social situations, using language directly in social communication, understanding the social aspects of language and their inclusion in real life situations, understanding of figurative language and socially based language constructions. In this category we must note that there are individuals with normal, good and exceptional language abilities with and without speech disorders, but in order to meet the criteria for ASD, they must also meet the condition of having “Persistent difficulty in social communication and social interaction across multiple contexts”. 12

In the second type ASD in comorbidity with DLD and/or SSD and/or VA, a child should meet all the criteria for autism spectrum disorder and all criteria for developmental language disorder. According to CATALISE project, DLD is a diagnosis that is close to DSM-5 Language Disorder. 12 The DLD diagnosis should exclude the existence of language difficulties due to insufficient knowledge of the community language and must take into account all environmental factors that could affect language development. The situation with the comorbidity between ASD and DLD, however, presents some inconsistencies. Thus, for example, the CATALISE project 58 identifies DLD as a possible part of the broader term “Language Disorder”, further specifying the developmental feature. In the description of the CATALISE project, the existence of ASD excludes the developmental characteristic due to probable genetic or neurological causes. The need for a separate approach to ASD interventions is considered as an additional factor in separating the two diagnoses. Thus, in order to discuss comorbidity, in addition to the ASD criteria, the criteria for disordered syntax, morphology, semantics, word finding, pragmatics, discourse, verbal learning/memory and/or phonology must be met and these disorders must not be directly derivable from the more generalized ASD diagnosis. However, to what extent individual differences would affect the presence or absence of some of these symptoms remains unclear. It also remains unclear how the criteria for both disorders are proven, provided that the child has impaired social functioning and communication difficulties, as well as specific behavior in the assessment.

The third type includes children with ASD in comorbidity with Intellectual Disability at the same time. In this situation, language difficulties would be relevant to the level of intellect, but they would also be affected by social dysfunctions. It is interesting how the main symptoms of ASD /difficulties in social communication and social reciprocity and restricted and repetitive patterns of behavior, interests, or activities/ would affect language development as a result of intellectual difficulties and whether intellectual difficulties and language disorders as a result of lower intelligence would affect the core symptoms of ASD.

The last type includes the secondary delay of language and/or speech, as a result of the lack of practice of language skills and speech praxis in cases of severe ASD with behavioral disorders without disorders of nonverbal intelligence. Characteristics of this category will include lack of speech and lack of age-appropriate language comprehension and language production. The children with ASD who fail to develop speech and language before the age of 5 and do not have nonverbal intellectual difficulties are likely to be included in that group. In this sense, early interventions for language and speech development would have a key role in preventing the development of this type of difficulty. Since parental language input would affect language and speech development in the first years of a child’s life, 59 a strong choice of interventions in this category would be parenting programs that target early development of language, communication, and social skills.

This group would also accounts for the cases of children with ASD who have a relatively good language comprehension, even manage to learn to read (probably due to good language input), but fail to speak because speech praxis emerges from the sensitive period in which it may develop spontaneously.

The above subtypes refer to the DSM-5 in the form of specifiers, and in the ICD-11 in the way of describing the different types of ASD in relation to language, the attempt here is the collection of these information in a type could be useful for the clinicians of different professions.

Recent knowledge about the ASD helps clinicians in better the understanding of the differences in the ASD field. These differences underline the therapeutic intervention choices and support the people with ASD and their families in the most appropriate way for the specific language and communication profile of each person. The current paper tries to give a clinical glance to the recent research knowledge regarding the language profiles and in the way which this knowledge could be used for therapeutic intervention.

The authors report no conflict of interest in this work.