People with ASD often have these characteristics:
- Ongoing social problems that include difficulty communicating and interacting with others
- Repetitive behaviors as well as limited interests or activities
- Symptoms that typically are recognized in the first two years of life
- Symptoms that hurt the individual’s ability to function socially, at school or work, or other areas of life
Some people are mildly impaired by their symptoms, while others are severely disabled. Treatments and services can improve a person’s symptoms and ability to function. Families with concerns should talk to their pediatrician about what they’ve observed and the possibility of ASD screening. According to the Centers for Disease Control and Prevention (CDC) around 1 in 68 children has been identified with some form of ASD.
What is the difference between Asperger’s syndrome and ASD?
In the past, Asperger’s syndrome and Autistic Disorder were separate disorders. They were listed as subcategories within the diagnosis of “Pervasive Developmental Disorders.” However, this separation has changed. The latest edition of the manual from the American Psychiatric Association, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), does not highlight subcategories of a larger disorder. The manual includes the range of characteristics and severity within one category. People whose symptoms were previously diagnosed as Asperger’s syndrome or Autistic Disorder are now included as part of the category called Autism Spectrum Disorder (ASD).
Signs and Symptoms
Parents or doctors may first identify ASD behaviors in infants and toddlers. School staff may recognize these behaviors in older children. Not all people with ASD will show all of these behaviors, but most will show several. There are two main types of behaviors: “restricted / repetitive behaviors” and “social communication / interaction behaviors.”
Restrictive / repetitive behaviors may include:
- Repeating certain behaviors or having unusual behaviors
- Having overly focused interests, such as with moving objects or parts of objects
- Having a lasting, intense interest in certain topics, such as numbers, details, or facts.
Social communication / interaction behaviors may include:
- Getting upset by a slight change in a routine or being placed in a new or overly stimulating setting
- Making little or inconsistent eye contact
- Having a tendency to look at and listen to other people less often
- Rarely sharing enjoyment of objects or activities by pointing or showing things to others
- Responding in an unusual way when others show anger, distress, or affection
- Failing to, or being slow to, respond to someone calling their name or other verbal attempts to gain attention
- Having difficulties with the back and forth of conversations
- Often talking at length about a favorite subject without noticing that others are not interested or without giving others a chance to respond
- Repeating words or phrases that they hear, a behavior called echolalia
- Using words that seem odd, out of place, or have a special meaning known only to those familiar with that person’s way of communicating
- Having 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.
- People with ASD may have other difficulties, such as being very sensitive to light, noise, clothing, or temperature. They may also experience sleep problems, digestion problems, and irritability.
- ASD is unique in that it is common for people with ASD to have many strengths and abilities in addition to challenges.
Strengths and abilities may include:
- Having above-average intelligence – the CDC reports 46% of ASD children have above average intelligence
- Being able to learn things in detail and remember information for long periods of time
- Being strong visual and auditory learners
- Exceling in math, science, music, or art.
- Diagnosing ASD
Doctors diagnose ASD by looking at a child’s behavior and development. Young children with ASD can usually be reliably diagnosed by age two.
Older children and adolescents should be evaluated for ASD when a parent or teacher raises concerns based on watching the child socialize, communicate, and play.
Diagnosing ASD in adults is not easy. In adults, some ASD symptoms can overlap with symptoms of other mental health disorders, such as schizophrenia or attention deficit hyperactivity disorder (ADHD). However, getting a correct diagnosis of ASD as an adult can help a person understand past difficulties, identify his or her strengths, and obtain the right kind of help.
Diagnosis in older children and adolescents
Older children whose ASD symptoms are noticed after starting school are often first recognized and evaluated by the school’s special education team. The school’s team may refer these children to a health care professional.
Parents may talk with a pediatrician about their child’s social difficulties including problems with subtle communication. These subtle communication issues may include understanding tone of voice, facial expressions, or body language. Older children may have trouble understanding of figures of speech, humor, or sarcasm. Parents may also find that their child has trouble forming friendships with peers. The pediatrician can refer the child for further evaluation and treatment.
Diagnosis in adults
Adults who notice the signs and symptoms of ASD should talk with a doctor and ask for a referral for an ASD evaluation. While testing for ASD in adults is still being refined, adults can be referred to a psychologist or psychiatrist with ASD expertise. The expert will ask about concerns, such as social interaction and communication challenges, sensory issues, repetitive behaviors, and restricted interests. Information about the adult’s developmental history will help in making an accurate diagnosis, so an ASD evaluation may include talking with parents or other family members.