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What are the autistic spectrum disorders?
Autism spectrum disorders are also called Pervasive Developmental disorders , because they involve delay in many areas of development. They include Autistic Disorder, Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS), Asperger Syndrome , and Rett Syndrome. PDD is really just a category that includes many different areas of developmental delay, of differing severities
What is autism or autistic disorder?
Autism is the most severe of the PDDs. People with autism have differences in the development of their thinking, language, behavior and social skills. The differences appear before age three, and can be diagnosed by 18 months. To be considered autistic, a child must have a certain number of symptoms in the areas of social interaction, communication (meaning a language delay), and a restricted range of behaviors, activities and interests (often called stereotypic behaviors). If you think your child may have these traits, see a specialist right away. Read on to find out more.
What is Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS)?
PDD-NOS is also called atypical autism or mild autism. It means having differences in the same areas as in autism, only not to such a great extent. A child with PDD-NOS does not meet the criteria for any specific PDD.
What is Rett syndrome?
See YourChild: Rett Syndrome
What is Asperger syndrome?
See YourChild : Asperger syndrome.
How common is autism?
Autism/PDD occurs in about 1 in 125 births. It is four times more common among
boys than girls. Autism is found all through the world in families of all
racial, ethnic and social backgrounds. According to a recent study in California, the
number of cases of autism is on the rise. This is probably a national
trend.
What causes autism?
Current research suggests that differences in the development
of the brain and central nervous system cause autism. What causes
these differences in brain development is not known for sure. However,
a variety of factors are being investigated. These include infectious,
metabolic, genetic, and environmental factors. A 1995 National
Institutes of Health (NIH) working group reached a consensus that
autism probably results from a genetic susceptibility that involves
multiple genes. To date, genetic causes for one disorder commonly
accompanied by autism (Fragile X) and one autism-spectrum disorder
(Rett syndrome) have been identified and
genetic "hotspots" for
autism have been found. NIH research on possible genetic, infectious,
immunological, and environmental causes and mechanisms of autism
continues.
Do vaccines cause autism?
Research continues on vaccines and
autism, and so far does not point to a connection between
them. Here are some helpful resources from the American Academy
of Pediatrics:
How are autism spectrum disorders diagnosed?
Your general pediatrician may hesitate to diagnose autism earlier than age three.
But you may suspect a problem as early as 18 months. Go with
your gut feeling, no matter what your child's regular doctor says. Language
and hearing concerns are the most usual first signs.
If your child is not developing language or is losing language,
does "not hear you" a lot of the time, or does not share
interest in things with you, you should have your child evaluated.
Many children can be reliably diagnosed at 18 months old - and
the earlier the diagnosis, the sooner you can start treatment.
Take your child to a developmental and behavioral pediatrician,
pediatric psychiatrist, or pediatric neurologist. They are experts
in diagnosing autism, and can help you figure out the best treatment
plan. An alternative to seeing a specialist is to go to your
school system.
Ask your school system in writing for an evaluation of
your child. They are required to provide it, at no cost to you.
The purpose of an evaluation is to find out why your child
is not meeting their developmental
milestones. A team of professionals will work with
you to evaluate your child. If they do not find a problem,
you can ask the school system to pay for an Independent Educational
Evaluation (IEE). There are strict rules about this, so you
may not get it. You can also have your child tested again
privately, and pay for it yourself. But check with your school
district first to make sure they will accept the private test results. By
law, the school system must consider the results of the second
evaluation when deciding if your child can get special services.
- New Visions
for Parents, from Zero to Three, is a guide
for parents who are concerned about their baby’s, toddler’s
or preschooler’s development and learning. It will help
you prepare for an evaluation, and know what to expect. Use
the red navigation bar at the top of the New Visions screen
to guide you through the materials.
- Basics
for Parents: Your Child’s Evaluation explains what
parents of school-aged kids need to know about the evaluation
process.
What treatments are there for autism?
The most important thing is to start treatment as early
and intensively as possible!
If you are concerned about your child's development, check out First
Signs, a website with information and resources for early
identification and intervention for children with developmental
delays and disorders.
There is no cure for autism, but early and intensive treatment
can help children with autism improve their communication and social
skills. Treatment may include support and facilitation, behavior
modification, educational therapy, and medicine.
Every state has an early intervention program that you will want
to get your child into right away. If you live in Michigan,
your doctor may refer you to the Early On Program in your
local school district. (Outside Michigan, you can find your state’s early intervention services through
the NICHCY website.) Early
On (and all states’ early intervention programs) offer many
different services and will help set up an individualized program
for your family. It is called an Individual
Family Service Plan (IFSB).
It is most important to start treatment as early as possible,
and make sure it involves lots of one-on-one interaction with
your child.
The National Research Council's Committee on Educational Interventions
for Children with Autism has published Educating
Children with Autism. It is a publication of the results of
a committee of experts from many different fields who got together
to look at research and policy. They have created a "map" to
guide the education of young children (birth to age eight) with
autistic spectrum disorders. A section entitled "Characteristics
of Effective Interventions," on page 6 of the Executive Summary
of the report, states [1]:
"The consensus across programs is generally strong concerning
the need for: early entry into an intervention program; active
engagement in intensive instructional programming for the equivalent
of a full school day, including services that may be offered in
different sites, for a minimum of 5 days a week with full-year
programming; use of planned teaching opportunities, organized around
relatively brief periods of time for the youngest children (e.g.
15- to 20-minute intervals); sufficient amounts of adult attention
in one-to-one or very small group instruction to meet individualized
goals. Overall, effective programs are more similar than different
in terms of levels of organization, staffing, ongoing monitoring,
and the use of certain techniques, such as discrete trial, incidental
learning, and structured teaching periods. However, there are real
differences in philosophy and practice that provide a range of
alternatives for parents and school systems."
You can go online to read the full report from the National Academy
Commission on Behavioral and Social Sciences and Education, Educating
Children with Autism.
We do not endorse any particular interaction-based treatment program,
but want you to be aware of some of the options. Some of the treatment
programs that focus on working intensively and one-on-one with
children are:
What about alternative treatments?
You may hear about new or alternative treatments that people are talking about.
Before starting your child on one of these, talk about it with your child's
doctor. Take a look at these red
flags and rules of thumb for evaluating treatments. If you are curious
about the research behind a specific treatment, do a search on Quackwatch.org. Many "treatments" that
are marketed to parents of children with autism are very expensive, may harm
you child, and are not based on sound research. Beware of treatments that claim
to have a miracle "cure" for autism. Do not let alternative or complementary
treatments infringe in any way on intensive one-on-one interactive treatment
programs, as described in the section above. We know beyond a doubt that these
kinds of intensive treatments work.
What is special education?
Special education means “educational programming designed
specifically for the individual.” If your school-aged child
qualifies for special education, they will have an Individualized
Education Program (IEP) designed just for them.
What happens as my child grows up and eventually becomes an
adult?
Transition planning means planning to get your child
ready to lead a rewarding life as an adult. As your child
gets closer to adulthood, they will need an IEP
transition plan. Transition planning begins at age 14. It
is part of the IEP every year after that. At age 16, planning
will begin for how your child will transition from school into
the community. The goal is for your child to become as independent
as possible. Your child should take part
in the planning, because their input will help make the plan
more successful. For a thorough discussion (28 pages when
printed) of the transition plan, see Transition
Planning: A Team Effort , from NICHCY. For resources on youth
with intellectual disabilities attending college, visit the ThinkCollege website.
What do I need to
know about the laws that have to do with early intervention
and special education? What are our
rights?
delete.
What are some tips for parenting kids with autism?
Pay attention to your child's environment and routine:
- Keep the environment predictable and familiar, and prepare
your child for changes.
- Provide structure and routine.
- Pay attention to sensory input from the environment, like noise,
temperature, smells, lots of people around, etc.
When you talk to your child:
- Be logical, organized, clear, concise and concrete. Avoid jargon,
double meanings, sarcasm, nicknames, and teasing.
- Explain abstract concepts in concrete terms.
- Don't talk about your child in front of them, unless you include
them in the conversation.
To help your child improve their behavior:
- Help your child learn to communicate using gestures, sign language,
picture boards, communication devices, and/or speech. Work on
communication early, and be consistent to help your child improve
more. Better communication will help relieve frustration and
may lead to better behavior.
- Teach your child to make choices.
- Be consistent in rewarding positive behavior.
- Replace the unwanted behavior with a favorite activity. In
other words, use distraction.
- Choose rewards you know your child will like.
Always remember to show love and caring for your child.
My child was just diagnosed. Where do we start?
- Get your child in an early intervention program right away.
Every state has one. Start by calling your local school district.
For help locating your state's early intervention or special
education program, visit NICHCY (National
Information Center for Children and Youth with Disabilities),
and go to your state's list of resources or call them at 1-800-695-0285.
- Begin an intensive behavioral program right away. This could
be an ABA or "Floortime" - type program. delete
- Make sure your child's therapy includes lots of speech and
language.
- Include occupational therapy as well, especially if your child
has sensory integration (SI) issues.
- Your child's specialist doctor may prescribe medication to
help with certain behaviors/symptoms.
- Using diet and vitamins or other alternative therapies are
not helpful in the majority of cases. Use your time and money
on proven treatments: intensive, one-on-one behavioral therapy.
Other good starting points for parents of a newly diagnosed child:
How can I get more information, help and support?
Related topics on YourChild:
Additional Resources:
- The National Institutes of Health has a delete pamphlet on
autism. It also comes in Spanish.
The pamphlet includes a list of resources at the end.
- Clinical
Practice Guideline for Autism/Pervasive Developmental Disorders:
Assessment and Intervention for Young Children (Age 0-3 Years) from
the New York State Department of Health Early Intervention
Program.
- The American Academy of Pediatrics policy statement on The
Pediatrician’s Role in the Diagnosis and Management of Autistic
Spectrum Disorder in Children.
- The Autism Society
of America (ASA) works to increase public awareness about
autism and the day-to-day issues faced by people with autism
and their families. They provide information and education,
support research and advocate for programs and services for
the autism population. The ASA has state and local chapters.
Call toll-free 1-800-328-8476.
- The Autism Society of Michigan:
1-800-223-6722.
- The Autism National Committee strives
to protect and advance the human rights and civil rights of all
persons with autism, PDD, and related differences of communication
and behavior. Their website contains information on politics
and legal issues, early intervention and education, community
living issues, and advocacy.
- Autism National Committee
635 Ardmore Avenue Ardmore, PA 19003-1831
- NICHCY (National Information
Center for Children and Youth with Disabilities, now called the
National Dissemination Center for Children with Disabilities)
provides information and makes referrals in areas related to:
early intervention, special education and related services, individualized
education programs (IEPs), family issues, disability organizations,
professional associations, education rights, transition to adult
life, and more. They can provide personal answers to your questions,
fact sheets, state resource sheets, parent guides, reading lists,
and referrals to other organizations. Materials are also available
in Spanish. Call toll-free 1-800-695-0285
- Early On Michigan is
the state of Michigan’s early intervention service. Call
1-800-EARLY-ON. If you live outside Michigan, NICHCY can help you find your
own state’s early intervention service.
- The University of Michigan
Autism and Related Communication Disorders Center (UMACC)
is committed to integrating research, training, and clinical
service. The Center conducts research designed to advance knowledge
of autism and train future researchers and clinicians. They
offer complete diagnostic evaluations, intervention, consultation
to schools, therapists, and other professionals, as well as
training and resources to families and professionals working
with children with autism.
- The Yale Child Study Center's Developmental Disabilities
Clinic and Research Homepage has lots of information on
PDDs, including autism, Asperger syndrome, Rett disorder, and
childhood disintegrative disorder.
- Autism web resources from
the AAP National Center of Medical Home Initiatives for Children
with Special Needs
- Division TEACCH (Treatment and Education
of Autistic and Related Communication Handicapped Children) at
the University of North Carolina at Chapel Hill has information
about autism, Asperger syndrome, and educational and communication
approaches.
- The National Institute of Child Health and Human Development
has an autism page that lists their
resources.
- Parents of Autistic Children is
a New Jersey-based organization of parents that provides service
to the autism community. Their website offers an on-line distance
learning lecture on
Applied Behavior Analysis (ABA) and verbal learning.
- NAAR (National Alliance for
Autism Research) promotes and funds research on causes, prevention,
and treatment of PDDs. Phone is 609-430-9160.
- TASH is a worldwide organization
that works for inclusion of all people in all aspects of society.
Call 410-828-8274.
- Project Perform is
an information and support resource for families of children
with special needs in Michigan. They have an information folder
on autism/PDDs available, a lending library, and can refer you
to parent support groups. 1-800-552-4821.
- The
Family Support Subsidy Program from the Michigan Department
of Community Health can provide money for special expenses
for caring for a child with severe disabilities. Call 517-335-3573
for more information.
- Project Find can
help you figure out whether your child (from birth to age 26)
qualifies for special education services in Michigan. Call 1-800-252-0052.
- Zero to Three is the nation's leading
resource on the first three years of life, with a mission to
strengthen and support families, practitioners and communities
to promote the healthy development of babies and toddlers.
- Council for Exceptional
Children is a professional organization that provides publications
for educators, and can also provide referral to ERIC (Educational
Resource Information Center Clearinghouse on disabilities and
gifted education). Call 1-703-620-3660.
- NAPSEC(National Association
of Private Schools for Exceptional Children) provides referrals
for private special education programs. Call 1-202-408-3338.
- Exceptional Parent Magazine -
provides information, support, ideas, encouragement and outreach
for parents and families of children with disabilities, and the
professionals who work with them.
- Long list of links to cognitive and developmental
disabilities websites.
- The
Different Shades of Autism Video
Literature cited:
[1] National Research Council (2001) Educating Children with Autism . Committee on Educational Interventions for Children with Autism. C Lord and JP McGee, eds. Division of Behavioral and Social Sciences and Education. Washington, DC: National Academy Press.
Still have questions about this topic? Go to
our survey to ask your questions, and we’ll try
to answer them on an upcoming
YourChild podcast.
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Reviewed by faculty and staff at the University of Michigan
Updated September 2005 U-M Health System Related Sites:
U-M Pediatrics
Our editorial policy
The information and links we provide are reviewed by University of Michigan developmental and behavioral pediatricians and child psychologists who are experts in child behavioral health. In choosing the links we provide, we use strict criteria to ensure that the information is accurate, and the source is reputable. As much as possible, we focus on information that is based on research. In areas where there is inadequate research, we include information compatible with prevailing expert opinion.
This website is updated regularly, but because of the dynamic nature of the Internet, we cannot be responsible for misinformation that may be accessed through the links provided. As always, this website is not a tool for self-diagnosis, and is not a substitute for professional care.
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