The experts at the Seaver Autism Center for Research and Treatment have compiled the following answers to frequently asked questions about autism spectrum disorder and related conditions.
There is strong data indicating that genetics are the major cause of autism. However, not all genetic risk is inherited; some genetic changes leading to autism occur as mutations in the egg or sperm.
There are several epidemiological studies that have disproven the connection between autism and vaccines.
In toddlers, obvious symptoms may not be present, so it is often the absence of expected behavior that indicates a developmental problem. Autism has two core symptom domains as defined by the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5): The first is deficits in social communication and social interaction, and the second is repetitive and restricted behaviors and interests. The ways in which these symptoms manifest themselves vary from one child to the next. Common symptoms to look for include: fleeting eye contact, limited gesturing such as pointing or waving, limited pretend play, difficulty reading nonverbal cues, odd language such as scripted speech or echolalia (repeating another person’s words), repetitive motor movements, and difficulties with changes in environment or routine.
While there is no medical test for autism, an autism spectrum diagnosis is made based on observed behavior, developmental history, and autism-specific assessment tools. The “gold standard” assessment includes the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) and the Autism Diagnostic Interview - Revised (ADI-R). These tools, along with clinical judgment, are used to make a DSM-5 diagnosis of autism spectrum disorder. Early diagnosis is important because it can lead to earlier treatment, which research has linked to more positive outcomes.
Families have reported improvements in behavior and language as a result of special diets, including elimination diets that remove gluten (a protein in wheat and related grains) and casein (a protein in milk). However, research results do not support the widespread use of elimination diets as a treatment for autism symptoms.
Autism research is quickly developing across many areas, including genetics, neurobiology, educational interventions, and targeted medications. One promising area of research seeks to identify autism genes in order to develop new medications based on genetic findings.
The first step is a conversation with your child’s pediatrician. The American Academy of Pediatrics recommends that all children be screened for autism at their 18-month and 24-month well-child checkups. If there are concerns, your pediatrician should refer you to a specialist (such as a child psychiatrist or psychologist, developmental pediatrician, or pediatric neurologist) for a more extensive evaluation. An evaluation conducted by a multidisciplinary team (including a speech therapist, occupational therapist, and physical therapist) may also be beneficial for treatment planning. In addition to an autism-specific evaluation, a hearing test and lead screening should be conducted.
The primary and first-line treatments include intensive behavioral and educational therapies that promote the development of the unique social and communication deficits seen in individuals with autism. Specific interventions should be tailored to each individual’s needs and may include both behavioral and pharmacological interventions. Many children benefit from a multidisciplinary team that may include applied behavior analysis (ABA) therapists, speech and language pathologists, occupational therapists, physical therapists and other professionals. There is currently no cure for autism.