Learn about the core symptoms, diagnosis, and early intervention strategies for autism spectrum disorder to support children's development and social integration.

Autism spectrum disorder presents with impairments in key skills:

1. Impaired social skills in interacting with others

• Avoids eye contact or makes less eye contact than normal

• Does not point to indicate needs

• Shows no shared interest with caregivers and does not imitate others

• Does not show objects when excited about new or interesting items

• Prefers solitary play, has a personal world, tends to isolate

2. Impaired language development and communication skills, both understanding and usage

• Does not vocalize in response to caregivers

• Does not respond when name is called

• Shows no interest in instructions and does not follow commands

• Does not use gestures to communicate

• Delayed speech or absence of speech, speech not age-appropriate, echolalia, or self-created language

3. Behavioral abnormalities, usually not apparent in children under 2 years old

• Repetitive behaviors such as jumping, spinning, hand flapping, rocking, lining objects up, fascination with spinning objects

• Restricted interests or rigid routines, such as selective eating or wearing only certain clothes; resists changes or becomes irritable and anxious when routines are disrupted

• Unusual sensory responses, such as smelling or licking objects, covering ears at loud sounds, or tiptoe walking

Causes

The exact cause remains unclear. It likely results from a combination of genetic and environmental factors.

Prevalence

International studies show the prevalence of autism spectrum disorder is steadily increasing, currently about 1 in 60 children. Boys are affected about 2–3 times more often than girls.

Diagnosis

Diagnosis is made by a developmental pediatrician or child psychiatrist based on clinical symptoms, detailed behavioral observation in a clinical setting, caregiver questionnaires, and follow-up after early intervention.

Management of children with autism

There is no cure. Management focuses on developmental stimulation and behavioral therapy to reduce impairments, helping children transition from their own world to family life, society, and school. Early, individualized, and continuous intervention is crucial because children’s brains are highly adaptable and responsive to training.

Provide predictable routines and structure, possibly using visual schedules to aid understanding

1. Behavioral therapy to encourage appropriate behavior and promote overall development

2. Speech therapy to improve speech and communication skills

Nonverbal communication

Includes training children to make eye contact, point to indicate needs, point to pictures, and use gestures to communicate needs

Understanding language and verbal communication

Includes teaching children to recognize their name, respond to calls, follow instructions, and speak

3. Social skills training: learning to recognize self, family, and others; developing shared interest with others; learning to play, understand emotions, join groups, and participate in peer activities

4. Occupational therapy to develop fine motor skills and self-help abilities

5. Self-help and daily living skills training: using utensils, dressing, toilet training, personal hygiene — starting with hand-over-hand assistance and gradually reducing help until the child can act independently through repeated practice

6. Appropriate education tailored to each child’s abilities and intelligence

7. Medication: No specific drugs treat autism spectrum disorder directly, but medication may help manage undesirable symptoms or behaviors, such as aggression, hyperactivity, or inattention, when necessary