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The seventh annual World Autism Awareness Day is April 2, 2014. Every year, autism organizations around the world celebrate the day with unique fundraising and awareness-raising events
What Is Autism?
What Is Autism? What is Autism Spectrum Disorder?
Autism spectrum disorder (ASD) and autism are both general terms for a group of complex disorders of brain development. These disorders are characterized, in varying degrees, by difficulties in social interaction, verbal and nonverbal communication and repetitive behaviors. With the May 2013 publication of the DSM-5 diagnostic manual, all autism disorders were merged into one umbrella diagnosis of ASD. Previously, they were recognized as distinct subtypes, including autistic disorder, childhood disintegrative disorder, pervasive developmental disorder-not otherwise specified (PDD-NOS) and Asperger syndrome.
ASD can be associated with intellectual disability, difficulties in motor coordination and attention and physical health issues such as sleep and gastrointestinal disturbances. Some persons with ASD excel in visual skills, music, math and art.
Autism appears to have its roots in very early brain development. However, the most obvious signs of autism and symptoms of autism tend to emerge between 2 and 3 years of age. Autism Speaks continues to fund research on effective methods for earlier diagnosis, as early intervention with proven behavioral therapies can improve outcomes. Increasing autism awareness is a key aspect of this work and one in which our families and volunteers play an invaluable role.
How Common Is Autism?
Autism statistics from the U.S. Centers for Disease Control and Prevention (CDC) identify around 1 in 68 American children as on the autism spectrum–a ten-fold increase in prevalence in 40 years. Careful research shows that this increase is only partly explained by improved diagnosis and awareness. Studies also show that autism is four to five times more common among boys than girls. An estimated 1 out of 42 boys and 1 in 189 girls are diagnosed with autism in the United States.
ASD affects over 2 million individuals in the U.S. and tens of millions worldwide. Moreover, government autism statistics suggest that prevalence rates have increased 10 to 17 percent annually in recent years. There is no established explanation for this continuing increase, although improved diagnosis and environmental influences are two reasons often considered.
What Causes Autism?
Not long ago, the answer to this question would have been “we have no idea.” Research is now delivering the answers. First and foremost, we now know that there is no one cause of autism just as there is no one type of autism. Over the last five years, scientists have identified a number of rare gene changes, or mutations, associated with autism. A small number of these are sufficient to cause autism by themselves. Most cases of autism, however, appear to be caused by a combination of autism risk genes and environmental factors influencing early brain development.
In the presence of a genetic predisposition to autism, a number of nongenetic, or “environmental,” stresses appear to further increase a child’s risk. The clearest evidence of these autism risk factors involves events before and during birth. They include advanced parental age at time of conception (both mom and dad), maternal illness during pregnancy and certain difficulties during birth, particularly those involving periods of oxygen deprivation to the baby’s brain. It is important to keep in mind that these factors, by themselves, do not cause autism. Rather, in combination with genetic risk factors, they appear to modestly increase risk.
A growing body of research suggests that a woman can reduce her risk of having a child with autism by taking prenatal vitamins containing folic acid and/or eating a diet rich in folic acid (at least 600 mcg a day) during the months before and after conception.
Increasingly, researchers are looking at the role of the immune system in autism. Autism Speaks is working to increase awareness and investigation of these and other issues, where further research has the potential to improve the lives of those who struggle with autism.
What Does It Mean to Be “On the Spectrum”?
Each individual with autism is unique. Many of those on the autism spectrum have exceptional abilities in visual skills, music and academic skills. About 40 percent have average to above average intellectual abilities. Indeed, many persons on the spectrum take deserved pride in their distinctive abilities and “atypical” ways of viewing the world. Others with autism have significant disability and are unable to live independently. About 25 percent of individuals with ASD are nonverbal but can learn to communicate using other means. Autism Speaks’ mission is to improve the lives of all those on the autism spectrum. For some, this means the development and delivery of more effective treatments that can address significant challenges in communication and physical health. For others, it means increasing acceptance, respect and support.
How Is Autism Diagnosed?
Presently, we don’t have a medical test that can diagnose autism. Instead, specially trained physicians and psychologists administer autism-specific behavioral evaluations.
Often parents are the first to notice that their child is showing unusual behaviors such as failing to make eye contact, not responding to his or her name or playing with toys in unusual, repetitive ways. For a description of early indicators of autism, see Learn the Signs.
The Modified Checklist of Autism in Toddlers (M-CHAT) is a list of informative questions about your child. The answers can indicate whether he or she should be further evaluated by a specialist such as a developmental pediatrician, neurologist, psychiatrist or psychologist. (Take the M-CHAT here.)
We encourage parents to trust their instincts and find a doctor who will listen and refer their child to appropriate specialists for diagnosis. Unfortunately, doctors unfamiliar with diagnosing autism sometimes dismiss parent concerns, delaying diagnosis and the opportunity for early intervention therapies. Autism Speaks and other autism organizations are working hard to raise awareness of early signs among physicians as well as parents.
From birth to at least 36 months of age, every child should be screened for developmental milestones during routine well visits. When such a screening—or a parent—raises concerns about a child's development, the doctor should refer the child to a specialist in developmental evaluation and early intervention. These evaluations should include hearing and lead exposure tests as well as an autism-specific screening tool such as the M-CHAT. Among these screening tools are several geared to older children and/or specific autism spectrum disorders. (Also see our pages on What Is Autism?, Asperger Syndrome and PDD-NOS.)
A typical diagnostic evaluation involves a multi-disciplinary team of doctors including a pediatrician, psychologist, speech and language pathologist and occupational therapist. Genetic testing may likewise be recommended, as well as screening for related medical issues such as sleep difficulties. This type of comprehensive helps parents understand as much as possible about their child's strengths and needs. (For local and regional centers specializing in the coordinated medical care of children and adolescents with autism, explore Autism Treatment Network )
Sometimes an autism spectrum disorder is diagnosed later in life, often in relation to learning, social or emotional difficulties. As with young children, diagnosis of adolescents and adults involves personal observation and interview by a trained specialist. Often, a diagnosis brings relief to those who have long struggled with difficulties in relating socially while not understanding the source of their difficulties. A diagnosis can also open access to therapies and assistive technologies that can improve function in areas of difficulty and, so, improve overall quality of life.
The American Psychiatric Association is currently revising the medical definition of autism spectrum disorder in ways that are expected to change its diagnostic characteristics. This change will go into effect in May 2013.
Autism spectrum disorders (ASD) are characterized by social-interaction difficulties, communication challenges and a tendency to engage in repetitive behaviors. However, symptoms and their severity vary widely across these three core areas. Taken together, they may result in relatively mild challenges for someone on the high functioning end of the autism spectrum. For others, symptoms may be more severe, as when repetitive behaviors and lack of spoken language interfere with everyday life.
As illustrated by the graph on the left, the basic symptoms of autism are often accompanied other medical conditions and challenges. These, too, can vary widely in severity.
While autism is usually a life-long condition, all children and adults benefit from interventions, or therapies, that can reduce symptoms and increase skills and abilities. Although it is best to begin intervention as soon as possible, the benefits of therapy can continue throughout life.
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