Healthy Minds

Emotional Growth

Autism Spectrum Disorder (ASD)

Autism spectrum disorder is a developmental disability caused by differences in the brain. Scientists do not know yet exactly what causes these differences for most people with ASD.

However, some people with ASD have a known difference, such as a genetic condition. There are multiple causes of ASD, although most are not yet known.

ASD begins before the age of 3 and last throughout a person’s life, although symptoms may improve over time.

Some children with ASD show hints of future problems within the first few months of life. In others, symptoms may not show up until 24 months or later. Some children with an ASD seem to develop normally until around 18 to 24 months of age and then they stop gaining new skills, or they lose the skills they once had.

Studies have shown that one third to half of parents of children with an ASD noticed a problem before their child’s first birthday, and nearly 80%–90% saw problems by 24 months of age.

There is often nothing about how people with ASD look that sets them apart from other people, but they may communicate, interact, behave, and learn in ways that are different from most other people. The learning, thinking, and problem-solving abilities of people with ASD can range from gifted to severely challenged.

Children with ASD usually have significant difficulties in the following 3 areas:

Social Skills

Social issues are one of the most common symptoms in all of the types of ASD. People with an ASD do not have just social “difficulties” like shyness. The social issues they have cause serious problems in everyday life.

Examples of social issues related to ASD:

  • Does not respond to name by 12 months of age
  • Difficult to get a responsive smile by 6 months of age
  • Avoids eye-contact
  • Prefers to play alone
  • Does not share interests with others
  • Only interacts to achieve a desired goal
  • Has flat or inappropriate facial expressions
  • Does not understand personal space boundaries
  • Avoids or resists physical contact
  • Is not comforted by others during distress
  • Has trouble understanding other people’s feelings or talking about own feelings


Each person with ASD has different communication skills. Some people can speak well. Others can’t speak at all or only very little.

About 40% of children with an ASD do not talk at all. About 25%–30% of children with ASD have some words at 12 to 18 months of age and then lose them. Others might speak, but not until later in childhood.

Examples of communication issues related to ASD:

  • Delayed speech and language skills
  • Repeats words or phrases over and over (echolalia)
  • Reverses pronouns (e.g., says “you” instead of “I”)
  • Gives unrelated answers to questions
  • Does not point or respond to pointing
  • Uses few or no gestures (e.g., does not wave goodbye)
  • Talks in a flat, robot-like, or sing-song voice
  • Does not pretend in play (e.g., does not pretend to “feed” a doll)
  • Does not understand jokes, sarcasm, or teasing

Unusual Interests and Behaviors

Many children with ASD have unusual interest or behaviors. A child with an ASD might spend a lot of time repeatedly flapping their arms, rocking from side to side, spinning self in a circle for a long time, repeatedly turning a light on and off or spin the wheels of a toy car. They types of activities are known as “self-stimulation” or “stimming”.

Examples of unusual interests and behaviors related to ASD:

  • Lines up toys or other objects
  • Plays with toys the same way every time
  • Likes parts of objects (e.g., wheels)
  • Is very organized
  • Gets upset by minor changes
  • Has obsessive interests
  • Has to follow certain routines
  • Flaps hands, rocks body, or spins self in circles

Autism and Co-Morbid Mental Health Condition

  • Attention-Deficit/Hyperactivity Disorder (ADHD)
  • Anxiety Disorder
  • Attachment Disorder
  • Depression
  • Obsessive-Compulsive Disorder(OCD)
  • Oppositional Defiant Disorder(ODD)
  • Post-traumatic Stress Disorder(PTSD)

Screening and Diagnosis

Screening: There are many different developmental screening tools. Some examples of screening tools for general development and ASD including Ages and Stages Questionnaires (ASQ) and Modified Checklist for Autism in Toddlers (MCHAT).

ASD can sometimes be detected at 18 months of younger. By age 2, a diagnosis by an experienced professional can be considered very reliable.

Diagnosis: ASD Diagnostic tools usually rely on two main sources of information-parents’ or caregivers’ descriptions of their child’s development and a professional’s observation of the child’s behavior.

Two examples of diagnostic tools including: Autism Diagnosis Interview- Revised (ADI-R) and Autism Diagnosis Observation Schedule (ADOS-2).


According to reports by the American Academy of Pediatrics and the National Research Council, behavior and communication approaches that help children with ASD are those that provide structure, direction, and organization for the child in addition to family participation.

Research shows that early intervention treatment services can improve a child’s development. Early intervention services help children from birth to 3 years old learn important skills. It is important to talk to a specialist as soon as possible if you think your child might have an ASD or other developmental problems.

There are NO MEDICATION that can cure ASD or even treat the main symptoms. But there are medications that can help some children with related symptoms, such as manage high energy levels, inability to focus, depression, or seizures.

Types of behavioral treatment

Applied Behavior Analysis (ABA)

ABA encourages positive behaviors and discourages negative behaviors in order to improve a variety of skills. The child’s progress is tracked and measured.

Developmental, Individual Differences, Relationship-Based (DIR/Floortime)

Floortime focuses on emotional and relational development (feelings, relationships with caregivers). It also focuses on how the child deals with sights, sounds, and smells.

Speech Therapy

Speech therapy helps to improve the person’s communication skills. Some people are able to learn verbal communication skills. For others, using gestures or picture boards is more realistic.

Sensory Integration Therapy

Sensory integration therapy helps the person deal with sensory information, like sights, sounds, and smells. Sensory integration therapy could help a child who is bothered by certain sounds or does not like to be touched.

Dietary Approaches

Some dietary treatments have been developed by reliable therapists. But many of these treatments do not have the scientific support needed for widespread recommendation. An unproven treatment might help one child, but may not help another.

If you are thinking about changing your children’s diet, talk with nutritionist to make sure your child is getting important vitamins and minerals.

Effects of electronic devices

The study found that the more handheld screen time parents reported, the more likely their toddlers were to have delays in expressive language skills.

For every 30 minute increase in handheld screen time, there was a 49% increase in the risk of speech delay.

Vaccine Safety

A meta-analysis of ten studies involving more than 1.2 million children reaffirms that vaccines don’t cause autism. If anything, immunization was associated with decreased risk that children would develop autism, a possibility that’s strongest with the measles-mumps-rubella vaccine.