What Is Autism Spectrum Disorder (ASD)?

People with Autism spectrum disorder, or ASD, usually have trouble with social interaction, but they also tend to have certain strengths. Here’s what you should know.

Autism spectrum disorder (ASD) isn’t just a childhood disease. Today, most people with ASD are adults.

Their outlook is much brighter than it was 50 years ago; more people with the condition are able to speak, read, and live in the community rather than in institutions. As many as a third may even be mostly free from symptoms by adulthood. But it’s still true that most adults with ASD cannot work full-time or live independently, and about a third are intellectually disabled.

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What is autism spectrum disorder (ASD)?

Pediatricians have been advised to screen all children for autism spectrum disorder, which usually begins to show up by age two. Early treatment can help a child with ASD flourish.

According to a guide for psychiatrists diagnosing mental disorders, the DSM-5, people with ASD have:

• Difficulty with communication and interaction with other people
• Restricted interests and repetitive behaviors
• Symptoms that hurt the person’s ability to function properly in school, work, and other areas of life

To match that diagnosis, a child could show any of a wide range — or spectrum — of symptoms ranging from mild to severe. Someone with ASD won’t act in all the ways that are typical of the condition, but most likely several.

What are the signs of ASD?

A child with ASD might avoid eye contact, or do so inconsistently. He may not look at people or listen to them and may not try to share activities. While another child would show you his toy, a child with ASD will play with it in the corner.

If you call out to him, he might not answer, and when you try to start a conversation, he might not respond. When he does talk, his expressions and gestures may not match his words, and he might have a sing-songy or flat, robot-like voice. He might repeat words or phrases, a pattern called echolalia. Sometimes he will talk for a long time about one subject — often providing many details, especially numbers — even if you try to interrupt or show that you’re not interested. If another child is acting cranky, or seeking his company, he may not notice.

He also could get upset by slight changes in routine and be bothered by light, noise, temperature, and a collar on a shirt. He might have trouble sleeping and become irritable.

Children with ASD are more likely than other children to have tics or epilepsy. About half have gastrointestinal problems, and a quarter are obese.

What are the strengths of people with ASD?

Your child may be a good student, able to remember details for a long time. He may excel especially in math, science, music, and art. But it’s a myth that all children with ASD are talented. Among preschool children with ASD, many have an intellectual disability as well and disabilities can last into adulthood.

What causes ASD?

We don’t know. We do know that genes play a role. Children with certain genetic conditions — Down syndrome, fragile X syndrome, and Rett syndrome — are also more likely to have ASD. Mothers older than 40 and fathers older than 50 are more likely to produce children with ASD. A sibling with ASD is another risk factor. Childhood vaccinations are not a cause of ASD, and you can’t blame bad parenting. Environmental factors may play a role.

How is ASD treated?

Early treatment can help a child with ASD make the most of his strengths and learn needed skills. Because ASD children are so different from each other, parents need to work closely with the experts treating their child. Medication may help tame irritable or aggressive behavior, hyperactivity, lack of attention, anxiety, and depression. Therapists can coach your child to master social and language skills or, as your child gets older, perhaps learn to live on his own. Parents need to understand that only about a quarter of individuals with ASD with average intelligence live in their own households; the rest stay with their families. Marriage and long-term intimate relationships are still rare.

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