We have finally made it to the month of April and this year is flying by! April is the month to celebrate and spread autism awareness. This month, everyone is encouraged to wear blue to celebrate and show support. Maybe you know someone with autism or are working in the medical field. Maybe you are a family member of a kiddo who was recently diagnosed and are just learning about autism. In this blog, we will shed some light into autism and provide some facts about the diagnosis.
To begin, what is autism spectrum disorder? According to the Mayo Clinic (2018), Autism Spectrum Disorder (ASD) is “…is a condition related to brain development that impacts how a person perceives and socializes with others, causing problems in social interaction and communication. The disorder also includes limited and repetitive patterns of behavior. The term “spectrum” in autism spectrum disorder refers to the wide range of symptoms and severity.”
Here are some facts about ASD according to the Centers for Disease Control and Prevention (CDC):
• Males are more likely to be diagnosed with autism than females by 4:1.
• Many females are not diagnosed with autism until they are older due to different presentation of symptoms
• Approximately, 1 in every 44 children has autism spectrum disorder. This number has increased since 2000 when it was 1 in every 150 children.
• An autism diagnosis occurs across all races and socioeconomic groups
Autism is diagnosed through testing (e.g., skill assessment), interview with parents on symptoms shown, and comparing the symptoms to the child’s developmental milestones using the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Autism is diagnosed through assessing their ability to engage socially, communicate, and their patterns of behavior. There are no blood tests or genetic tests at this time that can diagnose autism.
What are the signs and symptoms of ASD?
According to the Centers for Disease Control and Prevention and the Mayo Clinic, there are two main categories of deficits related to autism. The categories are troubles with social communication skills and restricted or repetitive behaviors of interest. It is important to note that some characteristics of autism do not apply to each person and no two people with autism may have the same symptoms. This is why the diagnosis of autism is a spectrum as it varies between individuals. It is also important to know the signs of autism as the earlier the diagnosis and intervention, the more likely the individual is to need less intensive support.
Early signs in the social communication domain-
• Does not make eye contact with others or maintain it
• Does not respond to name when called
• Does not share experiences with others (e.g., will not look at a toy when shown, show off an item that they like, or engage in games like peek-a-boo).
• Does not engage in pretend play (e.g., pretends to be a chef with a play kitchen or a singer with a microphone).
• Does not communicate their needs or engage in conversation
Early signs in the restricted or repetitive behaviors of interest domain-
• Only plays with toy items in a specific and repeated way (e.g., always rolls a car back-and-forth, pushes the same button on a piano toy multiple times, or taps a drumstick repeatedly).
• Fixates on parts of a toy or item (e.g., wants to look at the light on the toy or lays down to watch the wheels on a car move).
• Engages in repetitive body movements (e.g., flapping hands up/down, toe walking, and bouncing up and down when walking or sitting).
• Gets upset or angry when there is a change in routine or daily activity (e.g., if you play with car toys on a track, but you play with them on the floor or if you eat in the living room, but not the table).
• Is uninterested in age-appropriate toy items (e.g., would rather play with spoons than a puzzle).
Outside of the two domains above, there are some other signs that have been found in children with autism:
• Sensitivities to sound (e.g., will become upset when the toilet flushes or cries when the vacuum is used).
• Sensitivities to textures (e.g., will only wear certain fabrics or tolerate crunchy foods).
• Troubles sleeping
• Limited diet or tolerance of foods (e.g., will only eat chicken nuggets or drink orange juice but no other liquids).
While the above are the common signs and symptoms, it is important to also consider if there are any differences in signs based on gender. There are some factors to consider and research to support differences in presentation amongst males and females with autism. With an increase in males being diagnosed with autism compared to their female counterpart, research is currently being conducted to find out the reason behind the prevalence rates. One reason for the discrepancy between the genders is the way the symptoms of autism are presented and the biological factors behind it. The data on the prevalence of autism may be skewed as the female presentation of symptoms is harder to detect due to masking. Research has shown that females are more likely to “mask,” their characteristics of autism from others. This means that they are more likely to suppress their emotions or characteristics of autism, and imitate the behavior of others to blend in. Research has shown that females with autism are generally stronger at engaging in social communication skills (e.g., initiating interactions, eye contact, speaking with others), less-outward with their feelings and tend to internalize, and their interests are generally age-appropriate (e.g., liking to play with dolls or fixated on a specific show).
Males with autism
• Engage in more repetitive behaviors and restricted interests in play (e.g., moving trains in the same motion or only wanting to play with the guitar toy).
• Social skills are the initial indicator of autism in their early years (e.g., avoiding eye contact or unable to express their wants).
• Need more support to stay focused on a task, this often presents itself as hyperactive behaviors
• Engage in problem behaviors outwardly for items or actions (e.g., crying, whining, hitting, etc.) and are less likely to hide their true feelings.
• Are more likely to play by themselves than with others
Females with autism
• Mask or camouflage their symptoms
• Keep to themselves and appear to be “shy” around others
• Seem overly reliant on others speaking for them and limited initiation of wants (e.g., will wait for parent to answer a question for them or advocate for their needs).
• Are more likely to have difficulty maintaining friendships
The impairments and intensity of the signs mentioned above determine what level the individual’s autism may be classified as. Since autism is a spectrum and varies across individuals, there is a set criterion for diagnosing the level of support needed. Using the DSM-5, there are three levels of autism classification:
• Level 1- Requiring Support
• Level 2- Requiring Substantial Support
• Level 3- Requiring Very Substantial Support
These levels can determine what services are necessary to improve symptoms and create a comprehensive treatment plan. The varying levels also provide insight into what level of support the individual needs at that time. While the individual’s autism diagnosis does not go away, the level of support needed may decrease with time.
In sum, autism is a prevalent condition that affects 1 in 44 children in the world. Autism is more likely to be diagnosed in males than in females based on a variety of factors. Autism effects an individual’s ability to engage in social communication skills (e.g., making friends, playing with others, or expressing their feelings), engage in age-appropriate behaviors (e.g., playing with toys how they are intended or broad range of interests), and sometimes their diet or lifestyle (e.g., routines and community engagement). If you are concerned with your child’s behaviors or progress with meeting their milestones, the CDC has a checklist that can be used from 2 months of age up to 5 years old of developmental milestones (the link to the milestones can be found under the References list). If you are concerned that your child has autism, please see your pediatrician to discuss the signs and schedule an evaluation.
If you would like more information on the contents of this blog, references for diagnosing providers in the area, or to schedule an assessment for your child, please contact us at (813) 814-2000. We are happy to help in any way that we can!
Centers for Disease Control and Prevention. (2022, March 28). Signs and symptoms of autism spectrum disorders. Centers for Disease Control and Prevention. Retrieved January 31, 2023, from https://www.cdc.gov/ncbddd/autism/signs.html
Centers for Disease Control and Prevention. (2022, December 29). CDC’s Developmental Milestones. Centers for Disease Control and Prevention. Retrieved January 31, 2023, from https://www.cdc.gov/ncbddd/actearly/milestones/index.html
Centers for Disease Control and Prevention. (2022, March 2). Data & statistics on autism spectrum disorder. Centers for Disease Control and Prevention. Retrieved January 31, 2023, from https://www.cdc.gov/ncbddd/autism/data.html
Fletcher, J. (2022, October 11). Autism in boys vs. girls. Psych Central. Retrieved January 31, 2023, from https://psychcentral.com/autism/comparison-of-boys-and-girls-living-with-autism-spectrum-disorder#recap
Mayo Foundation for Medical Education and Research. (2018, January 6). Autism spectrum disorder. Mayo Clinic. Retrieved January 31, 2023, from https://www.mayoclinic.org/diseases-conditions/autism-spectrum-disorder/symptoms-causes/syc-20352928