Social Behavior And Social Understanding
Basic social interaction can be difficult for children with autism spectrum disorders. Symptoms may include:
- Unusual or inappropriate body language, gestures, and facial expressions .
- Lack of interest in other people or in sharing interests or achievements .
- Unlikely to approach others or to pursue social interaction comes across as aloof and detached prefers to be alone.
- Difficulty understanding other peoples feelings, reactions, and nonverbal cues.
- Resistance to being touched.
- Difficulty or failure to make friends with children the same age.
Diagnosing Autism Spectrum Disorder
In order to determine whether your child has autism spectrum disorder or another developmental condition, clinicians look carefully at the way your child interacts with others, communicates, and behaves. Diagnosis is based on the patterns of behavior that are revealed.
If you are concerned that your child has autism spectrum disorder and developmental screening confirms the risk, ask your family doctor or pediatrician to refer you immediately to an autism specialist or team of specialists for a comprehensive evaluation. Since the diagnosis of autism spectrum disorder is complicated, it is essential that you meet with experts who have training and experience in this highly specialized area.
The team of specialists involved in diagnosing your child may include:
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Level : Requiring Substantial Support
The communication issues that a person with Level 2 ASD may face include:
- noticeable issues with verbal and nonverbal social communication skills
- social issues being apparent despite supports in place
- limited initiation of social interaction
- reduced response to social interactions from others
- interactions that are limited to narrow special interests
- more significant differences in nonverbal communication
The repetitive behavioral issues a person with Level 2 ASD may face include:
- inflexible behavior
- struggling to cope with change
- restricted or repetitive behaviors that are obvious to a casual observer and interfere with functioning in several contexts
- difficulty changing focus or action
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Communication And Social Interaction For Autistic People
Autistic people often have difficulty with communication. They may have difficulty expressing their needs. Some autistic people never develop language, while others might have good verbal language skills.For those who do develop language, they may have difficulties using appropriate grammar and vocabulary, and constructing meaningful sentences. They may misunderstand words, interpret them literally or not understand them at all. Other peoples feelings and emotions can be difficult to understand.
Autistic people can find social skills and social communication very difficult.
This may mean that they appear disinterested in others, aloof or unsure of how to engage in social interactions. They may have difficulty using or interpreting non-verbal communication such as eye contact, gestures and facial expressions, or appear disinterested in the experiences and emotions of others. Establishing and maintaining friendships can be challenging for some autistic people. Some autistic people appear to be withdrawn and can become isolated others try very hard to be sociable, but may not seem to get it right. There is a range of help available, including assessment, education programs and family support.
What Are The Symptoms Of Rett Syndrome
The age when symptoms appear varies. But most babies with Rett syndrome seem to grow normally for the first 6 months before any signs of the disorder become obvious.
The most common changes usually show up when babies are between 12 and 18 months, and they can be sudden or progress slowly.
Some symptoms of Rett syndrome are:
Slowed growth. The brain doesnât grow properly, and the head is usually small — doctors call this microcephaly. This stunted growth becomes clearer as your child gets older.
Problems with hand movements. Most children with Rett syndrome lose the use of their hands. They tend to wring or rub their hands together.
No language skills. Between the ages of 1 to 4, social and language skills start to decline. Children with Rett syndrome stop talking and can have extreme social anxiety. They may stay away from or not be interested in other people, toys, and their surroundings.
Problems with muscles and coordination. This can make walking awkward.
Trouble with breathing. This can include very fast breathing , forceful exhaling of air or saliva, and swallowing air.
Seizures. Most people with Rett syndrome have seizures at some point in their lives.
Itâs also possible to have:
Behavior changes. Children with Rett syndrome tend to become tense and irritable as they get older. At times they may cry or scream for a while or have long fits of laughter.
Some kids with Rett syndrome also make unusual faces, lick their hands, or grasp at hair or clothes.
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What Is The Difference Between Autism And Autism Spectrum Disorder
The term autism was changed to autism spectrum disorder in 2013 by the American Psychiatric Association. ASD is now an umbrella term that covers the following conditions:
- Autistic disorder.
- Pervasive developmental disorder not otherwise specified .
- Asperger syndrome.
People with ASD have trouble with social interactions and with interpreting and using non-verbal and verbal communication in social contexts. Individuals with ASD may also have the following difficulties:
- Inflexible interests.
- Insistence on sameness in environment or routine.
- Repetitive motor and sensory behaviors, like flapping arms or rocking.
- Increased or decreased reactions to sensory stimuli.
How well someone with ASD can function in day-to-day life depends on the severity of their symptoms. Given that autism varies widely in severity and everyday impairment, the symptoms of some people arent always easily recognized.
Signs And Symptoms Of Asd
People with ASD have difficulty with social communication and interaction, restricted interests, and repetitive behaviors. The list below gives some examples of common types of behaviors in people diagnosed with ASD. Not all people with ASD will have all behaviors, but most will have several of the behaviors listed below.
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What Are The 5 Types Of Autism
Autism refers to a wide range of neurodevelopmental disorders. If your child is living with autism, it is important for you to understand the various types of autism and the symptoms presented by each.
Understanding the unique challenges presented by each type of autism will guide you in helping your child cope with the disorder. There are five major types of autism which include Aspergers syndrome, Rett syndrome, childhood disintegrative disorder, Kanners syndrome, and pervasive developmental disorder not otherwise specified.
Understanding Autism Spectrum Disorders
Autism is not a single disorder, but a spectrum of closely related disorders with a shared core of symptoms. Every individual on the autism spectrum has problems to some degree with social interaction, empathy, communication, and flexible behavior. But the level of disability and the combination of symptoms varies tremendously from person to person. In fact, two kids with the same diagnosis may look very different when it comes to their behaviors and abilities.
If youre a parent dealing with a child on the autism spectrum, you may hear many different terms including high-functioning autism, atypical autism, autism spectrum disorder, and pervasive developmental disorder. These terms can be confusing, not only because there are so many, but because doctors, therapists, and other parents may use them in dissimilar ways.
But no matter what doctors, teachers, and other specialists call the autism spectrum disorder, its your childs unique needs that are truly important. No diagnostic label can tell you exactly what challenges your child will have. Finding treatment that addresses your childs needs, rather than focusing on what to call the problem, is the most helpful thing you can do. You dont need a diagnosis to start getting help for your childs symptoms.
Whats in a name?
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What Conditions Are Considered Spectrum Disorders
Until recently, experts talked about different types of autism, such as autistic disorder, Aspergerâs syndrome, pervasive developmental disorder not otherwise specified . But now they are all called âautism spectrum disorders.â
If you still hear people use some of the older terms, youâll want to know what they mean:
Asperger’s syndrome. This is on the milder end of the autism spectrum. A person with Asperger’s may be very intelligent and able to handle their daily life. They may be really focused on topics that interest them and discuss them nonstop. But they have a much harder time socially.
Pervasive developmental disorder, not otherwise specified . This mouthful of a diagnosis included most children whose autism was more severe than Asperger’s syndrome, but not as severe as autistic disorder.
Autistic disorder. This older term is further along the autism spectrum than Aspergerâs and PDD-NOS. It includes the same types of symptoms, but at a more intense level.
Childhood disintegrative disorder. This was the rarest and most severe part of the spectrum. It described children who develop normally and then quickly lose many social, language, and mental skills, usually between ages 2 and 4. Often, these children also developed a seizure disorder.
Restricted Or Repetitive Patterns Of Behavior Or Activities
In addition to the communication and social issues mentioned above, autism also includes symptoms related to body movements and behaviors.
These can include:
- repetitive movements, like rocking, flapping their arms, spinning, or running back and forth
- lining objects, like toys, up in strict order and getting upset when that order is disturbed
- attachment to strict routines, like those around bedtime or getting to school
- repeating words or phrases they hear someone say over and over again
- getting upset over minor changes
- focusing intently on parts of objects, like the wheel of a toy truck or the hair of a doll
- unusual reactions to sensory input, like sounds, smells, and tastes
- obsessive interests
- exceptional abilities, like musical talent or memory capabilities
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Autism And Your Environment
Sometimes, when a situation is too much to cope with due to sensory input , or being asked to do things that cause stress or distress, an autistic person can become overwhelmed.
Meltdowns and shutdowns
When an autistic person becomes overwhelmed and isnt able to use or benefit from their coping strategies, they might have meltdowns or shutdowns.
Its important, for parents of autistic children in particular, to be aware that a meltdown isnt a tantrum. A tantrum is something that a child can control, and tantrums often happen because a child wants something. A meltdown or shutdown isnt something an autistic person can control, and its caused by being overwhelmed.
During a meltdown, an autistic person might try to make themselves feel less overwhelmed. This can include doing things like:
- trying to get away from people for example by running away or hiding
- trying to get people away from them for example by shouting, screaming, hitting, or acting aggressively
During a shutdown, an autistic person might try to block everything out for example by not responding to anything or anyone around them.
Like everyone else, autistic people can display challenging behaviour if theyre in the wrong environment. While it can be challenging for the people around them, this behaviour is often a result of distress or frustration, particularly if an autistic person has difficulty with communicating.
What Are The Treatments
Thereâs no cure for Rett syndrome, but treatments can help with a childâs symptoms. They should get these treatments for their entire life.
The best options for treating Rett syndrome include:
Standard medical care and medication. Meds may help control symptoms like seizures, stiff muscles, and problems with sleeping, breathing, the heart, or digestive tract.
Physical therapy. PT and using braces or casts can help children who need hand or joint support or have scoliosis. Sometimes, physical therapy can help them keep moving, sit more easily, walk better, and improve their balance and flexibility. Assistive devices like a walker or wheelchair might also help.
Speech therapy. If your child has trouble talking, this could help them learn nonverbal ways to communicate and socialize.
Occupational therapy. This can boost your childâs ability to use their hands to do things like put on clothes and feed themselves. If they have trouble making repetitive movements with their arms and hands, the occupational therapist might recommend splints that limit elbow and wrist motion.
Good nutrition. Work with your childâs doctor to make sure theyâre eating a balanced diet, which is important for healthy growth and better mental, physical, and social skills. Also ask the doctor what you need to do prevent your child from choking on food or vomiting while eating. Some children and adults with Rett syndrome benefit from being fed through a tube placed into the belly.
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How Is Autism Spectrum Disorder Treated
ASD is most often a life-long condition. Both children and adults with autism benefit from behavioral interventions or therapies that can teach new skills to address the core deficits of autism and to reduce the core symptoms. Every child and adult with autism is unique. For this reason, the treatment plan is individualized to meet specific needs. It is best to begin interventions as soon as possible, so the benefits of therapy can continue on throughout the course of life.
Many people with ASD often have additional medical conditions, such as gastrointestinal and feeding issues, seizures and sleep disturbances. Treatment can involve behavioral therapy, medications or both.
Early intensive behavioral treatments involves the entire family and possibly a team of professionals. As your child ages and develops, treatment may be modified to cater to their specific needs.
During adolescence, children benefit from transition services that promote skills of independence essential in adulthood. The focus at that point is on employment opportunities and job skill training.
How Do Doctors Diagnose Rett Syndrome
Doctors can make the diagnosis by observing your childâs pattern of symptoms and behavior. Theyâll probably also ask you about things like when the symptoms started.
Because Rett syndrome is rare, doctors will first rule out other conditions, including autism spectrum disorder, cerebral palsy, metabolic disorders, and prenatal brain disorders.
Genetic testing can help confirm the mutation in 80% of girls with suspected Rett syndrome. Doctors also rely on whatâs called an RTT Diagnostic Criteria Worksheet. It assesses your childâs early growth and development.
If you have one child with Rett syndrome, your chances of having another child with the disorder are small â even less than a 1% chance, according to the International Rett Syndrome Foundation.
Still, you and your partner can get tested for gene mutations before you decide whether you want to have more kids. You can get more information by talking with an experienced genetic counselor.
If a mother learns that she has an MECP2 mutation , any daughters she has who donât have Rett syndrome can choose to get tested once they become old enough to have kids. It could help them find out if they also have the mutated gene.
A diagnosis of Rett syndrome shouldnât solely be based on genetic testing because the mutation can be seen in other similar conditions.
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Can It Be Prevented
There is currently no known way to prevent autism spectrum disorders, as the causes are not yet fully understood. However, there is evidence that early intervention and therapy can improve symptoms and help children with ASD reach their full potential.
Additionally, many other interventions have been suggested in the literature and may be beneficial for some people with ASD. These include:
- medications such as selective serotonin reuptake inhibitors or antipsychotics
- music therapy
- speech-language pathology services
- animal-assisted therapies such as equine-facilitated psychotherapy or canine obedience training classes.
Cognitive behavioral therapy, a form of talk therapy that aims to reduce distress by changing patterns of thinking and behavior, has also been found to be effective in some cases.
Supportive counselling also helps families cope with having a child on the autistic spectrum disorder. As a result, parents should understand that they should never blame themselves because they had nothing to do with causing this.
A lot of medical professionals recommend following certain diets which include gluten-free and casein free diets.
Additionally, scientists believe it might be important for mothers who are pregnant or breastfeeding to take folate supplements and vitamin D to protect her child from developing the disorder later on in life.
What Is The Outlook For People With Autism Spectrum Disorder
In many cases, the symptoms of ASD become less pronounced as a child gets older. Parents of children with ASD may need to be flexible and ready to adjust treatment as needed for their child.
People with ASD may go on to live typical lives, but there is often need for continued services and support as they age. The needs depend on the severity of the symptoms. For most, it’s a lifelong condition that may require ongoing supports.
A note from Cleveland Clinic
Through research, there has been much that has been learned about autism spectrum disorder over the past 20 years. There is ongoing active research on the causes of ASD, early detection and diagnosis, prevention and treatments.
Last reviewed by a Cleveland Clinic medical professional on 12/29/2020.
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How Can Autistic People Be Supported
Autism is a life-long condition and many people see it as an important part of their identity.
However, there are a number of strategies and behavioural programmes that help to enable learning and development which autistic people may find helpful.
If your child is autistic, its also good idea to find out as much as you can about autism.
The NHS recommends a number of interventions that can help your childs development, including:
communication skills such as using pictures, sign language or both to help communicate as speech and language skills can be significantly delayed
social interaction skills play-based strategies, comic strips and some computer-based interventions can help
imaginative play skills such as encouraging pretend play
learning skills such as pre-learning skills to help concentration, reading, writing and maths
Detailed advice and support programmes are also available for parents of children recently diagnosed with autism.
For example, the EarlyBird programme provided by the NAS is a free three-month course for parents of an autistic child under the age of five.
You can also find local and national services for families on the NASs Autism Services Directory.
Autistic adults can join the NASs online community to connect with other autistic adults or call the Autism Helpline on 0808 800 4104.
If you think you or a loved one might be autistic then you can contact your GP for more information.