Autism Spectrum Disorder

Autism is considered a spectrum because the symptoms often have drastic variations from one person to another. People with autism spectrum disorder (ASD) may pay attention, move, learn, and interact differently than others and from each other. 

Autism spectrum disorder communication & interaction

Children often exhibit signs of autism spectrum disorder early in life, as it is a lifelong condition. Parents may notice developmental delays and changing behaviors that can indicate autism spectrum disorder. People with autism spectrum disorder often experience challenges with social communication and interaction skills. According to the Centers for Disease Control and Prevention (CDC), children with autism may demonstrate the following signs:

• Avoiding or struggling to maintain eye contact
• Not responding to their name by nine months 
• Not demonstrating emotions through facial expressions by nine months
• Failing to engage in interactive games like pat-a-cake by one year old
• Using few or no gestures like waving “hello” or “goodbye” by one year old
• Showing no inclination to share particular interests with others by 15 months 
• Not pointing to indicate an interesting scene by 18 months old
• Struggling to notice when others are upset or hurt by two years old
• Taking no notice of other children or having no desire to join them by three years old
• Not engaging in pretend play by four years old
• Not singing, dancing, or otherwise performing for caregivers by age five

Note that children with autism may socially interact in ways that adults without autism may not notice, such as through unique gestures, sounds, or patterns. Studies show that people with autism spectrum disorder interact with other people with autism at the same level of efficiency as people without autism spectrum disorder. For this reason, children with autism may connect well with other children who live with autism spectrum disorder. This research shows that autism may not necessarily indicate a “social deficit” but a different type of socialization. 

People with autism spectrum disorders may fixate on interests that could seem to go against the norms of society. Below are examples of repetitive or restricted behaviors often associated with autism spectrum disorder:

• Frequently lining up toys or other objects and becoming upset when the order is changed or items are moved
• Echolalia, the repeating of specific words, phrases, or sounds
• Consistently playing with toys the same way every time
• Focus or fixation on certain parts of objects, such as the wheels of a toy car
• Quickly growing upset over minor changes in activity or routine
• Developing obsessive interests
• An overwhelming desire to follow specific routines
• Self-stimulation (stimming), including repetitive behaviors like flapping hands, rocking the body, or spinning in circles, among other sensory experiences 
• Unexpected or non-customary reactions to sensory input and the sound, smell, taste, look, or sensation of items in their environment
• Avoiding specific sensory experiences or seeking out experiences (sensory-seeking behavior) 

Additional autism spectrum disorder characteristics

While autism spectrum disorder has no physical markers, behavioral, developmental, and functional aspects may help you identify the condition, such as: 

• Delayed language skills (some people with ASD are non-verbal and do not speak at all)
• A disproportional sense of fear, either demonstrating a lack of fear or heightened anxiety 
• Delayed movement skills
• Excessive worry, anxiety, or stress about specific topics
• Delayed learning or cognitive abilities
• Atypical emotional reactions and moods
• Inattentive, impulsive, or hyperactive behavior patterns
• Gastrointestinal issues like constipation or diarrhea
• Seizure disorders or epilepsy
• Unusual eating habits
• Irregular sleep hygiene

Parents or guardians observing ASD symptoms in their children may be advised to contact their physician or another healthcare provider to schedule an evaluation. There are no medical tests to diagnose autism spectrum disorder, and the process of determining which disease or condition explains a person’s symptoms and signs involves multiple factors. While the condition can be identified at 18 months or younger, experienced professionals can often make a reliable diagnosis by age two. Some people are not diagnosed until adolescence or adulthood. 

Autism spectrum disorder in adults and women 

Some people with ASD are not diagnosed early in life, with girls and women being less often diagnosed than men and boys. In addition, autism presents differently in girls and women than it does in other genders. These gender gaps may be due to stigma² or the differences in symptoms between genders. 

Adults with autism are often misdiagnosed as having personality disorders or other mental illnesses. For that reason, it can be crucial for providers to understand the symptoms of autism in adults and how these symptoms can vary from childhood presentations. Below are a few symptoms to note: 

• Hyperfocus on hobbies or one’s area of work, such as building, engineering, coding, psychology, and other topics 
• Expressive sharing of interests or collecting items related to one’s interests
• Difficulty picking up on social cues adults without autism
• Sensory-seeking or sensory-avoidance behaviors 
• Difficulty making eye contact in social settings
• Social anxiety 
• Difficulty picking up on whether someone is interested in a relationship or conversation 
• Specific rituals or routines in daily life that are difficult to deviate from 
• Increased cognitive empathy 
• Emotional sensitivity
• A strong connection with animals or items
• Stimming using everyday items like jewelry, items in the workplace, skin-picking, or clothing 
• Self-harm or suicidal ideation due to social challenges or difficulty being understood 

Despite these symptoms, many adults with autism succeed in areas of life. According to studies, some adults with autism have exceptional abilities in sensory and visual-spatial skills, synaptic functions, attentional focus, decision-making, and interest in engineering and physical sciences. In addition, experts have found that adults with autism spectrum disorder have increased cognitive functioning when not conditioned to make eye contact or follow certain social norms that make them uncomfortable.  

There are often misconceptions about what causes autism spectrum disorder (ASD). Despite significant studies on the subject, researchers have not identified a singular cause for ASD. Instead, the data indicates that several risk factors can contribute to the development of autism spectrum disorders. According to the Centers for Disease Control and Prevention, genetics likely play a role in the development of the disorder, along with physiological and environmental risk factors that affect a child’s development. Below are a few of these potential causes:  

• Having a sibling with ASD 
• Having older parents 
• Genetic conditions like Fragile X or Down syndrome 
• Low birth weight 
• Prenatal factors, such as poor health in gestation 

The media has shared and highlighted numerous claims that vaccines cause autism, but the evidence doesn’t support these claims. A substantial body of peer-reviewed studies exists to indicate that vaccines do not cause autism. 

Many people identify with the neurodivergence model of looking at autism. Adults with autism spectrum disorder who identify as neurodivergent may see autism less as a disability and more as a difference in neurology, personality, and focus. Although autism can lead to challenges in daily life, some people who identify with neurodivergence may believe these challenges are due more to social conditioning and pressure than their own genetic makeup. However, each person with autism is different, and the language used to refer to autism depends on the individual diagnosed. It can also be helpful to note that people who are non-verbal or experiencing severe symptoms may not have this language to refer to themselves. 

Although ASD is considered a lifelong condition with no cure, treatment, coping skills, lifestyle changes, and structured routines may help an individual manage symptoms and increase functional ability. Some autism advocates share the opinion that autism spectrum disorder starts from birth and is a unique brain difference instead of a condition that should be treated or changed. 

Medication treatment for autism spectrum disorder

According to the Centers for Disease Control, there are no pharmacological treatment methods that address the primary symptoms of autism spectrum disorder. However, children and adults with autism may have comorbid behavioral, cognitive, or physical health conditions (e.g., attention-deficit/hyperactivity disorder).³ Medications may be used to treat comorbid health conditions, targeting specific behaviors or symptoms, such as aggression, trouble focusing, or self-harm. 

According to the National Alliance on Mental Illness, the following are disorders commonly associated with ASD:

• Intellectual disabilities impacting cognitive and language skills
• Seizure disorders, which are experienced by one in four children with autism, often with early childhood or adolescent onset 
• Gastrointestinal problems like constipation, diarrhea, vomiting, bloating, or acid reflux
• Fragile X syndrome, a genetic disorder and the most commonly diagnosed form of inherited intellectual impairment, which has symptoms similar to ASD. Studies suggest that approximately one-third also meet ASD diagnostic criteria. 
• Rett syndrome
• Attention-deficit hyperactivity disorder (ADHD) 
• Mental health conditions like depression, obsessive-compulsive disorder (OCD), and social anxiety disorder 
• Tuberous sclerosis

Other treatment options

• Parent training and education
• Various treatment modalities aimed at reducing behavior patterns that interfere with functional ability in daily life
• Support in practicing life skills focused on independent living

Research care options with your provider, and consider seeking information on healthy and ethical treatment from autism advocate groups like the Autistic Self-Advocacy Network (ASAN). 

Self-care

In addition to working with a mental health professional to develop and follow a comprehensive ASD treatment plan, individuals with autism may benefit from practicing self-care to cope with daily life, including the following options: 

• Record-tracking: Record sensory issues—particularly those that could affect self-care skills, such as personal hygiene—and adjust accordingly when possible. For example, some people with ASD experience sensory issues and may avoid washing tasks due to the smell of the soap or the texture of the washcloth. 
• Break down activities: Break new skills or activities into smaller steps that can be easier to learn—particularly if they can be learned in a forward-chaining method that works efficiently into a routine. 
• Set reminders: Use prompts, motivators, visual reminders, praise, and rewards to work new skills or habits into a routine since routine changes can be complex for those with ASD.
• Monitor mental health: Monitor mental health, as children with ASD may have trouble understanding and communicating their emotions. Caregivers can introduce words or signals within an individual’s personal functional ability to help them express when they are struggling. 
• Journaling: Adults may benefit from journaling about their thought processes, emotions, and behaviors to find new ways to cope.
• Mindfulness: Mindfulness can be a way to cope with challenging emotions that arise during the day.

Working with a therapist online through a virtual therapy platform like BetterHelp can be a way for parents, caregivers, or adults with autism to educate themselves about a condition like ASD while learning valuable skills. There are also virtual teletherapy platforms geared toward adolescents. Research suggests that online therapy can be as effective as in-person therapy. Other resources include:

• Local autism resources and programs: Contact your healthcare provider, local health department, ASD advocacy group, or school for support. 
• Autism support groups: Autism support groups can be valuable and practical resources for parents, family members, or adults with autism. They can be encouraging places to share information and experiences with people who can relate. Support groups can also help people with ASD learn more about coping skills and treatment options. 
• Find clinical trials related to ASD at Clinicaltrials.gov.
• Browse downloadable information about ASD online. 
• The Centers for Disease Control and Prevention’s Autism Spectrum Disorder page. 
• The Autistic Self-Advocacy Network offers support to adults with autism and families looking to support their children with autism. They provide an extensive resource library. 

Numerous avenues for support, allowances, special programming, and other resources for autism spectrum disorder are also available. While an internet search can yield thousands of results, reach out to local resources first, where the flow of information may be reliable but less overwhelming.

For those with thoughts of suicide, contact 988 Suicide & Crisis Lifeline at 988. Please also see our Get Help Now page for more immediate resources.

• Expanding diagnostic criteria, research, and understanding of ASD
• Increased screening efforts and clinician training
• More awareness campaigns to build public knowledge of ASD
• Improved survival rates for premature babies
• Environmental factors like increased air pollution and maternal stress, which may affect specific demographics at higher rates

About 70% of the children with autism spectrum disorder in the US receive treatment through therapy, medication, or a combination of the two

According to the CDC, approximately 9.8% of American children between ages 3 and 17 are diagnosed with ADHD, with boys more likely to be diagnosed than girls.¹

¹JAMA Pediatrics

Below are a few more statistics on autism spectrum disorder:

• Boys or men are four times as likely to be diagnosed with ASD as girls or women of the same age. However, data from a 2019 study indicates that ASD symptoms may be more challenging to detect and diagnose in females due to “camouflaging” or masking. As a result, the study suggests that ASD in females may be misdiagnosed, undiagnosed, or diagnosed after a substantial delay. 
• According to a 2023 report from the CDC, approximately one in 36 children in the United States is diagnosed with ASD. 
• Researchers at the Children’s Hospital of Philadelphia report that children with ASD often have other comorbid diagnoses. For instance, their data indicates that up to 85% of children with ASD also have a psychiatric diagnosis, 50% to 80% experience sleep disorders, up to 85% have gastrointestinal disorders, and 25% to 40% have epilepsy or other seizure disorders.