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Autism Spectrum Disorder

Autism Spectrum Disorder (ASD) is a developmental condition characterized by major impairments in cognitive and social functioning, communication, rigid, stereotyped or obsessive-compulsive patterns of behavior, and restricted or peculiar interests and movements. This diagnosis covers an enormous range of abilities and functioning.

Until 2013, Pervasive Developmental Disorders were divided into categories including Autistic Disorder, Asperger’s Syndrome, and Pervasive Developmental Disorder, Not Otherwise Specified. However, this has been revised in DSM-5, the newest version of the “encyclopedia” of generally accepted developmental and psychological diagnoses.

Henceforth, there is one single category for ASD in DSM-5, with diagnostic qualifiers pertaining to a number of important dimensions, including severity and adaptive functioning. How this change will ultimately affect understanding and outcomes in ASD, including ramifications in the way services and benefits are allocated, remans unclear.

How common is ASD?

Once thought to be far less common, alarmingly, the statistics regarding rates of ASD seem to be ever increasing. Why this is happening is a topic that has received enormous attention, but to date there is no definitive explanation. Broadening of diagnostic criteria and increasing public and professional awareness in recent years may be contributory, though this still does not seem to account for such a dramatic acceleration in prevalence.

Research suggests ASD is four times more common in boys than in girls, which may reflect actual gender related factors, but also some differences in symptom presentation and social norms that complicate identifying females. In any event, there is no question that ASD is being diagnosed far more often, and earlier, than in previous generations.

What causes ASD?

The search for a single cause of an ASD in a particular person has not been successful. As ASD is heterogeneous, meaning that there are numerous “varieties,” it appears there are likely to be many causal factors involved, including familial genetic vulnerabilities, dysfunction in certain brain structures and pathways, and diverse environmental and medical triggers.  Recent studies did not find any connection between early childhood vaccinations and ASD, but there remain many parents who are nervous about this subject.

Although knowledge in this area is constantly increasing, at this point perhaps looking for “why” a given person has an ASD might be a question best left to researchers, and valuable time and resources more fruitfully utilized in finding and implementing effective interventions.

How is ASD diagnosed?

Since early identification of ASD can potentially result in improved outcomes, the good news is that there are screening tools for children as young as two years old. However, there is no single, definitive test for ASD. Though earlier diagnosis is now feasible, there are many who remain undiagnosed for many years, often those that are especially high functioning or live in areas with fewer specialized practitioners.

A comprehensive, multidisciplinary approach is considered “best practice.” This methodology combines family and developmental history, clinical observations, structured questionnaires, and empirically validated tests. Some parents may delay getting their child diagnosed, worrying that their worst fears will be confirmed or fearful of stigma. Some may believe their son or daughter is “just immature” and will “grow out of it.” While this is very understandable, putting off needed evaluations and interventions is not recommended.

Parents are often the first to recognize that their child is not developing typically. If you suspect that your child may have an ASD, it’s best to trust your intuition and seek professional guidance, even if others do not share your concerns or think you are “over-reacting.”

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