What is autism spectrum disorder?

Autism spectrum disorder (also called ASD) is a developmental disability that can cause major social, communication, and behavior challenges.

People with ASD may communicate, interact, behave, and learn in ways that are different from most other people. Some people with ASD have strong skills in learning, thinking, and solving problems; others have severe challenges with these skills. Some people with ASD need a lot of help in their daily lives, but others need less help.

Premature babies (babies born before 37 weeks of pregnancy) may be more likely to show signs or symptoms of ASD than other babies. Health care providers can sometimes detect ASD in a child at 18 months old or younger. By the time a child is 2 years old, a provider may give an ASD diagnosis. But many children don’t get a final diagnosis until they’re much older. This delay means children with ASD may not get the early help they need.

It’s really important to learn the signs and symptoms of ASD and get help for your child right away if you think he has ASD. Getting early intervention services as soon as possible can help improve your child’s development. These services can help children from birth through 3 years old learn important skills. Services include therapy to help a child talk, walk, learn self-help skills, and interact with others. Visit the Early Childhood Technical Assistance Center to find your state’s contact information for early intervention services.

How common is autism spectrum disorder?

ASD affects about 1 in 68 children in the United States. It affects children of all backgrounds, but it’s almost 5 times more common in boys than in girls. More people are being diagnosed with ASD today than ever before. We’re not sure exactly why, but it may be because of several reasons, including:

• The way health care providers define and diagnose ASD has changed. A diagnosis of ASD now includes several conditions that used to be diagnosed separately, like autistic disorder, pervasive developmental disorder not otherwise specified (PDD-NOS), and Asperger syndrome. Now these conditions are all called ASD.
• In the past, only children with the most severe ASD symptoms were diagnosed. Today children with less severe ASD symptoms are diagnosed.
• People are more aware of ASD. More families know the signs and symptoms of ASD, so more children are checked for it. More providers are screening for ASD now than in the past.

How do you know if your child has autism spectrum disorder?

ASD can be hard to diagnose. There’s no medical test, like a blood test, to check for ASD. No two children with ASD have the exact same signs or symptoms. Providers diagnose ASD by looking at your child’s behavior and development.

Children with ASD usually show signs or symptoms when they’re 12 to 24 months old, but some may have them earlier or later. Some children with ASD develop normally until they’re around 18 to 24 months old, but then they stop gaining new skills or lose the skills they once had. This is called regression.

Babies may show signs of ASD before their first birthday if they have severe developmental delays. Developmental delays are when your child doesn’t reach developmental milestones when expected. A developmental milestone is a skill or activity that most children can do at a certain age. Milestones include sitting, walking, talking, having social skills, and having thinking skills.

Tell your baby’s health care provider if your baby isn’t meeting her milestones. It’s not unusual for a healthy baby to fall behind in some areas or move ahead in others. But babies who don’t meet these milestones need their development checked more closely by a provider:

• Babbling by 12 months
• Making gestures (like pointing or waving bye-bye) by 12 months
• Using single words by 16 months
• Using two-word phrases by 24 months
• Losing language or social skills at any age

Most children with ASD don’t have problems with early developmental milestones, like crawling and walking on time. But they may have delays in other areas, like communication, social, and behavior skills. If your child shows signs or symptoms of ASD, it doesn’t always mean he has ASD. Children with ASD may have different signs and symptoms, and they may not have all the signs and symptoms.

What is joint attention?

Problems with joint attention are one of the most early and common signs of ASD. Joint attention is when your child looks back and forth between an object (or event) and a person. When a child does this to share interest and interact with another person, he develops skills that help him connect with other people. Most children with ASD have delays in joint attention skills, or they don’t have any joint attention skills.

These are examples of how children with ASD may show different joint attention skills:

• At about 10 to 12 months old: When a parent points at an object (like a toy), most children quickly look towards the object and then look back at their parent. The child imitates (copies) the parent’s facial expression; if the parent is smiling, the child smiles back. Children with ASD may ignore the parent instead of smiling back.
• At 12 to 14 months old: If a child wants a toy or another object that they’re interested in but can’t reach, most children point to it. Instead of pointing to an object, a child with ASD may bring her parent to the object while avoiding eye contact. Or the child may take her parent’s hand and place it on the object, instead of pointing to it.
• At 14 to 16 months old: Most children can point at objects and look back and forth between objects and their parents. This helps them show their interest in an object and share the experience with a parent. A child with ASD doesn’t look at an object together with her parent. Instead, the child points to an object only so the parent gets it for her.

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