Autism Spectrum Disorder (ASD, or Autism) is a disorder that begins in the child developmental period. Its hallmark is problems with of social communication, social interaction, repetitive behaviours, and restrictive interests. The disorder affects every child differently. Some children have mild difficulties in social interactions, which was formerly known as “Aspergers Disorder.” Other children may have more severe impairments that may affect their ability to interact and communicate with other people, which may also be accompanied by challenges in intellectual capabilities.
How Common is Autism Spectrum Disorder?
Between 0.2-2% (2-20/1000) children have diagnosed Autism. It is also more commonly diagnosed in boys than girls.
What are the Initial Signs of Autism Spectrum Disorder
Signs of a child with ASD might include abnormal speech or language development early in childhood. There are two main types of symptoms. The first group of symptoms involve difficulties with social interactions and verbal communication. These impairments include things like:
- Not pointing at objects to show interest when they are a baby.
- Lack of eye contact and not having a “social smile” where they smile to other people or experiences they are having.
- A delay in speech or a lack of verbal interaction with others.
- Not interacting socially with other children.
- Not playing “pretend” games with other children
- Difficulty with back-and-forth conversation.
- Difficulty understanding metaphors or sarcasm.
The second group of symptoms involves restrictive or repetitive behaviours or interests. These impairments include things like:
- Some children with Autism can be rigid in their thinking, and therefore have difficulty adapting when a routine changes.
- Their sensory system might be altered which could included heightened or reduced sensitivity, or unusual interest in sounds, textures, touch, lights, or smells.
- Children might also show repetitive body movements such as rocking their body, flapping their hands, or tapping.
What Causes Autism:
The cause is not fully understood, but with more awareness and diagnoses in the past decade, more research has been conducted on the subject. Recent medical literature suggests that Autism Spectrum Disorder is caused by genetic factors that may alter the brain’s development. There are likely multiple genes involved, not just one single gene. Just like ADHD, Autism develops likely due to a combination of genes that are “turned on” by environmental stimuli. This process is known as the “epigenetic theory.”
As a result, the connection of cells within the brain are altered, affecting social communication and influencing restricted interests and repetitive behaviours. Environmental factors that may increase the risk for Autism Spectrum Disorder include:
- Older Parental age (both maternal and paternal)
- Toxic exposures during pregnancy
- Some infections during pregnancy
Despite previous remarks by some celebrities, there is overwhelming evidence that there is NO association between vaccinations and Autism.
How Do I Determine if my Child Has Autism?
Your care provider will do an extensive review of your child’s developmental history. The history will likely pay particular attention to early social-emotional and language milestones, play skills, behaviour, and loss of skills. Important questions they might ask you on history include:
- Does your child know their primary caregivers?
- How is your child with socializing with other children his/her age?
- Ability to understand another person’s perspective?
- Ability to infer about another person’s feelings, beliefs, intentions?
Your physician might also ask about:
- Any history of behaviours such as hand-flapping, body rocking, tapping, or spinning objects?
- Insistence on routine, sameness, or difficulty adapting to change?
- Fixated areas of interest in social or leisure activities.
Please see your care provider if you have concerns about your child’s development.
This post was co-authored by Stephanie Liu, MD, MSc, CCFP, BHSc and Suzanne Black, MD, BSc.
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [DSM-5]
Samaco RC, Nagarajan RP, Braunschweig D, LaSalle JM. Multiple pathways regulate MeCP2 expression in normal brain development and exhibit defects in autism-spectrum disorders. Hum Mol Genet 2004; 13:629.
This post was Co-written by Megan Crosby and Dr. Michelle Bischoff