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Overview of Autism

What is Autism Spectrum Disorder (ASD)?

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition that leads to characteristic differences in socialization and communication as well as characteristic behaviors (as defined by DSM-5). It is a spectrum disorder meaning that there is a highly varied set of symptoms among people with autism and varying degrees of severity.

What Is Asperger’s syndrome?

Asperger’s syndrome used to be a separate diagnosis from autism, but has been brought under the umbrella of Autism Spectrum Disorder (ASD) in recent definitions of ASD in the DSM-5. Asperger’s tends to refer to people on the less severe side of the autism spectrum, and though the term is no longer used in health care settings, some people may still use it from time to time to describe more mild forms of autism.

What causes autism?

The underlying biology in the brains of people with autism is not fully understood by researchers and scientists, and a single underlying process in the brain has not been found. The general consensus among scientists is that genetic factors cause changes in brain structure and connectivity, which in turn affects socialization and communication skills and causes the characteristic behaviors in people with autism. A significant amount of research time and funding is ongoing to better understand the biology of autism. We have additional details on the biology of autism and links to research in our new parent kit.

What are the main signs of autism?

It’s important to note that the initial signs of autism in children can vary significantly for each child. Different children will often show different signs—some children may show many signs and other children may show few signs. The time course can also vary by child, with some children showing signs at a very young age (first few months of life), others showing signs after 1-2 years of life, and still other children appearing to have a normal development for their first couple of years and then appearing to regress and lose abilities they used to have (such as losing communication skills). And it is also possible to have some of the symptoms of autism but not have autism spectrum disorder. Because of this complexity, a specialized health care provider is needed to establish a diagnosis of autism.

What are the different severity levels of autism?

The severity level is intended to capture the level of support and services required by a person with autism. The severity level can also change over time. The three levels are:

• Level 1: Requiring support
• Level 2: Requiring substantial support
• Level 3: Requiring very substantial support

At what age does autism typically show up?

The time course varies by child. Some children show signs at a very young age (first few months of life), others show signs after 1-2 years of life, and still other children appearing to have a normal development for their first couple of years and then appearing to regress and lose abilities they used to have (such as losing communication skills).

Does autism ever go away?

For the majority of people, autism is a lifelong condition. Said otherwise, children with autism become adults with autism. There are some examples of children who have received early intensive services and later no longer meet the diagnostic criteria of autism spectrum disorder. Such children may still need additional support (e.g., educational supports) relative to their neurotypical peers.

Is autism more common in boys or girls?

Autism is more common in boys. For instance, in Colorado, boys were 4.5 times as likely to be identified with autism than girls based on data from the CDC.

What can cause speech delay in toddlers?

There are a wide range of causes of a speech delay. Some children may have only a delay in language, for which many children "catch up" as they get older and undergo therapy. Other children may have a more general developmental condition where speech delay is one sign of a broader condition, such as autism. Still other children could have other issues such as a hearing impairment. If you notice speech delay in your toddler, you should speak to your pediatrician or a specialized health care provider about your concerns.

Is delayed speech a sign of autism?

Possibly, but not necessarily. About 10% of preschool children have a language delay, but only 2% of children have autism. This means that the majority of children with delayed speech do not have autism. Autism is often accompanied by other signs beyond speech delay.

Why is early identification important?

A wide body of scientific research supports that early detection of speech delays and early intervention is beneficial to young children. Indeed, the CDC has a campaign called Learn the Signs, Act Early to encourage early detection of potential delays in young children.

What if my provider doesn’t think anything is wrong?

Some providers may have been trained during a time when a “watch and wait” approach for developmental concerns was used. Today, leading medical societies including the CDC strongly advocate for early intervention to support a child’s long-term health. If you are in this situation, talk to your provider about your concerns and see if they can be addressed. You can also consider switching to another provider or asking for a second opinion. You are the ultimate advocate for your child!

What if I’m getting services through Early Intervention already? Do I need more?

Early Intervention (EI) is a government-run program focused on helping young children under the age of 3. EI programs and services covered by health insurance offer complementary approaches to helping a child.

What types of diagnostic testing do you perform for autism?

Our standard approach is a comprehensive intake, an ADOS-2, and a Vineland-3. These tools are used to identify autism spectrum disorders (ASDs) in children, focusing on communication, social interactions, behaviors, and other areas.

How do I know if my child should be tested for autism?

If your child is showing signs of delayed speech, challenges with social skills, unusual behaviors, or difficulties with changes in routine, it may be beneficial to undergo an autism diagnostic evaluation. These signs can appear as early as 12-18 months of age.

What can I expect during the diagnostic testing process?

The diagnostic testing process involves several steps, beginning with an initial consultation to gather detailed medical and developmental history. Following this, a series of assessments tailored to your or your child’s specific needs will be conducted.

How long does it take to receive the results of the testing?

The time frame for receiving diagnostic test results can vary depending on the complexity of the case and the specific assessments administered. Typically, preliminary results are discussed immediately following the evaluation, with a detailed report provided within 2 to 4 weeks.

Will my insurance cover the cost of autism diagnostic testing?

Typically, yes, and Soar is in-network with the vast majority of insurance plans. However, insurance coverage for autism diagnostic testing can vary by individual plan.

What are the main treatment options for children with autism?

Conceptually, there are 3 broad categories of treatment modalities used to support children with autism: 1) behavior and communication approaches, 2) medications, and 3) complementary and alternative medicines, including dietary approaches.

What are the goals of therapy?

In our view, the overarching goal is to help a child with autism reach their fullest potential and improve their long-term quality of life.

Why is early intervention so important?

There is a strong evidence base for early intervention on outcomes, and early intervention is supported by leading U.S. medical societies. Parents should, in consultation with a provider, strongly consider services at a young age to support a child’s long-term growth and development.

What is ABA?

Behavior therapy for children with autism is typically based on the principles of applied behavioral analysis, or ABA.

What is the difference between ABA and the ESDM?

There are multiple types of programs rooted in the principles of applied behavior analysis (ABA).

What is speech therapy for children with autism?

Speech therapy is a type of communication therapy typically performed by a Speech-Language Pathologist, a Master’s- or Doctorate-level clinician who specializes in speech and communication.

What is occupational therapy for children with autism?

Occupational therapy is a type of therapy typically performed by an Occupational Therapist, a Master’s- or Doctorate-level clinician.

Are there medicines to treat autism?

There are no medicines that have been shown to cure autism or treat its core symptoms. However, a health care provider may prescribe medication to support the well-being and functioning of a child with autism.

How do I pick a provider? What questions should I ask?

There is a wide variety of types of autism providers available for families. Some questions you may want to ask of potential providers include:

• What types of services will my child need, and who offers them? (e.g., ABA only or an integrated program of ABA, speech therapy, occupational therapy, and other supporting therapies)
• If behavior therapy is recommended for my child, what sub-type of behavior therapy do I want him or her to receive? (e.g., discrete trial training, naturalistic developmental behavior interventions, a hybrid)
• Do I want my child to receive services in a home- or clinic-based setting?
• What is the training and retention for staff? How much staff turnover do they see?
• Is the provider using evidence-based services?
• What are the treatment goals?
• What support will I get as a parent?
• What is their track record of success and outcomes?
• What is the clinic leadership like? Who are they? What do they value?
• Is my insurance accepted?

If my child is diagnosed with autism at Soar Autism Center, can he/she be treated by another provider?

Yes. If you’d prefer to receive treatment at another provider, we are happy to refer you to another provider or coordinate with another provider on a care plan.

What role does Early Intervention play in treating autism?

Early Intervention (EI) is a program that provides free services to children under the age of 3 who have a developmental delay or disability, including but not limited to children with autism.

I’m feeling overwhelmed or stuck. What should I do?

We know that a new diagnosis of autism, or a concern for autism in a young child, can be an emotionally overwhelming time for parents, children, and families. It’s totally normal to feel anxious, sad, worried about the future, overwhelmed, confused, ashamed, frustrated, defeated, or tired—often all at the same time. If you’re feeling this way, know that you’re not alone.