Understanding Autism Spectrum Disorder

More people than ever before are being diagnosed with autism spectrum disorder (ASD). In the United States, about 1 in 59 children has been identified with ASD, and it is four times more common among boys than girls.

Despite its prevalence in children and adults, autism remains a mysterious condition to many Americans. To promote a greater understanding of autism spectrum disorder, we sat down with Dr. Candice Crewse, a pediatrician at River City Pediatrics in Memphis, Tennessee.

Autism Symptoms and Early Detection

The autism spectrum refers to a range of abilities, symptoms and levels of functioning—from severe to gifted. Some children and adults need little to no support, while others require considerable assistance with basic tasks such as communication.

According to the Centers for Disease Control and Prevention, individuals diagnosed with ASD have varying degrees of learning, thinking and problem-solving abilities. For children with autism, symptoms begin early and last throughout life.

“Typically, children begin to display autism symptoms from ages 1 to 2.5 years old,” said Crewse. “They may fixate on one toy, avoid eye contact and fail to develop verbal communication skills. Many children with autism develop repetitive behaviors and social and communication problems around age 3.”

Social Impairment and Communication Difficulties

Individuals with autism may be nonverbal or struggle with communication issues—including misunderstanding personal space or boundaries, resisting physical contact and not sharing interests with others.

“Children with autism appear to live in their own world or environment,” said Crewse. “Communication and social situations are challenging for them. Often, they’re not interested in playing with other kids. They don’t imitate their parents’ actions—like clapping or waving. They don’t make a lot of eye contact.”

Repetitive Behaviors and Stimming

“Many kids who are autistic are also resistant to change,” said Crewse. “They don’t do well with broken routines. Depending on a child’s level on the autism spectrum, disturbances in his or her normal routine can cause meltdowns.”

In addition to routine disruptions, sensory disorders also affect many people with autism. Noise, light, textures and smells can be overwhelming. Self-stimulatory behavior calms and regulates the senses.

“Some children and adults do repetitive behaviors, called stereotypies or stimming, where they flap their hands, rock from side to side or twirl,” said Crewse.

Stimming is a tool for managing strong emotions—such as anger, fear, anxiety, excitement or anticipation. Discouragement from stimming causes more distress for people with autism.

Causes, Diagnosis and Intervention 

The cause of autism is still unknown, but scientists believe genes and environment may play a role. Family and identical twin studies indicate a possible genetic predisposition. While some parents fear vaccinations increase the risk for autism, multiple peer-reviewed studies disprove this theory.

“Vaccines are not linked to autism,” said Crewse. “Scientists have thoroughly studied immunizations. The link between vaccines and autism has been disproven time and time again. Vaccines are safe. They continue to try to find a cause that can help inform earlier autism diagnoses.”

According to Crewse and the American Psychiatric Association, children should be screened for ASD at their 18- and 24-month checkups.

“We give children an M-CHAT [Modified Checklist for Autism in Toddlers] questionnaire,” said Crewse. “It looks at their communication and social skills. Do they bring you something to show you? Do they look at your face and smile? If a child fails the screening, we refer him or her to a developmental specialist.”

Many tools and therapies are available for children who are diagnosed with ASD, including speech therapy, occupational therapy and applied behavior analysis, an autism-specific therapy.

“I tell parents and caregivers—if they are worried about an autism diagnosis for their child, if they don’t want the label—once they have a diagnosis, children do much better when they get early help with therapies,” said Crewse. “They do better in school and socially as they get older.”

Crewse adds that many people with ASD, including renowned scientists, artists and entrepreneurs, lead fulfilling lives.

“It’s not necessarily a bad thing that people with autism see the world in a different way—people like Dan Aykroyd, Anthony Hopkins and Dr. Temple Grandin, the autism spectrum disorder activist and animal scientist,” said Crewse. “People with autism have brains that function differently—and that can work to their advantage. Just because a child has an autism diagnosis doesn’t mean that child can’t be successful.”

Learn more about leading-edge pediatric care services at the Spence and Becky Wilson Baptist Children’s Hospital. Find a doctor by visiting our Find a Doctor page.