The Facts About Autism Spectrum Disorder

For people with autism spectrum disorder (ASD), how they experience, perceive and interpret social interactions and sensory input from the environment around them is often vastly different from how their neurotypical counterparts experience, perceive and interpret the same aspects of life. These differences can affect interpersonal relationships, social communication, interests and behaviors.

Understanding how individuals with autism experience the world can help neurotypical people better empathize and connect with those with ASD.

Autism spectrum disorder is a neurodevelopmental disorder characterized by deficits in social communication, and the presence of restricted interests and repetitive behaviors, according to the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the most recent edition.

Autism spectrum disorder is a condition that includes Asperger syndrome, Rett syndrome, childhood disintegrative disorder, Kanner's syndrome and pervasive developmental disorder, all of which were previously considered separate disorders.

Due to the differences in how their brains develop, people with ASD often perceive social interactions differently than people without the disorder, which can lead to challenges in communication. Signs of autism spectrum disorder usually begin before a person is 3 years old.

According to Mayo Clinic, children with ASD exhibit various patterns of behavior and levels of severity, with some on the lower-functioning end of the spectrum and others on the higher-functioning end. Some children with autism spectrum disorder experience learning difficulties, while others enjoy normal or even higher than average intelligence, although communicating and applying their knowledge can remain a challenge.

Statistics from the Centers for Disease Control and Prevention (CDC) indicate about 1 in 44 children are diagnosed with ASD and the condition occurs across all racial, ethnic and socioeconomic groups.

While some research indicates autism spectrum disorder is four times more common in boys than in girls, other experts believe the actual male-to-female prevalence ratio is likely closer to 3 to l. It's unclear why ASD seems to occur in boys more often than in girls, though some people believe it's because of a higher rate of underdiagnosis or misdiagnosis in girls with autism spectrum disorder.

There is no single known cause of ASD. In fact, many medical experts believe there are likely many causes because of the condition's complexity and range of symptoms and severity. However, genetics and environment are thought to be contributors.

Research has found several different genes are involved with autism spectrum disorder, particularly ones associated with Rett syndrome, a rare genetic mutation affecting brain development in girls, and fragile X syndrome, which causes mild to severe intellectual disability in both males and females, though females usually experience milder symptoms.

For some children, the presence of genetic mutations—both inherited and spontaneously occurring—can increase the risk for the development of ASD. As for environmental factors, according to Mayo Clinic, researchers are investigating whether some viral infections, medications and air pollutants, as well as complications during pregnancy, could be connected to the development of autism spectrum disorder.

No reliable study has shown a definite link between ASD and vaccines, despite claims to the contrary that were perpetuated more than a decade ago by a now-retracted study. In fact, medical professionals warn that avoiding childhood vaccinations can place children, as well as those around them, at risk of contracting and spreading serious diseases.

Early signs of ASD typically appear by the age of 2. While all babies develop at different speeds, certain delays in cognitive, language and social skills may be a sign that a child has autism spectrum disorder.

Early signs of ASD include:

• Lack of smiling or happy facial expressions by 6 months old
• No mimicry of sounds or imitation of facial expressions by 9 months old
• Absence of babbling or cooing by 12 months old 
• Lack of imaginative play and pretending by 18 months old
• No use of single words by 16 months old or two-word phrases by 24 months old
• Loss of language or social skills at any age

Other signs of autism spectrum disorder include hyperactivity and self-stimulatory behavior (known as stimming), which often includes repetitive and unusual body movements or noises. If you are concerned about your child's development, consult a doctor right away, as early intervention for ASD has been found to produce positive long-term outcomes.

There is no way to prevent ASD. However, certain factors make an individual more likely to develop the condition.

Risk factors for autism spectrum disorder include:

• Co-occurring disorders. Children with fragile X syndrome, Rett syndrome or tuberous sclerosis are at a significantly higher risk for ASD.
• Family history. According to medical experts, having a child on the spectrum makes it more likely you will have another child with autism spectrum disorder.
• Preterm birth. Babies with low birth weight and babies born before 26 weeks of gestation are at an increased risk for developing ASD.
• Sex. More males than females are diagnosed with autism spectrum disorder each year.

Some individuals with ASD may experience certain complications, such as trouble with learning, doing well at school, maintaining gainful employment, social interactions and living independently. On the other hand, many people with autism spectrum disorder enjoy happy and healthy lives with few, or minor, complications.

If your pediatrician suspects your child is showing signs of developmental delays, they may recommend your child be evaluated by an ASD specialist.

The diagnostic process typically includes an evaluation of the child's history and developmental progress, and observation of the child's social and communication skills. The screening also gauges the child's hearing, speech and language abilities.

Genetic tests may be performed to determine if the child has fragile X syndrome, Rett syndrome or any other genetic developmental condition.

The diagnostician then compares the results of the child's screening to the diagnostic criteria for autism spectrum disorder as outlined by the DSM-5 before reaching an official diagnosis.

There's no cure for ASD, and the type of treatment and level of support an individual requires depends largely on the types and severity of symptoms they have.

Early intervention, particularly during the preschool years, has been found to be effective at helping children learn critical social, communication, functional and behavioral skills. Early intervention has been associated with positive long-term outcomes in these areas. Support and therapy for ASD are available at home, in schools and in specialized clinics.

Some common types of autism spectrum disorder support and therapy include:

• Applied behavior analysis (ABA) therapy 
• Communication therapy
• Educational therapy
• Family therapy
• Medication
• Occupational therapy
• Speech therapy

Living with autism means something different for each person on the spectrum. Some may have difficulty detecting and deciphering unspoken social cues, which may cause difficult situations at school, work, or in romantic and sexual relationships. It can also involve sensory issues, including sensitivity to light, strong odors, loud noises, and certain tastes and textures.

If you have a loved one with ASD, a great first step is to educate yourself on the characteristics of the condition and learn how they mirror your loved one's experience.

Navigating the world of dating with all of its unspoken social cues and nuances can be hard for anyone, but for individuals with ASD, dating can be even more of a challenge because of the complex communication skills needed to develop and maintain a romantic relationship.

For many individuals with autism spectrum disorder, direct communication is an important tool to keep handy in the toolbox of any relationship. Direct communication goes a long way toward avoiding misunderstandings, sharing feelings and helping all parties better understand one another's point of view.

It's important to meet in the middle. If you're in a "mixed neurology" relationship, ensure you're both adapting to each other's needs and that neither of you feels they have to fully change themselves and the way they operate in the world to maintain the relationship.

It is well known boys and men are diagnosed with ASD at much higher rates than girls and women. And while the rates of autism spectrum disorder are different in boys and girls, so are the ways the condition manifests.

According to a study by researchers at Stanford University School of Medicine, boys with ASD tend to have more repetitive and restrictive behaviors than girls do. The research also found that of children diagnosed with high-functioning autism spectrum disorder, boys outnumbered girls by a 4-1 ratio.

Despite the misconception that ASD is almost exclusively a boy's disorder, 1 in 145 girls have the condition.

While it's true boys are diagnosed with autism spectrum disorder at significantly higher rates, some people have pointed out the discrepancy is likely due, in part, to gender bias that leads to the misdiagnosis and underdiagnosis of girls with suspected ASD. Experts believe this could be due to the fact that girls face increased gender-based societal pressure to mask their ASD traits. Another reason may be that ADHD, which is very prevalent in people with ASD, is also diagnosed more easily for boys than girls.

Individuals with ASD can have meaningful romantic and intimate relationships.

Direct communication is important, including explicitly discussing feelings and desires. Consent is important for anyone, but particularly important and helpful for individuals with autism spectrum disorder who may not easily detect or interpret unspoken social cues.

It's important to keep in mind some of the core symptoms of ASD include hypersensitivities and hyposensitivities that may affect their physical experience of pleasure. What feels pleasurable to someone with sensory issues may be very different from what it feels like for someone without these sensory issues.

If you have ASD or are having sex with someone with the condition, make sure to constantly communicate about what feels good and what doesn't. Through conversation and some exploration, you can work together to achieve a fulfilling sex life.

In general, sex education should involve the same topics for all kids, whether they are on or off the spectrum. These topics include consent, safety, recognizing abuse, sexually transmitted infections and diseases (STIs/STDs), protection and contraception, and more.

However, the approach to a "birds and bees" conversation is likely to differ depending on the child's current developmental level mentally, emotionally and physically.

For kids with ASD, it's important to ensure that you give them time to mentally process everything you explain to them without throwing too much at them too fast. It can be helpful to address their primary questions first, which might include concerns about the changes to their body and if their feelings are normal. It may be helpful to break the sex ed conversation into multiple smaller conversations, tackling one or two aspects at a time to allow them to better process and retain the information.

As with any individual, it's important to make sure the topic of sex is shame-free and to encourage them to come to you with any questions they have in the future.

The CDC has online resources for anyone looking for essential information about ASD, from basic information to specific strategies for living with the condition.

Here are some other resources that provide educational information about autism spectrum disorder, as well as useful resources and online groups that may provide invaluable support:

• Autism Speaks
• Autism Society of America
• Autistic Self Advocacy Network (ASAN)
• Autism Now
• Operation Autism: A Resource Guide for Military Families
• Organization for Autism Research (OAR)

What are the five disorders on the autism spectrum?

Autism spectrum disorder is a neurodevelopmental condition that includes Asperger syndrome, Rett syndrome, childhood disintegrative disorder, Kanner's syndrome and pervasive developmental disorder. All of these conditions were previously considered separate disorders.

What is an autistic person like?

There is no catch-all description that can accurately depict what an autistic person is like because people with ASD can vary greatly in the types and severity of symptoms they present. Generally speaking, individuals with autism spectrum disorder have a degree of trouble with social communication, and may have restricted interests and repetitive behaviors.

Is Rett syndrome an ASD?

Rett syndrome, a rare genetic neurological disorder that affects 1 in 10,000 females and leads to severe mental and physical impairments, is considered to fall under the category of autism spectrum disorder.