FAQs
What is autism spectrum disorder?
Autism spectrum disorder (ASD) refers to a group of complex neurodevelopment disorders characterized by repetitive and characteristic patterns of behavior and difficulties with social communication and interaction. The symptoms are present from early childhood and affect daily functioning.
The term “spectrum” refers to the wide range of symptoms, skills, and levels of disability in functioning that can occur in people with ASD. Some children and adults with ASD are fully able to perform all activities of daily living while others require substantial support to perform basic activities. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5, published in 2013) includes Asperger syndrome, childhood disintegrative disorder, and pervasive developmental disorders not otherwise specified (PDD-NOS) as part of ASD rather than as separate disorders. A diagnosis of ASD includes an assessment of intellectual disability and language impairment.
ASD occurs in every racial and ethnic group, and across all socioeconomic levels. However, boys are significantly more likely to develop ASD than girls. The latest analysis from the Centers for Disease Control and Prevention estimates that 1 in 54 children has ASD.
What are some common signs of ASD?
Even as infants, children with ASD may seem different, especially when compared to other children their own age. They may become overly focused on certain objects, rarely make eye contact, and fail to engage in typical babbling with their parents. In other cases, children may develop normally until the second or even third year of life, but then start to withdraw and become indifferent to social engagement.
The severity of ASD can vary greatly and is based on the degree to which social communication, insistence of sameness of activities and surroundings, and repetitive patterns of behavior affect the daily functioning of the individual.
Social impairment and communication difficulties
Many people with ASD find social interactions difficult. The mutual give-and-take nature of typical communication and interaction is often particularly challenging. Children with ASD may fail to respond to their names, avoid eye contact with other people, and only interact with others to achieve specific goals. Often children with ASD do not understand how to play or engage with other children and may prefer to be alone. People with ASD may find it difficult to understand other people’s feelings or talk about their own feelings.
People with ASD may have very different verbal abilities ranging from no speech at all to speech that is fluent, but awkward and inappropriate. Some children with ASD may have delayed speech and language skills, may repeat phrases, and give unrelated answers to questions. In addition, people with ASD can have a hard time using and understanding non-verbal cues such as gestures, body language, or tone of voice. For example, young children with ASD might not understand what it means to wave goodbye. People with ASD may also speak in flat, robot-like or a sing-song voice about a narrow range of favorite topics, with little regard for the interests of the person to whom they are speaking.
Repetitive and characteristic behaviors
Many children with ASD engage in repetitive movements or unusual behaviors such as flapping their arms, rocking from side to side, or twirling. They may become preoccupied with parts of objects like the wheels on a toy truck. Children may also become obsessively interested in a particular topic such as airplanes or memorizing train schedules. Many people with ASD seem to thrive so much on routine that changes to the daily patterns of life — like an unexpected stop on the way home from school — can be very challenging. Some children may even get angry or have emotional outbursts, especially when placed in a new or overly stimulating environment.
How is ASD diagnosed?
ASD symptoms can vary greatly from person to person depending on the severity of the disorder. Symptoms may even go unrecognized for young children who have mild ASD or less debilitating handicaps.
Autism spectrum disorder is diagnosed by clinicians based on symptoms, signs, and testing according to the Diagnostic and Statistical Manual of Mental Disorders-V, a guide created by the American Psychiatric Association used to diagnose mental disorders. Children should be screened for developmental delays during periodic checkups and specifically for autism at 18- and 24-month well-child visits.
Very early indicators that require evaluation by an expert include:
no babbling or pointing by age 1
no single words by age 16 months or two-word phrases by age 2
no response to name
loss of language or social skills previously acquired
poor eye contact
excessive lining up of toys or objects
no smiling or social responsiveness
Later indicators include:
impaired ability to make friends with peers
impaired ability to initiate or sustain a conversation with others
absence or impairment of imaginative and social play
repetitive or unusual use of language
abnormally intense or focused interest
preoccupation with certain objects or subjects
inflexible adherence to specific routines or rituals
If screening instruments indicate the possibility of ASD, a more comprehensive evaluation is usually indicated. A comprehensive evaluation requires a multidisciplinary team, including a psychologist, neurologist, psychiatrist, speech therapist, and other professionals who diagnose and treat children with ASD. The team members will conduct a thorough neurological assessment and in-depth cognitive and language testing. Because hearing problems can cause behaviors that could be mistaken for ASD, children with delayed speech development should also have their hearing tested.
What services can help individuals with ASD be as successful as possible?
Therapies and behavioral interventions are designed to remedy specific symptoms and can substantially improve those symptoms. There is no “cure” for ASD. The ideal treatment plan coordinates therapies and interventions that meet the specific needs of the individual. Most health care professionals agree that the earlier the intervention, the better.
Educational/behavioral interventions: Early behavioral/educational interventions have been very successful in many children with ASD. In these interventions therapists use highly structured and intensive skill-oriented training sessions to help children develop social and language skills, such as applied behavioral analysis, which encourages positive behaviors and discourages negative ones. In addition, family counseling for the parents and siblings of children with ASD often helps families cope with the particular challenges of living with a child with ASD.
Medications: While medication can’t cure ASD or even treat its main symptoms, there are some that can help with related symptoms such as anxiety, depression, and obsessive-compulsive disorder. Antipsychotic medications are used to treat severe behavioral problems. Seizures can be treated with one or more anticonvulsant drugs. Medication used to treat people with attention deficit disorder can be used effectively to help decrease impulsivity and hyperactivity in people with ASD. Parents, caregivers, and people with autism should use caution before adopting any unproven treatments.
What can schools do to support students on the spectrum and their caregivers?
Here are three ways school and district administrators can support the families of students with autism.
Check in, Encourage, and Empower
It may seem like a relatively small gesture, but simply checking in can have a big impact. Asking a parent or guardian how they are coping, letting them vent, or even giving them an opportunity to cry lets them know they are not alone and that you are there to support them.
It is also important to encourage families to give themselves some grace and recognize that they are only human. In a similar vein, you can empower parents and guardians by assuring them they are doing the best they can during an unprecedented and incredibly stressful time.
Help Maintain Clear Rules, Expectations, and Routines
Children with autism will struggle in an unstructured environment. Consequently, school and district leaders should help families foster stability—and to the extent possible, provide the structures their child was receiving in the classroom setting.
For example, parents and caregivers can create a visual schedule, develop a daily routine, and/or make checklists. They can also establish clear rules and expectations for behavior to set their children up for success.
Determine Manageable Goals and Adjust Assignments Accordingly
Although it is important that all students attend to their schoolwork as assigned, online learning might be more challenging for some students. For students with autism, education leaders should encourage families to focus on feasibility and flexibility.
Put another way, parents and caregivers should first establish what is achievable for their child, given the time frame and other factors. After that, they should determine what is essential for them to learn, set goals accordingly, and recognize that “no size fits all” in terms of how those goals are met.
For more resources and research-based strategies on supporting students with autism and their families during this time, education leaders can check out the following organizations:
Does SBBC Accept Insurance?
SBBC accepts private pay and most insurance companies, including Indiana Medicaid and the Medicaid Waiver for in-home services and is a provider for Indiana School Medicaid for school-based services.