No. 11; Updated October 2013
Most infants and young children are very social creatures who need and want contact with others to thrive and grow. They smile, cuddle, laugh, and respond eagerly to games like "peek-a-boo" or hide-and-seek. Occasionally, however, a child does not interact in this expected manner. Instead, the child seems to exist in his or her own world, a place characterized by repetitive routines, odd and peculiar behaviors, problems in communication, and a total lack of social awareness or interest in others. These are characteristics of a developmental disorder called autism.
Autism is usually identified by the time a child is 30 months old. It is often discovered when parents become concerned that their child may be deaf, is not yet talking, resists cuddling, and avoids interaction with others.
Some of the early signs and symptoms which suggest a young child may need further evaluation for autism include:
- no smiling by six months of age
- no back and forth sharing of sounds, smiles or facial expressions by nine months
- no babbling, pointing, reaching or waving by 12 months
- no single words by 16 months
- no two word phrases by 24 months
- regression in development
- any loss of speech, babbling or social skills
A preschool age child with "classic" autism is generally withdrawn, aloof, and fails to respond to other people. Many of these children will not even make eye contact. They may also engage in odd or ritualistic behaviors like rocking, hand flapping, or an obsessive need to maintain order.
Many children with autism do not speak at all. Those who do may speak in rhyme, have echolalia (repeating a person's words like an echo), refer to themselves as a "he" or "she," or use peculiar language.
The severity of autism varies widely, from mild to severe. Some children are very bright and do well in school, although they have problems with school adjustment. They may be able to live independently when they grow up. Other children with autism function at a much lower level. Mental retardation is commonly associated with autism.
Occasionally, a child with autism may display an extraordinary talent in art, music, or another specific area.
The cause of autism remains unknown, although current theories indicate a problem with the function or structure of the central nervous system. What we do know, however, is that parents do not cause autism.
Children with autism need a comprehensive evaluation and specialized behavioral and educational programs. Some children with autism may also benefit from treatment with medication. Child and adolescent psychiatrists are trained to diagnose autism, and to help families design and implement an appropriate treatment plan. They can also help families cope with the stress which may be associated with having a child with autism.
Although there is no cure for autism, appropriate specialized treatment provided early in life can have a positive impact on the child's development and produce an overall reduction in disruptive behaviors and symptoms.