American Speech-Language-Hearing Association
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Autism (Autism Spectrum Disorders)

What is autism?

Autism is a developmental disability that causes problems with social skills and communication. Autism can be mild or severe. It is different for every person. Autism is also known as autism spectrum disorders.

What are some signs or symptoms of autism?

Children with autism may have problems with communication, social skills, and reacting to the world around them. Not all behaviors will exist in every child. A diagnosis should be made by the child's doctor or other professional with experience in working with children with autism. Possible signs and symptoms are outlined below.

Communication:

  • Not speaking or very limited speech
  • Loss of words the child was previously able to say
  • Difficulty expressing basic wants and needs
  • Poor vocabulary development
  • Problems following directions or finding objects that are named
  • Repeating what is said (echolalia)
  • Problems answering questions
  • Speech that sounds different (e.g., "robotic" speech or speech that is high-pitched)

Social skills:

  • Poor eye contact with people or objects
  • Poor play skills (pretend or social play)
  • Being overly focused on a topic or objects that interest them
  • Problems making friends
  • Crying, becoming angry, giggling, or laughing for no known reason or at the wrong time
  • Disliking being touched or held

Reacting to the world around them:

  • Rocking, hand flapping or other movements (self-stimulating movements)
  • Not paying attention to things the child sees or hears
  • Problems dealing with changes in routine
  • Using objects in unusual ways
  • Unusual attachments to objects
  • No fear of real dangers
  • Being either very sensitive or not sensitive enough to touch, light, or sounds (e.g., disliking loud sounds or only responding when sounds are very loud; also called a sensory integration disorder)
  • Feeding difficulties (accepting only select foods, refusing certain food textures)
  • Sleep problems

How is autism diagnosed?

It is important to have your child evaluated by professionals who know about autism. Speech-language pathologists (SLPs), typically as part of a team, may diagnose autism. The team might include pediatricians, neurologists, occupational therapists, physical therapists, and developmental specialists, among others. SLPs play a key role because problems with social skills and communication are often the first symptoms of autism. SLPs should be consulted early in the evaluation process. There are a number of tests and observational checklists available to evaluate children with developmental problems. The most important information, however, comes from parents and caregivers who know the child best and can tell the SLP and others all about the child's behavior.

What treatments are available for people with autism?

There is no known cure for autism. In some cases, medications and dietary restrictions may help control symptoms. Intervention should begin when the child is young. Early intervention and preschool programs are very important. An evaluation by an SLP should be completed to determine social skill and communication needs. An appropriate treatment plan that meets the needs of the child and family can then be established. Treatment may include any combination of traditional speech and language approaches, augmentative and alternative communication, and behavioral interventions. It is also important to have the child's hearing evaluated to rule out hearing loss.

Read more in this guide from the Agency for Healthcare Research and Quality (AHRQ), Therapies for Children with Autism Spectrum Disorders: A Review of the Research for Parents and Caregivers.

What other organizations have information about autism?

This list is not exhaustive and inclusion does not imply endorsement of the organization or the content of the website by ASHA.

What causes autism?

Autism is a lifelong problem with a number of possible causes, including but not limited to:

  • genetic problems or syndromes
  • severe infections that affect the brain (meningitis, celiac disease, encephalitis, etc.)
  • exposure to toxins or illness during pregnancy (rubella, chemicals, etc.)

How common is autism?

Statistics about autism vary. There is controversy surrounding some reports. See ASHA's report Communication Facts: Special Populations: Autism for more information.

What other disorders are similar to autism?

Autism is often referred to as autism spectrum disorders. Severity and signs and symptoms vary greatly from person to person. Other terms are used to describe disorders that are similar to or even part of autism spectrum disorders. These disorders are typically included under the term pervasive developmental disorder.

Pervasive developmental disorder (PDD)

PDD is sometimes used to describe any group of developmental disorders that affect social skills and communication. PDD is used by some people to refer to autism, although the difference between the two is under debate. PDD may refer to any of five diagnoses:

  • Autistic disorder (autism)
  • Asperger's syndrome—severe and sustained problems with social skills, with repetitive behaviors and restricted interests and activities. Language skills tend to be good, although social communication may be affected.
  • Rett's disorder—a progressive brain disorder that occurs almost only in girls. Children tend to develop normally for a period of time followed by loss of skills, especially hand skills, which are replaced by repetitive hand movements. Symptoms begin between the ages of 1 and 4 years old. Poor eye contact, a lag in brain and head growth, problems walking, language problems, and seizures are also symptoms.
  • Childhood disintegrative disorder—a rare condition that occurs without a known medical cause. Typically children have at least 2 years of typical development before the beginnings of severe loss of skills in a number of areas, such as language, social skills, play, or motor skills. This disorder is associated with severe cognitive impairment.
  • Pervasive developmental disorder - not otherwise specified (PDD-NOS)—an overall delay in development of communication and social skills that does not fit into another category and does not have a known cause.
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How effective are speech and language treatments for autism?

ASHA produced a treatment efficacy summary on autism [PDF] that describes evidence about how well treatment works. This summary is useful not only to individuals with autism and their caregivers but also to insurance companies considering payment for much needed services for autism.

What do SLPs do when working with individuals with autism?

In 2006, four documents were developed by ASHA outlining the role of the SLP in working with individuals with autism, as well as the knowledge and skills needed to serve this population:

The position statement listed above - Roles and Responsibilities of Speech-Language Pathologists in Diagnosis, Assessment, and Treatment of Autism Spectrum Disorders Across the Life Span - states that "speech-language pathologists play a critical role in screening, diagnosing, and enhancing the social communication development and quality of life of children, adolescents, and adults with autism spectrum disorders (ASD)." Further, "individuals with ASD should be eligible for speech-language pathology services due to the pervasive nature of the social communication impairment, regardless of age, cognitive abilities, or performance on standardized testing of formal language skills."

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