Autism Spectrum Disorder

Autism spectrum disorder (ASD) is a neurological condition that affects a child’s behavior, ability to communicate and social interaction skills. Children with autism spectrum disorder understand and interact with the world differently than their peers.

Autism is called a spectrum disorder because symptoms and behaviors are different for every child.

The wide range of characteristics or symptoms of ASD fall into two main categories.

The first category is deficits in communications and social interactions. This includes:

Deficits in social-emotional reciprocity. This means a child does not respond to his or her name, does not share emotions with others (such as smiling back when someone smiles at him or her) and seems to be in his or her own world.
Deficits in nonverbal communicative behaviors used for social interaction. This is when a child does not make eye contact and does not respond to body language. He or she may have limited facial expressions and a voice that sounds different.
Deficits in developing, maintaining and understanding relationships. This is when a child struggles to make friends and often does not know how to fit in. Pretend play can be difficult. He or she may prefer playing alone.

The second category is restricted, repetitive patterns of behavior, interests or activities. This includes:

Stereotyped or repetitive motor movements, use of objects or speech. Children with ASD may make a repeated motion such as rocking back and forth, or they may repeat specific phrases at inappropriate times. Instead of playing with their toys, children with ASD tend to line them up. Some children may use formal adult speech while others may make unexpected noises.
Insistence on sameness, inflexible adherence to routines or ritualized patterns of verbal or nonverbal behavior. Children with ASD prefer things to stay the same. They may want the same foods for every meal or continuously repeat the same play routines. Changes in routine or transition from one activity to another are difficult, often leading to a meltdown.
Highly restricted, fixated interests. In some cases, children zero in on one interest. For example, they may learn everything there is to know about dinosaurs and play with and talk about dinosaurs all the time.
Reactivity to sensory input. Children with ASD can experience sensory information (sounds, smells, touch, tastes, sights and balance) differently.

Hyper-reactivity. Children react to things that do not bother others such as loud noises or certain lights.
Hypo-reactivity. Children may show no reaction to pain or other stimuli, or they may crave sensory input such as being wrapped tightly in a blanket or spinning on swings.

Children with ASD may experience all of the symptoms from both categories, or they may show many characteristics from one category and just a few from another.

Autism spectrum disorder may occur with other conditions such as:

Language impairment (how children understand and speak)
Intellectual and cognitive disability
Attention-deficit/hyperactivity disorder
Anxiety
Depression
Learning disabilities

Many parents are caught by surprise when they learn their child has autism. Families often seek help from their child’s doctor because their child has behavior problems, has trouble in school or is not responding to normal cues.

An autism diagnosis can seem overwhelming at first. With regular therapy and treatment and the right supports, many children perform well in school and participate in childhood activities.

Diagnosis of Autism Spectrum Disorder

Doctors at Riley at IU Health will study your child's behavior to make a diagnosis of autism spectrum disorder. This condition cannot be diagnosed with a blood test or brain scan. Doctors from the following specialty departments at Riley at IU Health may be involved in making the diagnosis:

Child Development
Psychiatry
Developmental Pediatrics
Medical & Molecular Genetics
Neurology

Doctors generally use the following to evaluate a child for autism spectrum disorder:

Medical history. The specialists will obtain a thorough family medical history as well as a complete medical history for your child. The doctor will talk with you about your child’s behavior, including how it compares to the behavior of his or her siblings and/or peers.
Clinical evaluation. The specialists will examine your child’s body and basic sensory functions to check for any abnormalities. During the exam, the specialists will pay attention to how your child interacts with you and others and how he or she responds to questions or the chance to look at a new toy.
Psychological testing. In some cases, a child’s behaviors make diagnosis of autism spectrum disorder obvious. In other cases, more formalized testing is needed to make a diagnosis or determine if other factors are contributing to a child’s actions. These tests may seem like the doctor or psychologist is playing with your child, but the interactions are designed to put certain demands on your child to see how he or she responds.

Treatment for Autism Spectrum Disorder

Treatments for autism spectrum disorder will vary for every child depending on his or her specific behaviors and symptoms. Not every treatment will bring positive benefits to every child.

The specialists at Riley at IU Health first use a conservative behavioral approach to treatment and then follow up with additional care to manage exacerbating conditions. Treatment options include:

Behavioral therapy. A trained therapist will work with your child to teach positive behaviors and replace bad habits with good ones. This can include, but is not limited to, applied behavior analysis (ABA).
Occupational therapy. A therapist will work with your child to help him or her improve muscle function and learn and understand how to perform the more common activities of daily living, such as getting dressed or doing homework. Occupational therapy is also helpful for children with exaggerated reactions to sensory inputs.
Speech-language pathology. If your child has trouble communicating, a speech pathologist will work with him or her to improve communication skills. Speech therapists also work on the social aspects of communication.
Medicine. When autism spectrum behaviors do not subside or regulate with therapy alone, the doctor may recommend medicines. Medicines manage behaviors that may be getting in the way of progress, such as aggression, anxiety, hyperactivity or sleep disturbances. They are always used in combination with behavioral interventions and do not address the core symptoms of autism.
School interventions. Riley at IU Health works with families to help them access proper services for their child at school.
Family time. It is important to remember that your child is always learning. Encourage his or her interests, which might some day develop into a career. Remember to laugh and play with your child and find activities the entire family enjoys doing together.

Key Points to Remember

Autism spectrum disorder is a neurological condition that affects communication, social interaction and behavior.
The symptoms or characteristics of autism spectrum disorder vary greatly and are different for every child.
Children with autism can improve with behavioral, occupational and speech therapy and, sometimes, medicine.
While children with autism experience the world differently, they can be successful at school and active members of their community.

Support Services & Resources

Visit the links below to learn more about autism and find support groups.

Riley at IU Health offers a broad range of supportive services to make life better for families who choose us for their children's care.

Learn More About Riley Support Services

Autism Society of Indiana

This affiliate of the Autism Society of America provides support and resources to improve the lives of those living with autism in Indiana.

HANDS in Autism

This center provides outreach services to those living with autism spectrum disorder and those who support families managing the condition.

Indiana Resource Center for Autism

This Indiana University program provides outreach, training and coaching to school staff and others who deliver programming and services to children and families living with autism.