Understanding Autism: What is it and how is it diagnosed?

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Autism, also known as Autism Spectrum Disorder(ASD), is a range of conditions characterised by challenges with social skills, repetitive behaviours, speech and nonverbal communication, as well as by unique strengths and differences. We now know that there is not merely one kind of autism, but many types, caused by different combinations of genetic and environmental influences.

The most-obvious signs of autism tend to appear at between 2 and 3 years of age, but in some cases, it can be diagnosed as early as 18 months. Some developmental delays associated with autism can be identified and addressed even earlier. 

Signs and Symptoms

When a child shows signs and symptoms of autism can vary widely. Some children with autism show hints of future problems within the first few months of life, while in others, symptoms may not become obvious until 24 months or later. In fact, some children with autism appear to develop normally until around 18 to 24 months of age and then stop gaining new skills and/or start losing skills.

The following “red flags” could mean a child is at risk for autism. Some children without autism have some of these symptoms, and not all children with autism show all of them. That’s why further evaluation by a trained doctor is crucial if you are concerned that your child may be autistic. 

Possible signs of autism in babies and toddlers:

  • By 6 months, no social smiles or other warm, joyful expressions directed at people
  • By 6 months, limited or no eye contact
  • By 9 months, no sharing of vocal sounds, smiles or other nonverbal communication
  • By 12 months, no babbling
  • By 12 months, no use of gestures to communicate (e.g. pointing, reaching, waving etc.)
  • By 12 months, no response to name when called
  • By 16 months, no words
  • By 24 months, no meaningful, two-word phrases
  • Any loss of any previously acquired speech, babbling or social skills

Possible signs of autism at any age:

  • Avoids eye contact and prefers to be alone
  • Struggles with understanding other people’s feelings
  • Remains nonverbal or has delayed language development
  • Repeats words or phrases over and over 
  • Gets upset by minor changes in routine or surroundings
  • Has highly restricted interests
  • Performs repetitive behaviours such as flapping, rocking or spinning
  • Has unusual and often intense reactions to sounds, smells, tastes, textures, lights and/or colours

What causes autism?

Research suggests that autism develops from a combination of genetic and non-genetic, or environmental, influences. Research also tells us that autism tends to run in families with changes in certain genes increasing the risk that a child will develop autism. If a parent carries one or more of these gene changes, they may get passed to a child (even if the parent does not have autism). In other cases, these genetic changes happen in an early embryo or the sperm and/or egg that combine to create the embryo. Again, the majority of these gene changes do not cause autism by themselves. They simply increase risk for the disorder.

Certain environmental influences may further increase – or reduce – autism risk in people who are genetically predisposed to the disorder. Importantly, the increase or decrease in risk appears to be small for any one of these risk factors, with advanced parent age, pregnancy and birth complications and pregnancies spaced less than a year apart being seen as factors that increase risk, and diligently taking prenatal vitamins with folic acid seen as reducing risk.

What about the stories about childhood vaccines causing autism?

Each family has their own unique experience with an autism diagnosis, and for some it corresponds with the timing of their child’s vaccinations. At the same time, scientists have conducted extensive research over the last two decades to find out if there is any link between childhood vaccinations and autism. The results of this research are clear: Vaccines do not cause autism!