What is an Autism Spectrum Disorder (ASD)?
Autism spectrum disorder (ASD) is a neurodevelopmental disorder that a person is born with and affects everyday behaviors. Individuals with autism (also called autistic individuals) have differences in their ability to interact and communicate with others and show repetitive behaviors or restricted interests. The combination of these two groups of behaviors can challenge the individual in many ways.
Signs of ASD often appear in children 12 to 18 months old. That said, sometimes difficulties are not very apparent until children with autism are older and they start to engage more with the world around them (e.g., school).
Before 2013, clinicians viewed ASD as a group of individual disorders, including Autistic disorder, Asperger’s syndrome, disintegrative disorder, and pervasive development disorder. In 2013, the American Psychiatric Association combined all these disorders into one diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5): Autism Spectrum Disorder (ASD). All individuals with ASD have symptoms in the two core groups of behaviors noted above. However, individuals with ASD are incredibly diverse. Spectrum is a term used to describe a broad scope of strengths and challenges.
Autistic individuals can vary greatly in terms of their symptoms and the level of support they need. According to the DSM-5, clinicians can indicate the level of support someone needs from level 1 (needs support) to level 3 (needs very substantial support). Each person is unique; therefore, using these levels to differentiate ASD can help determine the most useful services and supports. However, the level of support needed can change over time.
Signs & Symptoms of Autism Spectrum Disorder
The signs and symptoms of autism spectrum disorder span two domains: Social Interaction and Communication and Restricted, Repetitive Behavior. It is important to note that not everyone with ASD experiences the same set of behaviors.
While some behaviors may be present in young children, some autism symptoms may not become apparent until individuals are older when more demands for social skills are placed on people. Some individuals may not receive a diagnosis until adulthood. Some signs include:
- Differences in body language (e.g., gestures) or eye contact
- Difficulty with emotional expression or interpreting others’ expressions
- Not responding to their name when called
- Trouble starting or maintaining interactions with others
- Challenges taking another person’s point of view
- Having an unusual tone of voice, for instance, sing-song or flat
- Difficulty making or maintaining relationships with others
- Early challenges with pretend or imaginative play
- Repetition of certain words or phrases
- Repeating certain body movements, like flapping hands, spinning, or twirling fingers
- Fixating on a specific subject or topic with high intensity
- Trouble transitioning in situations
- Strong focus on routine or rituals and may be upset with changes to routine
- Focus on parts of toys or objects
- Hyper-sensitive or hypo-sensitive to sensory input (e.g., light, sound, clothing texture, temperature)
What Causes Autism Spectrum Disorder?
We know that autism is something a person is born with and affects brain development. There does not appear to be a single cause for autism spectrum disorder. It is believed that numerous factors combined can affect the development of a person’s brain. Environmental factors and genetics are also believed to play a part in the presence of ASD.
- Genetics – There is strong evidence that genetics contribute to autism. Having one child with autism increases the risk of having another biological sibling with autism, and twins have a higher rate of autism diagnosis as well. There is a growing list of genetic disorders that researchers have found increase the likelihood of autism.
- Environmental factors – Being born premature or small, having infections or stress during pregnancy, and some maternal medications may contribute to autism risk. Other studies are looking at the role of environmental toxins and other environmental exposure in increasing the likelihood of autism.
Vaccines do not cause autism. Extensive research has been done, and conclude with great confidence that childhood vaccines do not cause autism. The American Academy of Pediatrics and The Institute of Medicine recommend that children receive their scheduled childhood vaccinations. An unvaccinated child is at risk, along with others around them, of catching or spreading serious diseases such as pertussis (whooping cough), measles, or mumps.
Factors That Increase the Likelihood of Autism
There has been an increase in children diagnosed with autism spectrum disorder since its first description in 1943. Most clinicians and researchers suggest there are various reasons why this is the case. First, there is more awareness about the diagnosis, so clinicians are getting better at identifying red flags and diagnosing at earlier ages. The social stigma has changed regarding understanding the need to identify the disorder in individuals to provide timely support and earlier interventions that may be helpful.
ASD affects people of all races and nationalities, children and adults alike. We do know that difficulties accessing care can delay ASD diagnosis.
More males are diagnosed with autism than females. In addition to biological differences, clinicians may be more biased to see autism in males. We know that females can have ASD but often present with different behaviors that are not as noticeable and can lead to delayed diagnoses.
Tremendous advancements have been made in supporting individuals with autism. Early detection and diagnosis are important. Children do not grow out of autism—it is a lifelong disorder; however, some individuals may no longer need support or other types of support as they grow up. Most individuals with ASD benefit from some support throughout their lifetime. Intervention options are available for people with ASD, and support for the family members and caregivers involved. Stay abreast of information that becomes available on the subject.
Trust NewYork-Presbyterian for Autism Spectrum Disorder Care
NewYork-Presbyterian prides itself on being a leader in autism diagnosis and intervention.
Various providers often deliver care to individuals with ASD. Initial concerns from primary care providers often direct families to local service providers, such as early intervention for early diagnosis and management. Other clinical providers who may diagnose ASD include psychologists, developmental pediatricians, child neurologists, and child psychiatrists. Below we have listed various locations where individuals may have autism testing. At NewYork-Presbyterian, we have providers at various locations with different areas of expertise in diagnosis and management.
Our Center for Autism and the Developing Brain (CADB) provides autistic individuals and other developmental conditions with the most comprehensive programs available in one convenient location. Located in the Westchester Behavioral Health Center campus in White Plains, New York, our program brings together the best minds with the compassion and understanding needed to communicate with patients with these special needs. NewYork-Presbyterian, in conjunction with Weill Cornell Medicine and Columbia University Vagelos College of Physicians and Surgeons, in partnership with NEXT for AUTISM, realizes that ASD is a lifelong condition. We are here for the long haul. NewYork-Presbyterian cares and is determined to help keep you amazing.
ColumbiaDoctors Child Neurology maintains the highest standard of neurologic practice for pediatric patients and their families by combining the latest research and technological advances with individualized, compassionate care. The division of child neurology at ColumbiaDoctors constitutes over a dozen specialty providers and a behavioral neurology group with specific expertise and interest in caring for those with autism and related neurodevelopmental disorders. Our multi-disciplinary team in the Child Development Program is dedicated to providing integrated and collaborative care to a diverse population of children with various difficulties.
Behavioral Developmental pediatrics at Both Weill Cornell and Columbia provide evaluations, treatment, and referrals for conditions including delays in motor and language development, autism spectrum disorders, cerebral palsy, and school-related problems, including attention deficit hyperactivity disorder (ADHD).
Some children are also cared for by Psychiatric Providers across their lifespan. Psychiatrists may help diagnose co-occurring symptoms or disorders, such as depression, anxiety, or ADHD. They may provide medication management and behavioral coping tools.
Our digital health services give patients easy access to top pediatricians, surgeons, and doctors. In addition, our telehealth care service extends our healthcare services beyond the hospital walls making NewYork-Presbyterian one of the most requested hospitals in the New York metropolitan area.