Autism spectrum disorders (ASDs)

Upcoming changes

The 5th edition of Diagnostic and Statistical Manual of Mental Disorders (DSM) is expected to be published in May by the American Psychiatric Association, and it will include new diagnostic and classification criteria regarding developmental disorders. As soon as the new information is available, these web pages will be fully updated and will include all DSM changes in the area of autism spectrum disorders. 

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Autism is one of the most talked-about medical conditions today. But when you take a step back, you may find you have more questions than answers. What is autism, exactly? What does it mean if a child is “on the spectrum”? Can these conditions be treated?

If your child is having some developmental difficulties and your doctor has suggested that he be evaluated for an autism spectrum disorder, you’re probably overwhelmed, and you may be trying to make sense out of conflicting information.

Autism spectrum disorders (ASDs) are complex conditions, and our understanding of them is evolving rapidly as researchers get more and more answers. An ASD tends to affect a child’s ability to interact and communicate with others and may cause him to have behavioral challenges. Different children with ASDs are affected in very different ways. There’s currently no “cure,” but we’re finding that there are therapies that can often be very effective in helping children with ASDs gain the skills they’re having problems with.

Autism spectrum disorders are also called pervasive developmental disorders (PDDs).

ASDs are defined by behaviors that may include:

• difficulty with social interactions
• difficulty with language and other forms of communication
• unusual, restricted or repetitive interests or behaviors

The specific names given to ASDs are:

• autism (autistic disorder)
• Asperger's syndrome
• pervasive developmental disorder – not otherwise specified (PDD-NOS)

Some basic facts about ASDs are:

• ASDs are three to four times more common in boys than girls.
• They affect children in all ethnic and socioeconomic groups.
• Exactly what caused a child’s ASD usually can’t be determined. It appears that ASDs are sometimes caused, at least in part, by DNA changes. Understanding the factors that may lead to ASDs is an active area of research.
• Behavioral symptoms of ASDs typically appear before a child is 3, although more subtle differences can appear even in the first year of life.
• There’s no laboratory test that can tell whether your child has or will develop an ASD. Currently, the diagnosis is based solely on your child’s behavior and development.
• Research has shown that early diagnosis and therapy can be enormously helpful in improving behaviors and abilities.

As the word “spectrum” implies, autism spectrum disorders have a wide range of effects on children. And while an ASD impacts a child’s development, it doesn’t impact his development evenly, in every area. If your child has an ASD, he probably has both difficulties and strengths.

A range of behavioral therapies and teaching approaches are used to help children develop skills in the areas where they're having difficulties. Depending on your child's needs, occupational, physical and communication therapies may be very helpful, too.

How Children’s Hospital Boston approaches autism spectrum disorders

Children’s brings together an array of specialists—including developmental behavioral pediatricians, child neurologists, psychologists and speech-language pathologists—to provide the multi-faceted assessments and care that children with autism spectrum disorders need. Along with experienced resource specialists, we are dedicated to providing the best possible care for your child and helping your family access the right educational approaches and therapies for his unique situation.

The process of evaluating your child involves more than simply diagnosing him with autism, Asperger syndrome or PDD-NOS. Instead, we perform in-depth assessments, close follow-up and ongoing support for your family:

• We work to get the fullest possible understanding of your child’s strengths and challenges. This helps us provide detailed, expert recommendations that can help you and your child’s school system plan his therapy and education.
• The key challenge in caring for a child with an ASD is often simply finding and accessing the right therapies for him. So Children’s resource specialists work intimately with your family to help you find the services you need.
• We continue to see your child periodically as he grows up to see how he’s doing, make new recommendations for therapy and keep an eye out for any related medical concerns.

At Children’s, our team is devoted to advancing our understanding of autism spectrum disorders. Our researchers are approaching ASDs from many different angles, working together so that new discoveries translate quickly into new, effective methods for diagnosis and treatment.

Autism spectrum disorders (ASDs): Reviewed by Carolyn Bridgemohan, MD, Ellen Hanson, PhD, and Sarah Spence, MD, PhD
© Children’s Hospital Boston, 2010