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Autism Essay | Essay on Autism for Students and Children in English

February 13, 2024 by Prasanna

Autism Essay:  Autism, also known as autism spectrum disorder (ASD), is a neurodevelopmental disorder. Problems with communications and social interactions, along with repetitive and restricted behaviour, are common in autism. The associated factors of autism include genetics and specific environmental influences.

Autism includes a wide range of disorders of which, Asperger syndrome, childhood disintegrative disorder and pervasive developmental disorders have been added recently. The symptoms of autism occur before three years in a child, as observed by doctors.

You can also find more  Essay Writing  articles on events, persons, sports, technology and many more.

Long and Short Essays on Autism for Students and Kids in English

We provide students with essay samples on a long essay of 500 words and a short essay of 150 words on the topic Autism for reference.

Long Essay on Autism 500 Words in English

Long Essay on Autism is usually given to classes 7, 8, 9, and 10.

Autism is a complex neurodevelopmental disorder and affects a person’s responsive and interactive behaviour. It requires sensitivity and a certain intensity of the traits that affect social development for diagnosis. Autism includes persistent deficits in social communication and interactions. People who have autism also face difficulties in social and emotional reciprocity and a reduced interest in sharing emotions or feelings and often fail to respond to social interactions. Autistic people often face difficulties in maintaining, developing, or understanding relationships. They exhibit poorly integrative verbal or non-verbal communications and abnormalities in making eye-contacts and body language.

Autism is characterized by stereotypical and repetitive movements, phrases and words, and reactions along with inflexible adherence to a particular routine. The abnormal intensity of attachment with unusual objects is often seen in autistic people, and they are hypersensitive to small changes around them. The symptoms of autism result from changes related to maturation in different brain systems. The mechanisms of autism can be divided into two ways. The pathophysiology of the brain structure and associated processes regulates the behavioural characteristics. There are individual neurophysiological connections between the brain and behaviours also.

Autism is a significant form of Pervasive developmental disorders (PDD) and is also classified as syndromal and non-syndromal. The extent of non-syndromal autism is unclear, but syndromal autism includes an intellectual disability or congenital syndromes. Diagnosed reports suggest some children lose their language and social skills at 15-30 months. Researches have been restricted due to identification problems in traditional boundaries between the subgroups and disciplines like psychiatry, neurology, paediatrics, and psychology.

According to doctors, very few people suffering from autism exhibit savant syndrome. A person starts to exhibit extraordinary skills and abilities in a specific field, like, calculating complicated sums at a very high speed, reading two books simultaneously, memorizing things quickly, etc. The exact causes leading to autism are still not known. It just occurs due to a different functioning of the brain and is often believed to be genetic, as the doctors found pieces of evidence. Autistic people experience changes in the significant areas of the brain that affect their speech and behaviour. In cases of twins, a strong correlation between them has also been observed in terms of autism. Environmental factors also cause autistic disorders. The risk factors during pregnancy, including rubella, toxins, autoimmune diseases, fetal growth restrictions, and air pollution, also play a vital role.

Autism results in low tolerance and perseverance levels in distinctive individuals. Autistic people often suffer from regular panic attacks and societal trauma which causes anxiety, self-esteem issues, depression, obsessive-compulsive disorders, epilepsy, and sleep disturbances. This trauma adversely affects their development. There is no such proven treatment for curing autism, but proper therapies and strategies can manage mental health issues. Treatment interventions are beneficial in autism cases. Applied behaviour analysis (ABA) increases desirable behaviour, reduces harmful isolation from others, and might improve memory-focus, academic performance, and communications. Other interventions include Early Start Denver Model (ESDM), Occupational Therapy (OT), Pivotal Response Treatment (PRT), Speech Therapy, Relationship Development Intervention (RDI), Verbal Behaviour Therapy (VBT), and TEACCH.

Short Essay on Autism 150 Words in English

Short Essay on Autism is usually given to classes 1, 2, 3, 4, 5, and 6.

Autism is a neurodevelopmental disability that occurs at the age of three years. It affects the social, behavioural and communicative skills. The characteristics of autism vary from person to person. Parents start to notice the autistics characteristics in their child when he/she avoids social interactions, has behavioural issues and speech problems.

One of the important behavioural characteristics of an autistic child is aggressiveness or self-harming behaviour, either active or passive. They exhibit odd behaviours and have a resistance to change regular routines. However, in many cases, extraordinary talents and skills are observed in autistic people. The symptoms of autism first appear during infancy or early childhood days. Autistic people have specific impairments which include problems in social interactions, communications, repetitive behaviour. Atypical eating habits are also common.

The causes of autism have not been discovered yet, but genetics play an essential role along with significant risk factors during the time of pregnancy. It is a disorder and not a disease and is not curable. Medications, therapies and strategies help to improve the conditions, physically and mentally, and people need to get more aware and careful while dealing with autistic children.

10 Lines on Autism in English

• Autism is a neurodevelopmental disorder and not an illness.
• Genetics, environmental factors and risk factors at the time of pregnancy play a vital role in cases of autism.
• The first signs and symptoms of autism are seen during infancy and early childhood days.
• Autistic people face difficulties in communication and interactions and often suffer from mental health issues.
• Autistic people often have repetitive behaviour and may have speech problems.
• In some cases of autism, the person may exhibit unique talents and extraordinary skills in specific fields.
• Autism is a resultant form of differential performing of the brain.
• Autism is the most common form of Pervasive developmental disorders (PDD).
• Autistic people face issues related to the senses, memory and understanding verbal instructions.
• There is no cure for autism though medicines and therapies improve the mental health of the child.

FAQ’s on Autism Essay

Question 1.  What causes autism?

Answer:  There is no exact known cause of autism, but genetics and environmental often affect in cases of autism.

Question 2. What does ‘spectrum’ mean in autism cases?

Answer:  Autism does not come with a single disorder. It has a range of conditions related to behaviour, speech, communication and memory, and hence it is often called Autism Spectrum Disorder (ASD).

Question 3.  How to understand if a child is autistic?

Answer:  The signs of autism are identified in early childhood when the child isolates themselves or faces speech difficulties or have a tendency of repetitive behaviour or phrases.

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A Short Review on the Current Understanding of Autism Spectrum Disorders

Hye ran park.

1 Department of Neurosurgery, Seoul National University Hospital, Seoul 03080, Korea.

Jae Meen Lee

Hyo eun moon, dong soo lee.

2 Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul 03080, Korea.

Bung-Nyun Kim

3 Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul 03080, Korea.

Jinhyun Kim

4 Center for Functional Connectomics, Korea Institute of Science and Technology (KIST), Seoul 02792, Korea.

Dong Gyu Kim

Sun ha paek.

Autism spectrum disorder (ASD) is a set of neurodevelopmental disorders characterized by a deficit in social behaviors and nonverbal interactions such as reduced eye contact, facial expression, and body gestures in the first 3 years of life. It is not a single disorder, and it is broadly considered to be a multi-factorial disorder resulting from genetic and non-genetic risk factors and their interaction. Genetic studies of ASD have identified mutations that interfere with typical neurodevelopment in utero through childhood. These complexes of genes have been involved in synaptogenesis and axon motility. Recent developments in neuroimaging studies have provided many important insights into the pathological changes that occur in the brain of patients with ASD in vivo. Especially, the role of amygdala, a major component of the limbic system and the affective loop of the cortico-striatothalamo-cortical circuit, in cognition and ASD has been proved in numerous neuropathological and neuroimaging studies. Besides the amygdala, the nucleus accumbens is also considered as the key structure which is related with the social reward response in ASD. Although educational and behavioral treatments have been the mainstay of the management of ASD, pharmacological and interventional treatments have also shown some benefit in subjects with ASD. Also, there have been reports about few patients who experienced improvement after deep brain stimulation, one of the interventional treatments. The key architecture of ASD development which could be a target for treatment is still an uncharted territory. Further work is needed to broaden the horizons on the understanding of ASD.

INTRODUCTION

Autism spectrum disorder (ASD) is a set of neurodevelopmental disorders characterized by a lack of social interaction, verbal and nonverbal communication in the first 3 years of life. The distinctive social behaviors include an avoidance of eye contact, problems with emotional control or understanding the emotions of others, and a markedly restricted range of activities and interests [ 1 ]. The current prevalence of ASD in the latest large-scale surveys is about 1%~2% [ 2 , 3 ]. The prevalence of ASD has increased in the past two decades [ 4 ]. Although the increase in prevalence is partially the result of changes in DSM diagnostic criteria and younger age of diagnosis, an increase in risk factors cannot be ruled out [ 5 , 6 ]. Studies have shown a male predominance; ASD affects 2~3 times more males than females [ 2 , 3 , 7 ]. This diagnostic bias towards males might result from under-recognition of females with ASD [ 8 ]. Also, some researchers have suggested the possibility that the female-specific protective effects against ASD might exist [ 9 ].

A Swiss psychiatrist, Paul Eugen Bleuler used the term "autism" to define the symptoms of schizophrenia for the first time in 1912 [ 10 ]. He derived it from the Greek word αὐτὀς (autos), which means self. Hans Asperger adopted Bleuler's terminology "autistic" in its modern sense to describe child psychology in 1938. Afterwards, he reported about four boys who did not mix with their peer group and did not understand the meaning of the terms 'respect' and 'polite', and regard for the authority of an adult. The boys also showed specific unnatural stereotypic movement and habits. Asperger describe this pattern of behaviors as "autistic psychopathy", which is now called as Asperger's Syndrome [ 11 ]. The person who first used autism in its modern sense is Leo Kanner. In 1943, he reported about 8 boys and 3 girls who had "an innate inability to form the usual, biologically provided affective contact with people", and introduced the label early infantile autism [ 12 ]. Hans Asperger and Leo Kanner have been considered as those who designed the basis of the modern study of autism.

Most recently, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) adopted the term ASD with a dyadic definition of core symptoms: early-onset of difficulties in social interaction and communication, and repetitive, restricted behaviors, interests, or activities [ 13 ]. Atypical language development, which had been included into the triad of ASD, is now regarded as a co-occurring condition.

As stated earlier, the development of the brain in individuals with ASD is complex and is mediated by many genetic and environmental factors, and their interactions. Genetic studies of ASD have identified mutations that interfere with typical neurodevelopment in utero through childhood. These complexes of genes have been involved in synaptogenesis and axon motility. Also, the resultant microstructural, macrostructural, and functional abnormalities that emerge during brain development create a pattern of dysfunctional neural networks involved in socioemotional processing. Microstructurally, an altered ratio of short- to long-diameter axons and disorganization of cortical layers are observed. Macrostructurally, MRI studies assessing brain volume in individuals with ASD have consistently shown cortical and subcortical gray matter overgrowth in early brain development. Functionally, resting-state fMRI studies show a narrative of widespread global underconnectivity in socioemotional networks, and task-based fMRI studies show decreased activation of networks involved in socioemotional processing. Moreover, electrophysiological studies demonstrate alterations in both resting-state and stimulus-induced oscillatory activities in patients with ASD [ 14 ].

The well-conserved sets of genes and genetic pathways were implicated in ASD, many of which contribute toward the formation, stabilization, and maintenance of functional synapses. Therefore, these genetic aspects coupled with an in-depth phenotypic analysis of the cellular and behavioral characteristics are essential to unraveling the pathogenesis of ASD. The number of genes already discovered in ASD holds the promise to translate the knowledge into designing new therapeutic interventions. Also, the fundamental research using animal models is providing key insights into the various facets of human ASD. However, a better understanding of the genetic, molecular, and circuit level aberrations in ASD is still needed [ 15 ].

Neuroimaging studies have provided many important insights into the pathological changes that occur in the brain of patients with ASD in vivo. Importantly, ASD is accompanied by an atypical path of brain maturation, which gives rise to differences in neuroanatomy, functioning, and connectivity. Although considerable progress has been made in the development of animal models and cellular assays, neuroimaging approaches allow us to directly examine the brain in vivo, and to probably facilitate the development of a more personalized approach to the treatment of ASD [ 16 ].

ASD is not a single disorder. It is now broadly considered to be a multi-factorial disorder resulting from genetic and non-genetic risk factors and their interaction.

Genetic causes including gene defects and chromosomal anomalies have been found in 10%~20% of individuals with ASD [ 17 , 18 ]. Siblings born in families with an ASD subject have a 50 times greater risk of ASD, with a recurrence rate of 5%~8% [ 19 ]. The concordance rate reaches up to 82%~92% in monozygotic twins, compared with 1%~10% in dizygotic twins. Genetic studies suggested that single gene mutations alter developmental pathways of neuronal and axonal structures involved in synaptogenesis [ 20 , 21 , 22 ]. In the cases of related with fragile X syndrome and tuberous sclerosis, hyperexcitability of neocortical circuits caused by alterations in the neocortical excitatory/inhibitory balance and abnormal neural synchronization is thought to be the most probable mechanisms [ 23 , 24 ]. Genome-wide linkage studies suggested linkages on chromosomes 2q, 7q, 15q, and 16p as the location of susceptibility genes, although it has not been fully elucidated [ 25 , 26 ]. These chromosomal abnormalities have been implicated in the disruption of neural connections, brain growth, and synaptic/dendritic morphology [ 27 , 28 , 29 ]. Metabolic errors including phenylketonuria, creatine deficiency syndromes, adenylosuccinate lyase deficiency, and metabolic purine disorders are also account for less than 5% of individuals with ASD [ 30 ]. Recently, the correlation between cerebellar developmental patterning gene ENGRAILED 2 and autism was reported [ 31 ]. It is the first genetic allele that contributes to ASD susceptibility in as many as 40% of ASD cases. Other genes such as UBE3A locus, GABA system genes, and serotonin transporter genes have also been considered as the genetic factors for ASD [ 18 ].

Diverse environmental causative elements including pre-natal, peri-natal, and post-natal factors also contribute to ASD [ 32 ]. Prenatal factors related with ASD include exposure to teratogens such as thalidomide, certain viral infections (congenital rubella syndrome), and maternal anticonvulsants such as valproic acid [ 33 , 34 ]. Low birth weight, abnormally short gestation length, and birth asphyxia are the peri-natal factors [ 34 ]. Reported post-natal factors associated with ASD include autoimmune disease, viral infection, hypoxia, mercury toxicity, and others [ 33 , 35 , 36 ]. Table 1 summarizes the known and putative ASD-related genes and environmental factors contributing to the ASD.

In recent years, some researchers suggest that ASD is the result of complex interactions between genetic and environmental risk factors [ 37 ]. Understanding the interaction between genetic and environmental factors in the pathogenesis of ASD will lead to optimal treatment strategy.

Clinical features and Diagnosis

ASD is typically noticed in the first 3 years of life, with deficits in social behaviors and nonverbal interactions such as reduced eye contact, facial expression, and body gestures [ 1 ]. Children also manifest with non-specific symptoms such as unusual sensory perception skills and experiences, motor clumsiness, and insomnia. Associated phenomena include mental retardation, emotional indifference, hyperactivity, aggression, self-injury, and repetitive behaviors such as body rocking or hand flapping. Repetitive, stereotyped behaviors are often accompanied by cognitive impairment, seizures or epilepsy, gastrointestinal complaints, disturbedd sleep, and other problems. Differential diagnosis includes childhood schizophrenia, learning disability, and deafness [ 38 , 39 ].

ASD is diagnosed clinically based on the presence of core symptoms. However, caution is required when diagnosing ASD because of non-specific manifestations in different age groups and individual abilities in intelligence and verbal domains. The earliest nonspecific signs recognized in infancy or toddlers include irritability, passivity, and difficulties with sleeping and eating, followed by delays in language and social engagement. In the first year of age, infants later diagnosed with ASD cannot be easily distinguished from control infants. However, some authors report that about 50% of infants show behavioral abnormalities including extremes of temperament, poor eye contact, and lack of response to parental voices or interaction. At 12 months of age, individuals with ASD show atypical behaviors, across the domains of visual attention, imitation, social responses, motor control, and reactivity [ 40 ]. There is also report about atypical language trajectories, with mild delays at 12 months progressing to more severe delays by 24 months [ 40 ]. By 3 years of age, the typical core symptoms such as lack of social communication and restricted/repetitive behaviors and interests are manifested. ASD can be easily differentiated from other psychosocial disorders in late preschool and early school years.

Amygdala and ASD

The frontal and temporal lobes are the markedly affected brain areas in the individuals with ASD. In particular, the role of amygdala in cognition and ASD has been proved in numerous neuropathological and neuroimaging studies. The amygdala located the medial temporal lobe anterior to the hippocampal formation has been thought to have a strong association with social and aggressive behaviors in patients with ASD [ 41 , 42 ]. The amygdala is a major component of the limbic system and affective loop of the cortico-striato-thalamo-cortical circuit [ 43 ].

The amygdala has 2 specific functions including eye gaze and face processing [ 44 ]. The lesion of the amygdala results in fear-processing, modulation of memory with emotional content, and eye gaze when looking at human face [ 45 , 46 , 47 ]. The findings in individuals with amygdala lesion are similar to the phenomena in ASD. The amygdala receives highly processed somatosensory, visual, auditory, and all types of visceral inputs. It sends efferents through two major pathways, the stria terminalis and the ventral amygdalofugal pathway.

The amygdala comprises a collection of 13 nuclei. Based on histochemical analyses, these 13 nuclei are divided into three primary subgroups: the basolateral (BL), centromedial (CM), and superficial groups [ 42 ]. The BL group attributes amygdala to have a role as a node connecting sensory stimuli to higher social cognition level. It links the CM and superficial groups, and it has reciprocal connection with the orbitofrontal cortex, anterior cingulate cortex (ACC), and the medial prefrontal cortex (mPFC) [ 48 ]. The BL group contains neurons responsive to faces and actions of others, which is not found in the other two groups of amygdala [ 49 , 50 ]. The CM group consists of the central, medial, cortical nuclei, and the periamygdaloid complex. It innervates many of the visceral and autonomic effector regions of the brain stem, and provides a major output to the hypothalamus, thalamus, ventral tegmental area, and reticular formation [ 51 ]. The superficial group includes the nucleus of the lateral olfactory tract [ 42 ].

Neurochemistrial studies revealed high density of benzodiazepine/GABAa receptors and a substantial set of opiate receptors in the amygdala. It also includes serotonergic, dopaminergic, cholinergic, and noradrenergic cell bodies and pathways [ 52 ]. Since some patients with temporal epilepsy and aggressive behavior experienced improvement in aggressiveness after bilateral stereotactic ablation of basal and corticomedial amygdaloid nuclei, the role of amygdala in emotional processing, especially rage processing has been investigated [ 53 , 54 , 55 , 56 ]. Some evidences for the amygdala deficit in patients with ASD have been suggested. Post-mortem studies found the pathology in the amygdala of individuals with ASD compared to age- and sex-matched controls [ 57 , 58 , 59 ]. Small neuronal size and increased cell density in the cortical, medial, and central nuclei of the amygdala were detected in ASD patients.

Several studies proposed the use of an animal model to confirm the evidence for the association between amygdala and ASD [ 60 , 61 ]. Despite the limitation which stems from the need to prove higher order cognitive disorder, the studies suggested that disease-associated alterations in the temporal lobes during experimental manipulations of the amygdala in animals have produced some symptoms of ASD [ 62 ]. Especially, the Kluver-Bucy syndrome, which is caused by bilateral damage to the anterior temporal lobes in monkeys, has characteristic manifestations similar to ASD [ 63 , 64 ]. Monkeys with the Kluver-Bucy syndrome shows absence of social chattering, lack of facial expression, absence of emotional reactions, repetitive abnormal movement patterns, and increased aggression. Sajdyk et al. performed experiments on rats and discovered that physiological activation of the BL nucleus of the amygdala by blocking tonic GABAergic inhibition or enhancing glutamate or the stress-associated peptide corticotropin-releasing factor (CRF)-mediated excitation caused reduction in social behaviors [ 65 ]. On the contrary, lesioning of the amygdala or blocking amygdala excitability with glutamate antagonist increased dyadic social interactions [ 60 ]. Besides animals, humans who underwent lesioning of the amygdala showed impairments in social judgment. This phenomenon is called acquired ASD [ 66 , 67 , 68 ]. The pattern of social deficits was similar in idiopathic and acquired ASD [ 69 ]. Felix-Ortiz and Tye sought to understand the role of projections from the BL amygdala to the ventral hippocampus in relation to behavior. Their study using mice showed that the BLS-ventral hippocampus pathway involved in anxiety plays a role in the mediation of social behavior as well [ 70 ].

The individuals with temporal lobe tumors involving the amygdala and hippocampus provide another evidence of the correlation between the amygdala and ASD. Some authors reported that patients experienced autistic symptoms after temporal lobe was damaged by a tumor [ 71 , 72 ]. Also, individuals with tuberous sclerosis experienced similar symptoms including facial expression due to a temporal lobe hamartoma [ 73 ].

Although other researchers failed to find structural abnormalities in the mesial temporal lobe of autistic subjects by performing magnetic resonance imaging (MRI) studies [ 74 , 75 , 76 ], recent development in neuroimaging has facilitated the investigation of amygdala pathology in ASD. Studies using structural MRI estimated volumes of the amygdala and related structures in individuals with ASD and age-, gender, and verbal IQ-matched healthy controls [ 77 ]. Increase in bilateral amygdala volume and reduction in hippocampal and parahippocampal gyrus volumes were noted in individuals with ASD. Also, the lateral ventricles and intracranial volumes were significantly increased in the autistic subjects; however, overall temporal lobe volumes were similar between the ASD and control groups.

There was a significant difference in the whole brain voxel-based scans of individuals with ASD and control groups [ 78 ]. Individuals with ASD showed decreased gray matter volume in the right paracingulate sulcus, the left occipito-temporal cortex, and the left inferior frontal sulcus. On the contrary, the gray matter volume in the bilateral cerebellum was increased. Otherwise, they showed increased volume in the left amygdala/periamygdaloid cortex, the right inferior temporal gyrus, and the middle temporal gyrus.

Recently, the development of functional neuroimaging also provided some evidence for the correlation between amygdala deficit and ASD. A study using Technetium-99m (Tc-99m) single-photon emission computed tomography (SPECT) found that regional cerebral blood flow (rCBF) was decreased in the bilateral insula, superior temporal gyri, and left prefrontal cortices in individuals with ASD compared to age- and gender-matched controls with mental retardation [ 79 ]. Also, the authors found that rCBF in both the right hippocampus and amygdala was correlated with a behavioral rating subscale.

On proton magnetic resonance spectroscopy (MRS) in the right hippocampal-amygdala region and the left cerebellar hemisphere, autistic subjects showed decreased level of N-acetyl aspartate (NAA) in both areas [ 80 ]. There was no difference in the level of the other metabolites, such as creatine and choline. This study implies that a decreased level of NAA might be associated with neuronal hypofunction or immature neurons.

These findings support the claim that amygdala might be a key structure in the development of ASD and a target for the management of the disease.

Prefrontal cortex and ASD

Frontal lobe has been considered as playing an important role in higher-level control and a key structure associated with autism. Individuals with frontal lobe deficit demonstrate higher-order cognitive, language, social, and emotion dysfunction, which is deficient in autism [ 81 ]. Recently, neuroimaging and neuropsychological studies have attempted to delineate distinct regions of prefrontal cortex supporting different aspects of executive function. Some authors have reported that the excessive rates of brain growth in infants with ASD, which is mainly contributed by the increase of frontal cortex volume [ 82 , 83 ]. Especially, the PFC including Brodmann areas 8, 9, 10, 11, 44, 45, 46, and 47 has been noted for the structure related with ASD [ 84 ]. The PFC is cytoarchitectonically defined as the presence of a cortical granular layer IV [ 85 ], and anatomically refers to the regions of the cerebral cortex that are anterior to premotor cortex and the supplementary motor area [ 86 ]. The PFC has extensive connections with other cortical, subcortical and brain stem sites [ 87 ]. It receives inputs from the brainstem arousal systems, and its function is particularly dependent on its neurochemical environment [ 88 ].

The PFC is broadly divided into the medial PFC (mPFC) and the lateral PFC (lPFC). The mPFC is further divided into four distinct regions: medial precentral cortex, anterior cingulate cortex, prelimbic and infralimbic prefrontal cortex [ 89 ]. While the lPFC is thought to support cognitive control process [ 90 ], the mPFC has reciprocal connections with brain regions involved in emotional processing (amygdala), memory (hippocampus) and higher-order sensory regions (within temporal cortex) [ 91 ]. This involvement of mPFC in social cognition and interaction implies that mPFC might be a key region in understanding self and others [ 92 ].

The mPFC involves in fear learning and extinction by reciprocal synaptic connections with the basolateral amygdala [ 93 , 94 ]. It is believed that the mPFC regulates and controls amygdala output and the accompanying behavioral phenomena [ 95 , 96 ]. Previous authors investigated how memory processing is regulated by interactions between BLA and mPFC by means of functional disconnection [ 97 , 98 ]. Disturbed communication within amygdala-mPFC circuitry caused deficits in memory processing. These informations provide support for a role of the mPFC in the development of ASD.

Nucleus Accumbens and ASD

Besides amygdala, nucleus accumbens (NAc) is also considered as the key structure which is related with the social reward response in ASD. NAc borders ventrally on the anterior limb of the internal capsule, and the lateral subventricular fundus of the NAc is permeated in rostral sections by internal capsule fiber bundles. The rationale for NAc to be considered as the potential target of DBS for ASD is its predominant role in modulating the processing of reward and pleasure [ 99 ]. Anticipation of rewarding stimuli recruits the NAc as well as other limbic structures, and the experience of pleasure activates the NAc as well as the caudate, putamen, amygdala, and VMPFC [ 100 , 101 , 102 ]. It is well known that dysfunction of NAc regarding rewarding stimuli in subjects with depression. Bewernick et al. demonstrated antidepressant effects of NAc-DBS in 5 of the 10 patients suffering from severe treatment-resistant depression [ 103 ].

Two groups reported about the neural basis of social reward processing in ASD. Schmitz et al. examined responses to a task that involved monetary reward. They investigated the neural substrates of reward feedback in the context of a sustained attention task, and found increased activation in the left anterior cingulate gyrus and left mid-frontal gyrus on rewarded trials in ASD [ 104 ]. Scott-Van Zeeland et al. investigated the neural correlates of rewarded implicit learning in children with ASD using both social and monetary rewards. They found diminished ventral striatal response during social, but not monetary, rewarded learning [ 105 ]. According to them, activity within the ventral striatum predicted social reciprocity within the control group, but not within the ASD group.

Anticipation of pleasurable stimuli recruits the NAc, whereas the experience of pleasure activates VMPFC [ 106 ]. NAc is activated by incentive motivation to reach salient goals [ 106 ]. Increased activation in the left anterior cingulate gyrus and left mid-frontal gyrus was noted during both the anticipatory and consummatory phase of the reward response [ 104 , 107 , 108 ]. However, the activity within the ventral striatum was decreased in autistic subjects, which caused impairment in social reciprocity [ 105 ].

These findings indicate that reward network function in ASD is contingent on both the temporal phase of the response and the type of reward processed, suggesting that it is critical to assess the temporal chronometry of responses in a study of reward processing in ASD. NAc might be one of the candidates as a target of DBS which is introduced as below.

Various educational and behavioral treatments have been the mainstay of the management of ASD. Most experts agree that the treatment for ASD should be individualized. Treatment of disabling symptoms such as aggression, agitation, hyperactivity, inattention, irritability, repetitive and self-injurious behavior may allow educational and behavioral interventions to proceed more effectively [ 109 ].

Increasing interest is being shown in the role of various pharmacological treatments. Medical management includes typical antipsychotics, atypical antipsychotics, antidepressants, selective serotonin reuptake inhibitors, α2-adrenergic agonists, β-adrenergic antagonist, mood stabilizers, and anticonvulsants [ 110 , 111 ]. So far, there has been no agent which has been proved effective in social communication [ 112 ]. A major factor in the choice of pharmacologic treatment is awareness of specific individual physical, behavioral or psychiatric conditions comorbid with ASD, such as obsessive-compulsive disorder, schizophrenia, mood disorder, and intellectual disability [ 113 ]. Antidepressants were the most commonly used agents followed by stimulants and antipsychotics. The high prevalence of comorbidities is reflected in the rates of psychotropic medication use in people with ASD. Antipsychotics were effective in treating the repetitive behaviors in children with ASD; however, there was not sufficient evidence on the efficacy and safety in adolescents and adults [ 114 ]. There are also alternative options including opiate antagonist, immunotherapy, hormonal agents, megavitamins and other dietary supplements [ 109 , 113 ].

However, the autistic symptoms remain refractory to medication therapy in some patients [ 115 ]. These individuals have severely progressed disease and multiple comorbidities causing decreased quality of life [ 44 , 110 ]. Interventional therapy such as deep brain stimulation (DBS) may be an alternative therapeutic option for these patients.

Two kinds of interventions have been used for treating ASD; focused intervention practices and comprehensive treatments [ 116 ]. The focused intervention practices include prompting, reinforcement, discrete trial teaching, social stories, or peer-mediated interventions. These are designed to produce specific behavioral or developmental outcomes for individual children with ASD, and used for a limited time period with the intent of demonstrating a change in the targeted behaviors. The comprehensive treatment models are a set of practices performed over an extended period of time and are intense in their application, and usually have multiple components [ 116 ].

Since it was approved by the FDA in 1997, DBS has been used to send electrical impulses to specific parts of the brain [ 117 , 118 ]. In recent years, the spectrum for which therapeutic benefit is provided by DBS has widely been expanded from movement disorders such as Parkinson's disease, essential tremor, and dystonia to psychiatric disorders. Some authors have demonstrated the efficacy of DBS for psychiatric disorders including refractory obsessive-compulsive disorder, depression, Tourette syndrome, and others for the past few years [ 119 , 120 , 121 ].

To the best of our knowledge, there have been 2 published articles of 3 patients who underwent DBS for ASD accompanied by life-threatening self-injurious behaviors not alleviated by antipsychotic medication [ 122 , 123 ]. The targets were anterior limb of the internal capsule and globus pallidus internus, only globus pallidus, and BL nucleus of the amygdala, respectively. All patients obtained some benefit from DBS. Although the first patient showed gradual re-deterioration after temporary improvement, the patient who underwent DBS of the BL nucleus experienced substantial improvement in self-injurious behavior and social communication. These experiences suggested the possibility of DBS for the treatment of ASD. For patients who did not obtain benefit from other treatments, DBS may be a viable therapeutic option. Understanding the structures which contribute to the occurrence of ASD might open a new horizon for management of ASD, particularly DBS. Accompanying development of neuroimaging technique enables more accurate targeting and heightens the efficacy of DBS. However, the optimal DBS target and stimulation parameters are still unknown, and prospective controlled trials of DBS for various possible targets are required to determine optimal target and stimulation parameters for the safety and efficacy of DBS.

ASD should be considered as a complex disorder. It has many etiologies involving genetic and environmental factors, and further evidence for the role of amygdala and NA in the pathophysiology of ASD has been obtained from numerous studies. However, the key architecture of ASD development which could be a target for treatment is still an uncharted territory. Further work is needed to broaden the horizons on the understanding of ASD.

Acknowledgements

This study was partly supported by the Korea Institute of Planning & Evaluation for Technology in Food, Agriculture, Forestry, and Fisheries, Republic of Korea (311011-05-3-SB020), by the Korea Healthcare Technology R&D Project (HI11C21100200) funded by Ministry of Health & Welfare, Republic of Korea, by the Technology Innovation Program (10050154, Business Model Development for Personalized Medicine Based on Integrated Genome and Clinical Information) funded by the Ministry of Trade, Industry & Energy (MI, Korea), and by the Bio & Medical Technology Development Program of the NRF funded by the Korean government, MSIP (2015M3C7A1028926).

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👍 good autism essay topics, 💡 psychology research autism topics to write about, ⭐ simple & easy autism essay titles, ❓ research questions about autism.

• Autism Spectrum Disorder (ASD) Autism is a serious disorder that has the potential to disrupt the success of people living with it. This is to mean that the theory of causation regarding autism is not complete as yet.
• Exploring Autism in the Drama Film Rain Man Charlie Babbitt, the brother to Raymond, is the actor who portrays Raymond’s autism on the way to Los Angeles to secure his fair share in the Babbitt’s $3 million fortunes in form of inheritance.
• Autism. Child and Family Assessment The other common disorder associated with autism is that of mutism whereby it also lies under the category of speech disorder and in many cases it is difficult to be diagnosed and at the same […]
• Autism: Characteristics, Prevalence and Interventions The symptoms of autism are noticeable in the early years of childhood. Occupational therapy is one of the non-educational interventions used to assist kids with autism.
• Bright Not Broken: Gifted Kids, ADHD, and Autism It is possible to state that the book provides rather a high-quality review of the issues about the identification, education, and upbringing of the 2e children.
• How Does Having a Child With Autism Affects Parents’ Lifestyle? The creation of a system of psychological, pedagogical and social support can reduce the risk of a complete family life dedication to a child with autism.
• “Let Me Hear Your Voice: A Family’s Triumph Over Autism” by Catherine Maurice The book was published in 1994, and it was a success as parents of autistic children were waiting for someone to prove that autism was not an incurable disorder.
• Inclusion Curriculum for Children With Autism In the given paper, the issue of children autism, the developmental issues that autism triggers and the educational prospects for children with autism are going to be considered.
• Applied Behavior Analysis and Autism The primary subject of this study is applied behavior analysis while the secondary subject is applied behavior analysis and its effects on autism in children.
• Critical Analysis of Published Articles: Autism It was therefore the goal of the research to find out if the negative attitude of people towards autistic children can be altered to the benefit of the parents.
• One-To-One Programs: Supporting Autistic Children The purpose of conducting this essay will be to examine the educational intervention of one-to-one support programs during normal school times within a mainstream classroom and also to discuss the challenges faced by teachers and […]
• Impact of Autism Disorder on Adolescents This essay discusses the impact of autism disorder on adolescents in the community and a nursing intervention that can be used to assist adolescents in becoming prominent society members.
• Progression of Reading Ability in a Child Diagnosed With Autism The battery of assessments and interviews with parents on the participant’s socialization and early reading ability indicates the study applied the Psychometric and Social Contextual approaches.
• Analysis of Behavior of Preschool Age Child With Autism The child’s behavior in the video differs from that of a mentally healthy child, and these differences lie in the child’s other emotional state and degree of interest in talking to people.
• Autism and Disability Advocacy People with autism can contribute to the diversity of disability culture by expanding understanding of what disability is and how it can be accepted.
• Autism Spectrum Disorder Diagnosis According to DSM-5, to fit the diagnostic criteria for ASD, a child must have evident deficits in three major areas of social communication as well as 2 out of the 4 restricted or repetitive behaviors.
• Thinking in Pictures: Autism and Sensory Problems The chapter “The Squeeze Machine: Sensory Problems in Autism” in Grandin’s Thinking in Pictures presents a series of life perspectives of various individuals, including her own, regarding the sensory problems they experienced. They postulated that […]
• Therapeutic Programs for Children With Autism in K-12 Institutions In the paper, the gaps in the research of effective treatments for children with ASD are explored, after which the efficacy of a multi-system aquatic therapy and standardized equine-assisted therapy program is argued.
• Societal Issue Research Project: Autism Spectrum Disorder The first factor is the significant risk that the genetics of siblings who had ASD diagnosis will increase the chance of the disorder.
• Child-Centered Play Therapy and Autism The purpose of the discussed research was to investigate the effects of CCPT on the sample of children with autism, establishing and describing the connection between CCPT and social and emotional growth.
• Children With Autism Spectrum Disorder: The Training Program for Caregivers The latter means that many caregivers take care of children with ASD, hence the importance of equipping them with the necessary skills for effective and smooth parenting and coping with various difficulties.
• Autism Spectrum Disorder’s Impact on Child’s Learning In regards to the public-school setting, standardized testing demands youngsters to grasp and react to spoken as well as written communication at an anticipated pace and level.
• Laboratory Diagnosis of Autism Spectrum Disorders The purpose of my study is to discover which of these methods is more accurate, with the reason being the importance of early diagnosis of ASD, which leads to better treatment outcomes.
• Autism and Related Cognitive Concepts It has been suggested that children with autism show a general deficit of cognitive skills in multilevel planning and in the regulation of behavior.
• Bullying and Autism Spectrum Disorder In fact, bullying as a social phenomenon can be characterized as a social and interaction issue; therefore, it is possible to analyze the connection between autism and acts of bullying and inappropriate behavior.
• Face Emotion Recognition in Autism Phenotype One critical aspect of social communication is the capability to apprehend the emotions and intentions of another person. In conclusion, Autism Spectrum Disorder makes the interpretation of facial expressions difficult.
• Misrepresentation of Autism in the ‘Music’ Film While the film was not centered on the topic of autism as its message, the stereotype-heavy portrayal and a lack of research make it a harmful piece of media.
• Autism Spectrum Disorder Prevalence and Impact in Society It has therefore been impossible to determine the level of increase in autism cases that is as a result of improved diagnostic measures and that which can be attributed to the real increase in autism […]
• Autism Spectrum Disorder: Diagnosis, Impact, Treatment The main diagnostic element for ASD is the evidence of difficulties, either in the present or past, which are different across the age groups.
• Autism and Vaccination Refusal Management Among Somalian Parents Somalian parents in their community in Minnesota refuse from their children being vaccinated, as they believe that vaccination causes autism.
• Everyone Has the Power to Effect Positive Change Within the Autism Community This paper presents what is autism, how every one reacts to the problem, what is the difference between the rich and the poor in their response towards the problem.”Autism is one of five developmental disorders […]
• Reducing Off-Task Behaviors Using a Token Economy System in Children With Autism Token economy is a strategy of positive reinforcement that can be provided to children in the form of tokens for completing the assigned tasks.
• Autism Spectrum Disorder: Key Points The requirement to meet these needs is supported by the fact that the rate of students with ASD is high: according to the Australian Institute of Health and Welfare, more than 83 per cent of […]
• “Theoretical Aspects of Autism” by Helen Ratajczak On the whole, it is possible to say that the standards set by Austin Hill cannot be always met, in part because the physiological aspects of this disease have not been fully investigated.
• Dr. Temple Grandin’s Argument on Visual Thinking and Autism A more in-depth analysis of visual activities can reveal the all imagery can be mentally processed and modified by children so that images are rotated and analyzed to make the brain map expand.
• Intellectual Disability: Autism In their adulthood, and because of the communication issues that most individuals with autism tend to have, they will naturally have difficulty in finding and keeping jobs.
• Hyperbaric Oxygen Therapy for Children With Autism On the positive side, it fastens the production of different types of reactive oxygen used in the body. It is arguable that the size of the samples used in the study was small.
• Analysis of Children Autism in “The Black Balloon” It is imperative to note that Charlie’s emotions are not regulated and as such, manifest in immature behaviors such as flapping of his hands.
• Occupational Therapy for Children With Autism The main reason for the appearance of autism is the disturbance of the development of the patients brain which results in the appearance of various symptoms.
• The Mitochondria and Autism – Results and Main Function The results are important in health because children with autism were more probable to have dysfunctions and abnormalities of the mitochondria such as over replication and deletion of mitochondrial DNA compared to those without the […]
• Autism Etiology, Symptoms, Beliefs, and Management To date, debate on the cause or etiology of autism still remains divided, with extant literature demonstrating that “although many hypotheses have been proposed, a singular or specific combination of causes has yet to be […]
• Quantitative Assessment of Neuromotor Function in Adolescents With High Functioning Autism: Critique The study authors did not give the benefits and/or risks associated with the study participation. The authors indicated that the ZNA was appropriate for collecting the data because it could measure the 11 parameters of […]
• Critical Appraisal on the Impact of Autism Spectrum Disorders on the Family: A Qualitative Study of Mothers’ Perspectives The study researchers established the significance of the study by outlining the social and financial implications of taking care of children with ASD.
• Autism: External Forces, Causes and Treatment The increasing prevalence of Autism in the United States and across the world is attracting great attention from the healthcare sector to design critical programs tailored to stem the disorder in terms of prevention, treatment, […]
• The Importance of Services for Children With Autism The plea of the majority of Americans for the reverse of healthcare budget allocation is well because it is wrong to interfere with services offered to children with autism. With childcare initiative in place, the […]
• Autism: General Information and Treatment She argues that the treatment of autism is through scientific proven medication that aids in controlling aggressive behaviors and that Trisperidone is the commonly used antipsychotic.
• The Issue of Autism: Task-Group Project The role of B.N.in the meeting can be seen as a summarizer, providing a summary of the minutes of the previous meeting.
• Concepts of Autism and Williams Syndrome The disorder manifests itself in the early years of a child’s life, with long-lasting effects that are not curable but controllable and easy to deal with on condition that, the concerned parties take the necessary […]
• Autism Programs to Enhance Students’ Outcomes In addition to social and behavioral challenges, ASD typically hinders a learner’s ability to gain and process the necessary academic information.
• Autism Program’s Impact Across Contexts In other words, a detailed overview of the issues that administrators face when designing the program and which the teachers have to deal with when addressing the needs of children with autism must be carried […]
• Autism: Teaching Plan for Taking All the Features Into Account For the first child, caregiver training was done at child’s bedroom, and for the second child it was done at living room, and for the third child with severe mental retardation it was carried out […]
• Education Considerations for Students With Autism Two articles under consideration consider the opposite views regarding the education of students with autism; on the basis of the information obtained from these articles, it can be stated that none of the perspectives is […]
• Developmental Psychology: Autism and Vaccination Vaccination of infants is widely used today as the pattern of endemic diseases can be explained in terms of interplay of social, physical and biological factors in an area that is conducive to a continuous […]
• Social Work Methods to Treat the Child Who Is Suffering From Autism This is a clear indicator that alcohol intake by the family is costing the members and it is an issue that needs to be looked into.
• Autism and Immunization: Vaccines and the Changing Epidemiology The interest and attention invoked by this paper were largely due to the fact that it appeared to provide a biological means through which MMR vaccine resulted in autism.
• The Autism-Vaccine Debate, Arguments, and Research Autism is defined by the Autism Society of America as ” a complex developmental disability that typically appears during the first 3 years of life and is the result of a neurological disorder that affects […]
• Autism and False Belief in Psychology The theories are found to be covering the deficits of an individuals’ mind and factors relating to autism, research further indicates that a child’s behavior may be influenced by the executive functions this, therefore, brings […]
• Autism Spectrum Disorder and Interventions However, the negative side of it is that such an intervention is limited to those patients who are verbal and have limited vocabulary.
• Autism: Symptoms, Forms, Diagnostic Instruments Autism is basically a developmental disorder of the human brain that its first symptoms are initially manifested in infancy and it follows a steady cause without relapse.
• Autism Spectrum Disorder Features in Children One of the causes for the appearance of these issues is an inborn disability that might presuppose the need for specific methods to educate a child and guarantee a chance for integration with society.
• Autism Occurrence by Measles Vaccine Status The organization of information in the text follows a logical format by introducing the background for the vaccine, incorporating the issue of ASD connection, and leading up to the primary research question.
• Parental Report of Vaccine Receipt in Children With Autism Spectrum Disorder In the introduction, which is the first section, the study’s research problems and their significance to nursing are stated. The discussion section covers how the authors relate the findings to the research objective and the […]
• Teenagers With Autism Disorder Autism is seen as a spectrum disorder since its severity and symptoms vary greatly among affected individuals – from mild and occasional to persistent and interfering with all aspects of life.
• Impact of Autism Spectrum Disorders on Life However, between the ages of two and three, his lack of verbal activity and inability to “echo” simple sounds and syllables were found to be very concerning by the family.
• Autism Should Not Be Viewed as a Disability A good example is that the treatment of autism as a mental disorder makes it possible for pharmaceutical companies and clinics to invent new health systems or procedures that will meet the needs of the […]
• Autist Student’s Behavior and Remedial Plan In the process of reading, I would pay attention to the student’s concentration and ability to integrate what she was reading. She also took long in doing this and did not want to stop the […]
• Autism Treatment, Its Methods and Results It was appropriate to focus on the use of the DSE intervention and examine if addressed most of the challenges facing many ASD patients.
• Autism Spectrum Disorder: Programs Effectiveness The purpose of this PE, therefore, is to evaluate and analyze the efficiency of the programs implemented by the Day Support Services.
• Students With Autism Spectrum Disorders The main goal of this paper is to present a review of relevant literature addressing the issue of helping college students with ASD prepare for workforce readiness and job placement.
• Association Between Vaccination and Autism The study examined whether there is a link between the toxic effects of exposure to thimerosal-containing vaccines and the risk of developing ASD.
• Olfaction and Autism Spectrum Disorder Relationship These findings reveal that the sniff test can reveal both the presence and severity of ASD in young children. The link between ASD and olfaction can be used in diagnosing young children with autism.
• Abu Dhabi Autism Center The Abu Dhabi Autism Center has to operate within the laws and regulations of the Zayed Higher Organization for Humanitarian Care and Special Needs.
• Applied Behavior Analysis Treatment for Autism It is the most commonly applied autism treatment remedy in the United States and several other countries in the world and the major method that schools and therapists embrace and use.
• Inclusive Education: Child With Autism and Spina Bifida It is worth mentioning that Ted’s mother is willing to cooperate with teachers, and her participation can be of great assistance to the teacher.
• Children With Autism’ Communication in Saudi Arabia Parents of children with autism in Saudi Arabia have complained that the government has neglected the needs of autistic children by failing to finance their education and research to detect the effectiveness of the digital […]
• Autism Spectrum Disorders: Testing and Measurement It will begin with the rationale that explain why the issues are critical, followed by the reasons for unavailability of the solutions to the issues and the consequences of the issues.
• Autism Spectrum Disorders and Educational Interventions From this point, this paper aims to discuss the definition of Autism Spectrum Disorders, examine the etiology and incidence of the disorder, focus on the prevalence of autism, and analyze the effectiveness of the DTT […]
• Vaccines and Autism: Separating Facts From Fiction The advocacy groups say that thimerosal, a preservative used in vaccines, is toxic to the central nervous system and responsible for an alarming rise in rates of autism among children in the United States and […]
• Lesson for Learners With Autism: Reflection Observation The essay identifies the instructional methods used by the teacher during the exercise. The teacher also guided the learners to solve the mathematical problems using different visual objects.
• Autism Spectrum Disorder Concept Besides, Temple often explores her own experiences and attempts to understand the feelings of others that are unavailable to her by visualizing herself as other creatures people and animals.
• Dubai Autism Center’ Quality Management TQM employs strategies and effective communication within the organization to incorporate the quality principles into the culture and activities of the organization to ensure that all the activities are geared towards satisfying the customers.
• Vaccination and Autism in Children The problem with this case is that while it may be true that the cause for the development of autism in children have yet to be fully determined, the fact remains that there have been […]
• Video Modeling for Individuals With Autism The video model will be developed according to the needs of autistic children, with the focus on the role of visual and auditory stimuli in the teaching process.
• The Effects of Vaccines on Autism From their study, the findings demonstrate that the presence of thimerosal is one of the causes of the disorder. It is imperative to state that they have used many studies that have indicated that there […]
• Vaccination as a Cause Autism This paper borrows on the arguments of Monica Prasad and Washington and Haydn when they argue that the belief about vaccinations as a primary cause of autism stems from emotional, psychological, and behavioral barriers, as […]
• Youth With Autism Disorder: Education and Employment This includes the communication patterns of the teenager, the extent of social relations and the unusual behavioral characteristics of the teenager in the environment.
• Autism Children Education Inclusion Policy in Private Schools: Compulsory Enrollment Policy 2011 The following are the main areas will be addressed by the policy: Prohibited Private schools will be prohibited from ignoring the needs of children suffering from autism; they will be compelled by the act to […]
• Autism: Pathogenesis and Intervention Similarly, a person with autism has to be trained on the process of communicating normally and forming a relationship with objects, events and people in their lives.
• The Real Causes of Autism However, the main problem is that this association or correlation does not imply that autism is triggered by a vaccine. This is the main argument that can be put forward.
• Autism. Sensory Integration. Tactile Desensitization The poor development that is recorded at the early stages in life is likely to affect the development of different skills by the individuals even in the adult stages The signs that are associated with […]
• Autism Effect on Children It is crucial to understand the behavior of children with autism in the school set up in order to understand how autism affects children and their social interactions. It is up to the teacher to […]
• Autism and Its Effects on Social Interaction The article “Social Impairment in Children with Autism Spectrum Disorder” identifies the major challenges facing many people with autism. The authors wanted to examine the social problems and difficulties encountered by individuals with Autism Spectrum […]
• Older Dads More Likely to Have Kids With Autism The author highlights autism as one of the main outcomes of late fatherhood following the release of the results of a study involving the counting of the mutations corresponding to a father’s age at the […]
• Evidenced-Based Practice: Autism Management in Children Autism largely is connected to communication abilities of a child, a situation that later results into the child experiencing disability problems in effectively encoding and decoding communicative messages.
• Miami Dance Project for Autistic Children For me, what the Miami dance project represents is in line with what is known as the concept of confidence building wherein through the development of certain talents children with autism will begin to have […]
• Autism Spectrum Disorders and Family Impact One of the greatest fears of a parent with such a child is the fact that such a child would be taken care of until the advanced stages of their lives.
• Program Models in Autism The DTT technique has been designed in such a way as to target the individual behavior of an autistic child using the available curriculum.
• Autism Spectrum Disorder in Relation to Education Attending to students having ASD in the regular classrooms requires specialized teachers and supplementary staff in order to aid in the realization of the needs of the students having ASD.
• Autism in Saudi Arabia This support may come in the form of modification of the curriculum to cater for the special needs of the autistic children.
• Analysis of Autism Disorder This disorder affects the brain of the child during growth so that it does not develop in the right way thus affecting the social and communication skills of the child. This is especially to the […]
• Psychological Disorders and Their Treatment: An Overview of the Recent Progress and the Current Challenges in Treating Autism in Children In the given paper, the issue of psychological disorders is being addressed in reference to the ideas expressed in Chapter 11 “Psychological Disorders” in Carole Wade and Carol Tavris’s Invitation to Psychology.
• Early Intervention for Young Adults With Autism This is due to unavailability of information on children development stages and the importance of early detection and intervention in the case of autism.
• Different Behaviors in Children With Autism The purpose is to find out whether the co morbidity changes with the environment, and assess the influence that the environment has on the behavior of an autistic child.
• Diagnosis and Treatment for Autism Disorder Children with autism are therefore able to reason and even interpret the feelings of other people but the challenge is to communicate the response to other people.
• Autism: Qualitative Research Design Golafshani continues to argue that the use of the term “dependability” in qualitative studies is a close match to the idea of “reliability” in quantitative research.
• Autism Spectrum Disorder However, the reality is that the number of children with autism and having high intelligence is insignificant. It is apparent that, in autism, a disorder is found in the structure of the brain.
• Vaccines and Autism: A Critical Analysis of Thimerosal in Relation to Measles, Mumps, and Rubella The safety and efficacy of vaccines has been the subject of many studies in the medical field. The disorder was observed in one participant from each of the cohorts in the experiment.
• How to Recognize and Teach Students With Autism If these groups of students have to be given directions that are more than three steps, the directions have to be written down due to their inability to remember sequences.
• Autism and Visual Thought Suprisingly the quality of visual thinking according to Bogdashina is dependent on other factors like time and the state the autistic person is in.
• Autism and Educational Process Owing to these adverse effects that can stem from autism and the shear prevalence of the condition in the country’s population, a lot of research effort has been dedicated to the early diagnosis and treatment […]
• Do Vaccines Cause Autism? Thimerosal is alleged to increase the exposure of mercury in the vaccine to a substantiated high amount. In fact, the amount of antigens between children with autism and without is the same irrespective of the […]
• Language Development Problems in Children: An Indicative Characteristic of Autism This is because it is a time when it is expected that a majority of the kids should be able to talk.
• The Disease of Autism Origin The disorder is one of the new diagnoses of the autism. Other effects of the disorder are constipation and growth failures that may be a problem to the lives of the individual.
• Autism Spectrum Disorder in Children and Its Impact on the Family Manning, Wainwright and Bennet argue that children with autism are faced with a big challenge because of the nature of the symptoms the disorder.
• Autism’s Teaching Tips for Children and Adults The present description is concerned with the role of teacher in the better management of Autism in children. Further, assessment of the interactive and developmental skills is on of the important component in the teacher […]
• How Christopher’s Autism Affect His Life In spite of the fact that the issue of autism is not clearly explained in the story, the condition of the narrator is referred to as high-functioning autism or Aspersers Syndrome on the cover of […]
• What Are Autism Spectrum Disorders?
• How Does Autism Affect the Person With It and Those Around Them?
• What Are the Barriers of Learning for a Learner With Autism/Aspergers in Performing Arts?
• Does Gluten Effect Children With Autism?
• What Are the Causes of Autism?
• How Does Autism Affect a Child’s Educational Performance?
• What Can Autism Look Like and Things You Can Do to Spot It?
• Can Children With Autism Develop a Theory of Mind?
• Which Interventions Reduce Anxiety in Autistic People?
• What Influence Has the Development of Autism Had on a Diagnosed Individual?
• How Does Autism Affect the Development of a Child?
• Are Huddles the Missing Piece of the Puzzle in Implementing Clinical Innovation for the Eating Disorder and Autism Comorbidity?
• How Does Autism Start?
• Can Mouse Imaging Studies Bring Order to Autism Connectivity Chaos?
• How Does ‘Fake News’ Affect Autism Policy?
• Are There Any Relationships Between Latent Toxoplasma Gondii Infection, Testosterone Elevation, and Risk of Autism Spectrum Disorder?
• How Do People With Autism Experience the World?
• Can Robotic Systems Promote Self-Disclosure in Adolescents With Autism Spectrum Disorder?
• How Did the Media Perpetuate the Autism-Vaccine Scare?
• Are There Cultural Differences in Parental Interest in Early Diagnosis and Genetic Risk Assessment for Autism Spectrum Disorder?
• How Can the Therapist Help Autism Children?
• Can Vaccinations Cause Autism?
• Does Autism Spectrum Disorder Affect People All Around the World?
• Is There a Correlation Between Epigenetics and Autism Spectrum Disorder?
• How Does Autism Affect Regular Brain Functions as Well as Socialization Skills?
• What Can Responses to Music in Autism Tell Us About the Nature of Musical Emotions?
• Why Has the Incidence Rate of Autism Increased?
• What Are the Most Effective Ways to Support/Provide Social Care For Autistic Adults?
• Which Interventions Are Effective in the Development of Communication/Language Skills in Autism?
• How Can Parents and Family Members Be Supported/Educated to Care For and Better Understand an Autistic Relative?
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Educating Children with Autism (2001)

Chapter: 16 conclusions and recommendations.

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16 Conclusions and Recommendations This chapter summarizes the committee’s conclusions about the state of the science in early intervention for children with autistic spectrum disorders and its recommendations for future intervention strategies, pro- grams, policy, and research. The chapter is organized around seven key areas pertaining to educational interventions for young children with autistic spectrum disorders: how the disorders are diagnosed and as- sessed and how prevalent they are; the effect on and role of families; appropriate goals for educational services; characteristics of effective in- terventions and educational programs; public policy approaches to en- suring access to appropriate education; the preparation of educational personnel; and needs for future research. DIAGNOSIS, ASSESSMENT, AND PREVALENCE Conclusions Autism is a developmental disorder of neurobiologic origin that is defined on the basis of behavioral and developmental features. Autism is best characterized as a spectrum of disorders that vary in severity of symptoms, age of onset, and association with other disorders (e.g., mental retardation, specific language delay, epilepsy). The manifestations of au- tism vary considerably across children and within an individual child over time. There is no single behavior that is always typical of autism and no behavior that would automatically exclude an individual child from a 211 

212 EDUCATING CHILDREN WITH AUTISM diagnosis of autism, even though there are strong and consistent com- monalities, especially relative to social deficits. The large constellation of behaviors that define autistic spectrum dis- orders—generally representing deficits in social interaction, verbal and nonverbal communication, and restricted patterns of interest or behav- iors—are clearly and reliably identifiable in very young children to expe- rienced clinicians and educators. However, distinctions among classical autism and atypical autism, pervasive developmental disorder-not other- wise specified (PDD-NOS), and Asperger’s disorder can be arbitrary and are often associated with the presence or severity of handicaps, such as mental retardation and severe language impairment. Identifying narrow categories within autism is necessary for some research purposes; however, the clinical or educational benefit to subclas- sifying autistic spectrum disorders purely by diagnosis is debated. In contrast, individual differences in language development, verbal and non- verbal communication, sensory or motor skills, adaptive behavior, and cognitive abilities have significant effects on behavioral presentation and outcome, and, consequently, have specific implications for educational goals and strategies. Thus, the most important considerations in pro- gramming have to do with the strengths and weaknesses of the indi- vidual child, the age at diagnosis, and early intervention. With adequate time and training, the diagnosis of autistic spectrum disorders can be made reliably in 2-year-olds by professionals experi- enced in the diagnostic assessment of young children with autistic spec- trum disorders. Many families report becoming concerned about their children’s behavior and expressing this concern, usually to health profes- sionals, even before this time. Research is under way to develop reliable methods of identification for even younger ages. Children with autistic spectrum disorders, like children with vision or hearing problems, re- quire early identification and diagnosis to equip them with the skills (e.g., imitation, communication) to benefit from educational services, with some evidence that earlier initiation of specific services for autistic spectrum disorders is associated with greater response to treatment. Thus, well meaning attempts not to label children with formal diagnoses can deprive children of specialized services. There are clear reasons for early identifi- cation of children, even as young as two years of age, within the autism spectrum. Epidemiological studies and service-based reports indicate that the prevalence of autistic spectrum disorders has increased in the last 10 years, in part due to better identification and broader categorization by educators, physicians, and other professionals. There is little doubt that more children are being identified as requiring specific educational inter- ventions for autistic spectrum disorders. This has implications for the provision of services at many levels. Analysis of data from the Office of 

CONCLUSIONS AND RECOMMENDATIONS 213 Special Education Programs, gathered for school-age children since the autism category was recognized in 1991, would support investigation of whether the dramatic increases in the numbers of children served with autistic spectrum disorders are offset by commensurate decreases in other categories in which children with autistic spectrum disorders might have previously been misclassified or whether these dramatic increases have come about for other reasons. Although children with autistic spectrum disorders share some char- acteristics with children who have other developmental disorders and may benefit from many of the same educational techniques, they offer unique challenges to families, teachers, and others who work with them. Their deficits in nonverbal and verbal communication require intense effort and skill even in the teaching of basic information. The unique difficulties in social interaction (e.g., in joint attention) may require more individual guidance than for other children in order to attract and sustain their children’s attention. Moreover, ordinary social exchanges between peers do not usually occur without deliberate planning and ongoing struc- turing by the adults in the child’s environment. The absence of typical friendships and peer relationships affects children’s motivation systems and the meaning of experiences. Appropriate social interactions may be some of the most difficult and important lessons a child with autistic spectrum disorders will learn. In addition, the frequency of behavior problems, such as tantrums and self-stimulatory and aggressive behavior, is high. The need for sys- tematic selection of rewards for many children with autistic spectrum disorders, whose motivation or interests can be limited, requires creativ- ity and continued effort from teachers and parents to maximize the child’s potential. Although general principles of learning and behavior analysis apply to autistic spectrum disorders, familiarity with the specific nature of the disorder should contribute to analysis of the contexts (e.g., commu- nicative and social) of behaviors for individual children and result in more effective programming. For example, conducting a functional as- sessment that considers contexts, and then replacing problem behaviors with more appropriate ways to communicate can be an effective method for reducing problem behaviors. Recommendations 1-1 Because of their shared continuities and their unique social diffi- culties, children with any autistic spectrum disorder (autistic disorder, Asperger’s disorder, atypical autism, PDD-NOS, child- hood disintegrative disorder), regardless of level of severity or function, should be eligible for special educational services within the category of autistic spectrum disorders, as opposed to other 

214 EDUCATING CHILDREN WITH AUTISM terminology used by school systems, such as other health im- paired, social emotionally maladjusted, significantly developmen- tally delayed, or neurologically impaired. 1-2 Identification of autistic spectrum disorders should include a for- mal multidisciplinary evaluation of social behavior, language and nonverbal communication, adaptive behavior, motor skills, atypi- cal behaviors, and cognitive status by a team of professionals experienced with autistic spectrum disorders. An essential part of this evaluation is the systematic gathering of information from parents on their observations and concerns. If the school system cannot carry out such an assessment, the local education author- ity should fund the assessment through external sources. Early diagnosis should be emphasized. Because of variability in early development, younger children with autistic spectrum disorders should receive a follow-up diagnostic and educational assess- ment within one to two years of initial evaluation. 1-3 Professional organizations, with the support of the National Insti- tutes of Health (NIH) and the Department of Education’s Office of Special Education Programs (OSEP), should disseminate infor- mation concerning the nature and range of autistic spectrum dis- orders in young children to all professionals who have contact with children, particularly those who work with infants, toddlers, and preschool children. This information should include the vari- able presentations and patterns of behavior seen in autistic spec- trum disorders from toddlers to school age children. Members of “child find” teams within the early intervention systems, as well as primary care providers, should be trained in identifying the “red flags of autistic spectrum disorders” and the importance and means of early referral for comprehensive diagnostic evaluation. Advocacy groups and relevant federal agencies, as well as profes- sional organizations, should use effective media resources, in- cluding the Internet, to provide information concerning the range of behaviors in autistic spectrum disorders. ROLE OF FAMILIES Conclusions Having a child with an autistic spectrum disorder is a challenge for any family. Involvement of families in the education of young children with autistic spectrum disorders can occur at multiple levels, including advocacy, parents as participating partners in and agents of education or 

CONCLUSIONS AND RECOMMENDATIONS 215 behavior change, and family-centered consideration of the needs and strengths of the family as a unit. Nearly all empirically supported treat- ments reviewed by the committee included a parent component, and most research programs used a parent-training approach. More informa- tion is needed about the benefits of a family-centered orientation or com- bined family-centered and formalized parent training in helping parents. It is well established that parents can learn and successfully apply skills to changing the behavior of their children with autistic spectrum disorders, though little is known about the effects of cultural differences, such as race, ethnicity, and social class, nor about the interactions among family factors, child characteristics, and features of educational interven- tion. For most families, having a child with an autistic spectrum disorder creates added stress. Parents’ use of effective teaching methods can have a significant effect on that stress, as can support from within the family and the community. Parents need access to balanced information about autistic spectrum disorders and the range of appropriate services and technologies in order to carry out their responsibilities. They also need timely information about assessments, educational plans, and the avail- able resources for their children. This information needs to be conveyed to them in a meaningful way that gives them time to prepare to fulfill their roles and responsibilities. In the last ten years the widespread availability of the Internet and media attention to autistic spectrum disorders have increased parents’ knowledge but often conveyed perspectives that were not balanced nor well-supported scientifically. Of crucial importance is the question of how to make information available to parents and to ensure their active role in advocacy for their children’s education. Recommendations 2-1 Parents’ concerns and perspectives should actively help to shape educational planning. Specifically: a. In order for a family to be effective members of the Indi- vidualized Education Plan (IEP) team that plans a child’s educa- tion, the local school system should provide to the parents, at the beginning of the assessment process, written information con- cerning the nature of autistic spectrum disorders and eligibility categories, the range of alternatives within best practices in early education of autistic spectrum disorders, sources of funding and support (e.g., a support guide and bibliography), and their child’s rights. b. Prior to the IEP meeting, the local school system should provide to each family the written results of their child’s assess- 

216 EDUCATING CHILDREN WITH AUTISM ment, and a contact person to explain the findings if they wish, and should indicate that they will have the opportunity to present their concerns. Early during the IEP meeting, parents should be given an opportunity to voice their questions, concerns, and per- spectives about their child’s development and educational pro- gramming. 2-2 As part of local educational programs and intervention programs for children from birth to age 3, families of children with autistic spectrum disorders should be provided the opportunity to learn techniques for teaching their child new skills and reducing prob- lem behaviors. These opportunities should include not only di- dactic sessions, but also ongoing consultation in which individu- alized problem-solving, including in-home observations or training, occur for a family, as needed, to support improvements at home as well as at school. 2-3 Families that are experiencing stress in raising their children with an autistic spectrum disorder should be provided with mental health support services. Under Part C of the Individuals with Disabilities Education Act (IDEA), which addresses family sup- port and service coordination, including private service provid- ers, services should be extended to include families of children at least up to age 8 years. GOALS FOR EDUCATIONAL SERVICES Conclusions At the root of questions about the most appropriate educational inter- ventions lie differences in assumptions about what is possible and what is important to give students with autistic spectrum disorders through edu- cation. The appropriate goals for educational services are the same as those for other children: personal independence and social responsibility. These goals imply continuous progress in social and cognitive abilities, verbal and nonverbal communication skills, adaptive skills, amelioration of behavioral difficulties, and generalization of abilities across multiple environments. In some cases, reports have suggested that particular treat- ments can foster permanent “recovery”. However, as with other develop- mental disabilities, the core deficits of autistic spectrum disorders have generally been found to persist, to some degree, in most individuals. Research concerning outcomes can be characterized by whether the goal of intervention is broadly defined (e.g., “recovery” or “best out- 

CONCLUSIONS AND RECOMMENDATIONS 217 come”) or more specifically defined (e.g., increasing vocabulary or peer- directed social behavior); whether the design involves reporting results in terms of group or individual changes; and whether the goals are short term (i.e., to be achieved in a few weeks or months) or longer term (i.e., over years). A large body of single-subject research has demonstrated substantial progress in individual responses to specific intervention tech- niques in relatively short periods of times (e.g., several months) in many specific areas, including gains in social skills, language acquisition, non- verbal communication, and reductions in challenging behaviors. Studies over longer periods of time have documented joint attention, symbolic play, early language skills, and imitation as core deficits and hallmarks of the disorder that are predictive of longer term outcome in the domains of language, adaptive behaviors, and academic skills. Many treatment studies report postintervention placement as an out- come measure. While successful participation in regular classrooms is an important goal for some children with autistic spectrum disorders, the usefulness of placement in regular education classes as an outcome mea- sure is limited, because placement may be related to many variables other than the characteristics of the child (e.g., prevailing trends in inclusion, availability of other services). The most commonly reported outcome measure in group treatment studies of children with autistic spectrum disorders has been changes in IQ scores, which also have many limita- tions. Studies have reported substantial changes in large numbers of chil- dren in intervention studies and longitudinal studies in which children received a variety of interventions. Even in the treatment studies that have shown the strongest gains, children’s outcomes are variable, with some children making substantial progress and others showing very slow gains. The needs and strengths of young children with autistic spectrum disorders are very heterogeneous. Although there is evidence that many interventions lead to improvements and that some children shift in spe- cific diagnosis along the autism spectrum during the preschool years, there does not appear to be a simple relationship between any particular intervention and “recovery” from autistic spectrum disorders. Thus, while substantial evidence exists that treatments can reach short-term specific goals in many areas, gaps remain in addressing larger questions of the relationships between particular techniques, child characteristics, and outcomes. Recommendations The IEP and Individual Family Service Plan (IFSP) should be the vehicles for planning and implementing educational objectives. 

218 EDUCATING CHILDREN WITH AUTISM 3-1 Appropriate educational objectives for children with autistic spec- trum disorders should be observable, measurable behaviors and skills. These objectives should be able to be accomplished within 1 year and expected to affect a child’s participation in education, the community, and family life. They should include the devel- opment of: a. Social skills to enhance participation in family, school, and community activities (e.g., imitation, social initiations and re- sponse to adults and peers, parallel and interactive play with peers and siblings); b. Expressive verbal language, receptive language, and non- verbal communication skills; c. A functional symbolic communication system; d. Increased engagement and flexibility in developmentally appropriate tasks and play, including the ability to attend to the environment and respond to an appropriate motivational system; e. Fine and gross motor skills used for age appropriate func- tional activities, as needed; f. Cognitive skills, including symbolic play and basic con- cepts, as well as academic skills; g. Replacement of problem behaviors with more conven- tional and appropriate behaviors; and h. Independent organizational skills and other behaviors that underlie success in regular education classrooms (e.g., complet- ing a task independently, following instructions in a group, ask- ing for help). 3-2 Ongoing measurement of educational objectives must be docu- mented in order to determine whether a child is benefiting from a particular intervention. Every child’s response to the educational program should be assessed after a short period of time. Progress should be monitored frequently and objectives adjusted accord- ingly. CHARACTERISTICS OF EFFECTIVE INTERVENTIONS Conclusions In general, there is consistent agreement across comprehensive inter- vention programs about a number of features, though practical and, some- times, ethical considerations have made well-controlled studies with ran- dom assignment very difficult to conduct without direct evaluation. Characteristics of the most appropriate intervention for a given child must 

CONCLUSIONS AND RECOMMENDATIONS 219 be tied to that child’s and family’s needs. However, without direct evalu- ation, it is difficult to know which features are of greatest importance in a program. Across primarily preschool programs, there is a very strong consensus that the following features are critical: • entry into intervention programs as soon as an autism spectrum diagnosis is seriously considered; • active engagement in intensive instructional programming for a minimum of the equivalent of a full school day, 5 days (at least 25 hours) a week, with full year programming varied according to the child’s choronological age and developmental level; • repeated, planned teaching opportunities generally organized around relatively brief periods of time for the youngest children (e.g., 15- 20 minute intervals), including sufficient amounts of adult attention in one-to-one and very small group instruction to meet individualized goals; • inclusion of a family component, including parent training; • low student/teacher ratios (no more than two young children with autistic spectrum disorders per adult in the classroom); and • mechanisms for ongoing program evaluation and assessments of individual children’s progress, with results translated into adjustments in programming. Curricula across different programs differ in a number of ways. They include the ways in which goals are prioritized, affecting the relative time spent on verbal and nonverbal communication, social activities, behav- ioral, academic, motor, and other domains. Strategies from various pro- grams represent a range of techniques, including discrete trials, incidental teaching, structured teaching, “floor time”, and individualized modifica- tions of the environment, including schedules. Some programs adopt a unilateral use of one set of procedures, and others use a combination of approaches. Programs also differ in the relative amount of time spent in homes, centers, or schools, when children are considered ready for inclu- sion into regular classrooms, how the role of peers as intervention agents is supported, and in the use of distraction-free or natural environments. Programs also differ in the credentials that are required of direct support and supervisory staff and the formal and informal roles of collateral staff, such as speech language pathologists and occupational therapists. Overall, many of the programs are more similar than different in terms of levels of organization, staffing, ongoing monitoring, and the use of certain techniques, such as discrete trials, incidental learning, and struc- tured teaching. However, there are real differences in philosophy and practice that provide a range of alternatives for parents and school sys- tems considering various approaches. The key to any child’s educational program lies in the objectives specified in the IEP and the ways they are 

220 EDUCATING CHILDREN WITH AUTISM addressed. Much more important than the name of the program attended is how the environment and educational strategies allow implementation of the goals for a child and family. Thus, effective services will and should vary considerably across individual children, depending on a child’s age, cognitive and language levels, behavioral needs, and family priorities. Recommendations The committee’s recommendations for effective treatment are made on the basis of empirical findings, information from selected representa- tive programs, and findings in the general education and developmental literature. In particular, it is well established that children with autism spend much less time in focused and socially directed activity when in unstructured situations than do other children. Therefore, it becomes crucial to specify time engaged in social and focused activity as part of a program for children with autistic spectrum disorders. 4-1 Based on a set of individualized, specialized objectives and plans that are systematically implemented, educational services should begin as soon as a child is suspected of having an autistic spec- trum disorder. Taking into account the needs and strengths of an individual child and family, the child’s schedule and educational environment, in and out of the classroom, should be adapted as needed in order to implement the IEP. Educational services should include a minimum of 25 hours a week, 12 months a year, in which the child is engaged in systematically planned, develop- mentally appropriate educational activity aimed toward identi- fied objectives. Where this activity takes place and the content of the activity should be determined on an individual basis, de- pending on characteristics of both the child and the family. 4-2 A child must receive sufficient individualized attention on a daily basis so that individual objectives can be effectively implemented; individualized attention should include individual therapies, de- velopmentally appropriate small group instruction, and direct one-to-one contact with teaching staff. 4-3 Assessment of a child’s progress in meeting objectives should be used on an ongoing basis to further refine the IEP. Lack of objec- tively documentable progress over a 3 month period should be taken to indicate a need to increase intensity by lowering stu- 

CONCLUSIONS AND RECOMMENDATIONS 221 dent/teacher ratios, increasing programming time, reformulat- ing curricula, or providing additional training and consultation. 4-4 To the extent that it leads to the specified educational goals (e.g., peer interaction skills, independent participation in regular edu- cation), children should receive specialized instruction in settings in which ongoing interactions occur with typically developing children. 4-5 Six kinds of interventions should have priority: a. Functional, spontaneous communication should be the pri- mary focus of early education. For very young children, pro- gramming should be based on the assumption that most children can learn to speak. Effective teaching techniques for both verbal language and alternative modes of functional communication, drawn from the empirical and theoretical literature, should be vigorously applied across settings. b. Social instruction should be delivered throughout the day in various settings, using specific activities and interventions planned to meet age-appropriate, individualized social goals (e.g., with very young children, response to maternal imitation; with preschool children, cooperative activities with peers). c. The teaching of play skills should focus on play with peers, with additional instruction in appropriate use of toys and other materials. d. Other instruction aimed at goals for cognitive develop- ment should also be carried out in the context in which the skills are expected to be used, with generalization and maintenance in natural contexts as important as the acquisition of new skills. Because new skills have to be learned before they can be general- ized, the documentation of rates of acquisition is an important first step. Methods of introduction of new skills may differ from teaching strategies to support generalization and maintenance. e. Intervention strategies that address problem behaviors should incorporate information about the contexts in which the behaviors occur; positive, proactive approaches; and the range of techniques that have empirical support (e.g., functional assess- ment, functional communication training, reinforcement of alter- native behaviors). f. Functional academic skills should be taught when appro- priate to the skills and needs of a child. 

222 EDUCATING CHILDREN WITH AUTISM PUBLIC POLICIES Conclusions The Individuals with Disabilities Education Act (IDEA) contains the necessary provisions for ensuring rights to appropriate education for chil- dren with autistic spectrum disorders. However, the implementation and specification of these services are variable. Early intervention for young children with autistic spectrum disorders is expensive, and most local schools need financial help from the state and federal programs to pro- vide appropriate services. The large number of court cases is a symptom of the tension between families and school systems. Case law has yielded an inconsistent pattern of findings that vary according to the characteristics of the individual cases. The number of challenges to decision-making for programming within school systems reflects parents’ concerns about the adequacy of knowledge and the expertise of school systems in determining their children’s education and implementing appropriate techniques. The treatment of autistic spectrum disorders often involves many disciplines and agencies. This confuses lines of financial and intellectual responsibility and complicates assessment and educational planning. When communication between families and school systems goes awry, it can directly affect children’s programming and the energy and financial resources that are put into education rather than litigation. Support sys- tems are not generally adequate in undergirding local service delivery programs and maximizing the usefulness of different disciplines and agencies, and transitions between service delivery agencies are often prob- lematic. A number of states have successful models for providing services to children with autism, and mechanisms are becoming increasingly effi- cient and flexible in some states. In most cases, existing agencies at state and federal levels can develop appropriate programs without restructur- ing—with the possible addition of special task forces or committees de- signed to deal with issues particular to children with autistic spectrum disorders. Recommendations The committee recommends that a variety of steps be taken to ensure that policies are effectively carried out at the state and local levels. 5-1 At the federal level, the National Institutes of Health’s Autism Coordinating Committee and the Federal Interagency Coordinat- ing Council should jointly appoint a clinical research oversight 

CONCLUSIONS AND RECOMMENDATIONS 223 task force of professionals knowledgeable in the field of autistic spectrum disorders, to review and periodically report on basic and applied research programs to the parent agencies and to track program implementation through the State Interagency Coordi- nating Councils or relevant state agencies. Administrative sup- port for these efforts should be provided by the appropriate de- partment of the Secretary’s office. 5-2 States should have regional resource and training centers with expertise in autistic spectrum disorders to provide training and technical support to local schools. States should also have a mechanism to evaluate the adequacy of current support systems to local schools and recommend ways for improvement. One such mechanism could be an autistic spectrum disorders support systems task force that would examine the relevant provisions for personnel preparation, technical assistance, and demonstration of exemplary programs and would make recommendations as to what would be needed to bring a state’s support systems into alignment with quality education for children with autistic spec- trum disorders. States should monitor coordination among and transitions between service delivery systems and should develop ways to facilitate these processes. 5-3 Families should have access to consultation and legal knowledge such as provided by an ombudsman who is independent of the school system and who could be a standard part of Individual- ized Educational Plan planning and meetings. The ombudsman should be knowledgeable about autistic spectrum disorders and about relevant law and court decisions. The ombudsman’s role should include attending IEP meetings, interpreting the school system’s communications about a child to parents, and propos- ing, at the parents’ request, alternatives to those presented by the school system. Professional and advocacy groups should work together to provide this service, with the Governor’s Council for Developmental Disabilities or the Autistic Spectrum Disorders Support Systems Task Force responsible for ensuring funding for training and support of this service. 5-4 State and federal agencies should consider ways to work with and support professional and advocacy groups to provide up-to- date, practical, scientifically valid information to parents and practitioners. 

224 EDUCATING CHILDREN WITH AUTISM 5-5 States should have clearly defined minimum standards for per- sonnel in educational settings for children with autistic spectrum disorders. For example, at a minimum, teachers should have some special preparation (e.g., preservice course work, equiva- lent inservice training, workshops, and supervised practice in re- search-based practices in autistic spectrum disorders) and should have well-trained, experienced support personnel available to provide ongoing training and additional consultation. 5-6 States should develop a systematic strategy to fund the interven- tions that are necessary for children with autistic spectrum disor- ders in local schools, so that this cost is not borne primarily by the parents or local school systems. State education departments should develop interagency collaborations to pool support for local systems. A state fund for intensive intervention, or more systematic use of Medicaid waivers or other patterns of funding currently in place in some states, should be considered. Families should not be expected to fund or provide the majority of educa- tional programming for their children. 5-7 An updated, accurate summary of case law, consultation services, and mediation mechanisms in autistic spectrum disorders should be made accessible by the Office of Special Education Programs so that schools and parents can understand the options available to them when conflicts arise. 5-8 Since levels of information about autistic spectrum disorders vary greatly within the groups and agencies that make funding and policy decisions about autistic spectrum disorders, including state task forces in education and review panels in federal agencies, it is crucial that persons knowledgeable in the range of needs and interventions associated with autistic spectrum disorders be in- cluded in those decision-making activities. PERSONNEL PREPARATION Conclusions The nature of autistic spectrum disorders and other disabilities that frequently accompany them has significant implications for approaches to education and intervention at school, in the home, and in the commu- nity. Approaches that emphasize the use of specific “packages” of mate- rials and methods associated with comprehensive intervention programs 

CONCLUSIONS AND RECOMMENDATIONS 225 may understate the multiple immediate and long-term needs of children for behavior support and for instruction across areas. Teachers are faced with a huge task. They must be familiar with theory and research concerning best practices for children with autistic spectrum disorders, including methods of applied behavior analysis, naturalistic learning, assistive technology, socialization, communication, inclusion, adaptation of the environment, language interventions, assess- ment, and the effective use of data collection systems. Specific problems in generalization and maintenance of behaviors also affect the need for training in methods of teaching children with autistic spectrum disorders. The wide range of IQ scores and verbal skills associated with autistic spectrum disorders, from profound mental retardation and severe lan- guage impairments to superior intelligence, intensify the need for person- nel training. To enable teachers to adequately work with parents and with other professionals to set appropriate goals, teachers need familiar- ity with the course of autistic spectrum disorders and the range of pos- sible outcomes. Teachers learn according to the same principles as their students. Multiple exposures, opportunities to practice, and active involvement in learning are all important aspects of learning for teachers, as well as stu- dents. Many states and community organizations have invested substan- tial funds in teacher preparation through workshops and large-audience lectures by well-known speakers. While such presentations can stimulate enthusiasm, they do not substitute for ongoing consultation and hands- on opportunities to observe and practice skills working with children with autistic spectrum disorders. Personnel preparation remains one of the weakest elements of effec- tive programming for children with autistic spectrum disorders and their families. Ways of building on the knowledge of teachers as they acquire experience with children with autistic spectrum disorders, and ways of keeping skilled personnel within the field, are critical. This is particularly true given recent trends for dependence on relatively inexperienced assis- tants for in-home programs. Providing knowledge about autistic spec- trum disorders to special education and regular education administra- tors, as well as to specialized providers with major roles in early intervention (e.g., speech language pathologists) will be critical in effect- ing change that is proactive. Findings concerning change in educational and other opportunities suggest that administrative attitudes and sup- port are critical in improving schools. Recommendations The committee recommends that relevant state and federal agencies institute an agenda for upgrading personnel preparation for those who 

226 EDUCATING CHILDREN WITH AUTISM work with, and are responsible for, children with autistic spectrum disor- ders and their families. These efforts should be part of a larger effort to coordinate and collaborate with the already established infrastructure of special education, regional resource centers, technical assistance pro- grams, personnel preparation, communication sharing, and other relevant aspects of the existing infrastructure. Professionals aware of the special nature of these children are already carrying out many of these recom- mendations in a limited fashion. The committee urges agencies to pro- vide the personnel preparation resources needed for intensified efforts to build a viable support structure for educating children with autistic spec- trum disorders. 6-1 The Office of Special Education Programs should establish a 5- year plan to provide priority funds for preservice and inservice preparation for teachers, paraprofessionals, and other personnel providing services for children with autistic spectrum disorders, including children under age 3 years. 6-2 The need for a team approach involving many professions should be addressed by personnel preparation and practicum work within multidisciplined organizations and teams. 6-3 A special emphasis should be placed on training of trainers. There is a short supply of expertise and experience in the field of educa- tion for children with autistic spectrum disorders, and special attention should be paid to rapidly increase the capabilities of the trainers, who may have experience in special education or related fields, but not in the special skills and practices for children with autistic spectrum disorders. 6-4 The existing support systems that provide short-term training (e.g., technical assistance systems, resource centers, etc.) should include people with special expertise in autistic spectrum disor- ders on their staff. 6-5 The content of the curriculum for children with autistic spectrum disorders should be based on sound research. A continuing pro- gram should be established from such agencies as the National Institute of Mental Health and the National Institute of Child Health and Human Development to translate their research into usable information for practitioners. Work on family research is particularly relevant. 

CONCLUSIONS AND RECOMMENDATIONS 227 NEEDED RESEARCH Conclusions There are several distinct and substantial bodies of research relevant to young children with autistic spectrum disorders. One body identifies neurological, behavioral, and developmental characteristics. Another body of research addresses diagnostic practices and related issues of prevalence. Another has examined the effects of comprehensive early treatment programs on the immediate and long-term outcomes of chil- dren and their families. These treatment studies tended to use some form of group experimental design. An additional body of research has ad- dressed individual instructional or intervention approaches, with many studies in this literature using single-subject experimental methodology. Altogether, a large research base exists, but with relatively little integra- tion across bodies of literature. Highly knowledgeable researchers in one area of autistic spectrum disorders may have minimal information from other perspectives, even about studies with direct bearing on their find- ings. Most researchers have not used randomized group comparison de- signs because of the practical and ethical difficulties in randomly assign- ing children and families to treatment groups. In addition, there have been significant controversies over the type of control or contrast group to use and the conditions necessary for demonstrating effectiveness. Al- though a number of comprehensive programs have provided data on their effectiveness, and, in some cases, claims have been made that certain treatments are superior to others, there have been virtually no compari- sons of different comprehensive interventions of equal intensity. Across several of the bodies of literature, the children and families who have participated in studies are often inadequately described. Stan- dardized diagnoses, descriptions of ethnicity, the social class, and associ- ated features of the children (such as mental retardation and language level) are often not specified. Fidelity of treatment implementation has not been consistently assessed. Generalization, particularly across set- tings, and maintenance of treatment effects are not always measured. Though there is little evidence concerning the effectiveness of discipline- specific therapies, there is substantial research supporting the effective- ness of many specific therapeutic techniques. Recommendations 7-1 Funding agencies and professional journals should require minimium standards in design and description of intervention projects. All intervention studies should provide the following information: 

228 EDUCATING CHILDREN WITH AUTISM a. Adequate information concerning the children and fami- lies who participated, and who chose not to participate or with- drew from participation, including chronological age, develop- mental assessment data (including verbal and nonverbal IQ levels), standardized diagnoses, gender, race, family characteris- tics, socioeconomic status, and relevant health or other biological impairments; b. description of the intervention in sufficient detail so that an external group could replicate it; detailed documentation is crucial especially if no treatment manual is available; c. fidelity of treatment and degree of implementation; d. specific objective measures of expected outcomes, assessed at regular intervals; and e. measures of outcome that are independent of the interven- tion, in terms of both the evaluators and the measures, and in- clude broad immediate and long-term effects on children and families, particularly generalization and maintenance effects. 7-2 Funders and performers of research should recognize that valu- able information can be provided by a variety of approaches to research in intervention, including group experimental and single-subject designs. 7-3 In order to help educators and consumers make informed deci- sions about appropriate methods of intervention for particular children, federal agencies involved in autistic spectrum disorders initiatives (including the Office of Special Education Programs, the Office of Educational Research and Improvement, the Na- tional Institute of Child Health and Human Development, the National Institute of Mental Health, the National Institute of Neu- rological Disorders and Stroke, and the National Institute on Deaf- ness and Other Communication Disorders) and nonprofit agen- cies with similar national missions (such as Autism Society of America Foundation, Cure Autism Now, and National Alliance for Autism Research) should form a research task force and spe- cifically allocate federal responsibilites for recruiting and funding a comprehensive program of research related to intervention and treatment. This program should include: a. development of more specific, precise measures of impor- tant areas of outcome, such as social functioning, peer relation- ships, spontaneous communication and language, and the acqui- sition of competence in natural contexts (e.g., classroom, home); 

CONCLUSIONS AND RECOMMENDATIONS 229 b. definition of appropriate educational skills and sequences in social and cognitive development, informed by normal devel- opmental literature; c. measurement of the effects of the interactions between fam- ily variables (e.g., family structure, family supports, socioeco- nomic status), child factors (such as degree of language impair- ment), and responses to educational interventions (including family-centered, parent training, and other approaches) on out- comes. d. longitudinal treatment studies, where feasible, built on a clinical model with randomly assigned samples of sufficient size to assess the effectiveness of differing modes of treatment. 7-4 Treatment studies should recognize the common components of many comprehensive programs (e.g., standardized curriculum, family training, presence of typically developing peers) and should target and measure, longitudinally when feasible, “active ingredients” and mediating variables that influence the effects of intervention (e.g., communication and interaction opportunities for engagement, levels of interaction and initiation, specific teach- ing techniques, proportion of time in close proximity of peers). The concomitant development of innovative treatments building on these “active ingredients” should be supported. 7-5 In response to amendments in IDEA to make education more outcome oriented, a federal initiative should solicit and fund stud- ies in the following areas, not easily supported under the current review system: a. the development of instruments for measurement of diag- nosis and critical aspects of development, particularly tools for early screening of autistic spectrum disorders and for measure- ment of response to interventions; b. the development and application of sophisticated statisti- cal methods of analysis of change and growth, particularly multi- variate designs and those applicable to small samples; and c. the development and dissemination of novel research de- signs that combine individual and group approaches in ways that minimize biases and maximize the power of small samples. 7-6 Competitively funded initiatives in early education in autistic spectrum disorders should require plans and contain sufficient funding for short- and long-term assessment of child outcomes and measures of program efficacy. 

Autism is a word most of us are familiar with. But do we really know what it means?

Children with autism are challenged by the most essential human behaviors. They have difficulty interacting with other people—often failing to see people as people rather than simply objects in their environment. They cannot easily communicate ideas and feelings, have great trouble imagining what others think or feel, and in some cases spend their lives speechless. They frequently find it hard to make friends or even bond with family members. Their behavior can seem bizarre.

Education is the primary form of treatment for this mysterious condition. This means that we place important responsibilities on schools, teachers and children's parents, as well as the other professionals who work with children with autism. With the passage of the Individuals with Disabilities Education Act of 1975, we accepted responsibility for educating children who face special challenges like autism. While we have since amassed a substantial body of research, researchers have not adequately communicated with one another, and their findings have not been integrated into a proven curriculum.

Educating Children with Autism outlines an interdisciplinary approach to education for children with autism. The committee explores what makes education effective for the child with autism and identifies specific characteristics of programs that work. Recommendations are offered for choosing educational content and strategies, introducing interaction with other children, and other key areas.

This book examines some fundamental issues, including:

• How children's specific diagnoses should affect educational assessment and planning
• How we can support the families of children with autism
• Features of effective instructional and comprehensive programs and strategies
• How we can better prepare teachers, school staffs, professionals, and parents to educate children with autism
• What policies at the federal, state, and local levels will best ensure appropriate education, examining strategies and resources needed to address the rights of children with autism to appropriate education.

Children with autism present educators with one of their most difficult challenges. Through a comprehensive examination of the scientific knowledge underlying educational practices, programs, and strategies, Educating Children with Autism presents valuable information for parents, administrators, advocates, researchers, and policy makers.

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Autism - List of Essay Samples And Topic Ideas

Autism, or Autism Spectrum Disorder (ASD), refers to a broad range of conditions characterized by challenges with social skills, repetitive behaviors, speech, and nonverbal communication. Essays could explore the causes, symptoms, and treatment of autism, the experiences of individuals with autism, and societal understanding and acceptance of autism. We’ve gathered an extensive assortment of free essay samples on the topic of Autism you can find at Papersowl. You can use our samples for inspiration to write your own essay, research paper, or just to explore a new topic for yourself.

Rain Man and Autism

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Applied Behavior Analysis and its Effects on Autism

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Autism in Japanese Manga and its Significance on Current Progression in J-pop Culture

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Speech Therapist for Autism

Abstract Autism Spectrum Disorder is a condition that consists of various challenges to an individual such as social skills, nonverbal communication, repetitive behaviors and difficulties with speech. So far doctors have not been able to find out what causes autism although it is believed that it involves both environmental and genetic factors. Autism can usually be detected at an early age, therefore giving the patient and therapist an early start to improve their verbal skills. Speech language pathologists also known […]

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Growing up with Autism

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Kids with Autism

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Cultural Stereotypes and Autism Disorder

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Representation of Autism in the Netflix TV Show “Atypical”

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The Complexity of Autism

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The Evolution of Autism Diagnosis: from Misunderstanding to Scientific Approach

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Autism Spectrum Disorder and its Positive Effects

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Raising a Child with Autism

All impose severe identity crisis and role restrictions even in knowledgeable parents.. In some conditions, as in the case of physical challenges, the child needs physical reassurance and support from the parents against those conditions of cognitive deficits in which the demands are always parent’s constant attention and feedback. As far as autism is concerned, the child’s deficits are many namely social, emotional, communicational, sensual, as well as behavioral. Symptoms are usually identified between one and two years of age. […]

Is Autism a Kind of Brain Damage

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Trouble with Social Aspects and People on the Autism Spectrum

Autism in childhood starts as early as age two, and symptoms will become more severe as children continue into elementary school. When a child goes to a psychiatrist, they will work on social development. Adolescence with autism struggle when attempting to project others pain. For example, my brother has Asperger's and when I have a bone graph done on my hand, he could not stop touching my hand. He needed constant reminders to not touch and remind him of when […]

Effects of Autism

When he was eight years old, the parents of Joshua Dushack learned that their son was different. He had been diagnosed with Autism. According to the doctors, Joshua would never be able to read, write, talk, or go to school on his own. This might have been the case, had his parents accepted it. But his mother saw her son as a normal boy, and treated him as such. He did need some extra help in school, but because of […]

How Different Types of Assistive Technology Can Help Children with Autism

I. Introduction An anonymous speaker once said, “some people with Autism may not be able to speak or answer to their name, but they can still hear your words and feel your kindness.” Approximately thirty percent of people diagnosed with Autism Spectrum Disorder never learn to speak more than a few words (Forman & Rudy, 2018). Fortunately in today’s society, new technologies have made it possible for these individuals to communicate and socialize with others. Purpose The primary focus of […]

Searching Employment Autism

Over the last 20 years, there has been an alarming increase for children who have been diagnosed with Autism Spectrum Disorder (ASD) in the United States. According to the Centers for Disease Control, in the year 2000 1 in 159 children would be diagnosed with ASD. In the latest version of the study, the number has been reduced to 1 in 59 children will be diagnosed with ASD (Centers for Disease Control and Prevention, 2018). This is a subject that […]

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How To Write an Essay About Autism

Understanding autism.

Before writing an essay about autism, it's essential to understand what autism is and the spectrum of conditions it encompasses. Autism, or Autism Spectrum Disorder (ASD), is a complex developmental disorder that affects communication and behavior. It is characterized by challenges with social skills, repetitive behaviors, speech, and nonverbal communication. Start your essay by explaining the nature of autism, its symptoms, and the spectrum concept, which acknowledges a range of strengths and challenges experienced by individuals with autism. It's also important to discuss the causes and diagnosis of autism, as well as the common misconceptions and stereotypes surrounding it. This foundational knowledge will set the stage for a more in-depth exploration of the topic.

Developing a Focused Thesis Statement

A strong essay on autism should be centered around a clear, focused thesis statement. This statement should present a specific angle or argument about autism. For example, you might discuss the importance of early intervention and therapy, the representation of autism in media, or the challenges faced by individuals with autism in education and employment. Your thesis will guide the direction of your essay and ensure that your analysis is structured and coherent.

Gathering and Analyzing Data

To support your thesis, gather relevant data and research from credible sources. This might include scientific studies, statistics, reports from autism advocacy organizations, and personal narratives. Analyze this data critically, considering different perspectives and the quality of the evidence. Including a range of viewpoints will strengthen your argument and demonstrate a comprehensive understanding of the topic.

Discussing Implications and Interventions

A significant portion of your essay should be dedicated to discussing the broader implications of autism and potential interventions. This can include the impact of autism on individuals and families, educational strategies, therapeutic approaches, and social support systems. Evaluate the effectiveness of these interventions, drawing on case studies or research findings. Discussing both the successes and challenges in managing and understanding autism will provide a balanced view and demonstrate a comprehensive understanding of the topic.

Concluding the Essay

Conclude your essay by summarizing the key points of your discussion and restating your thesis in light of the evidence and examples provided. Your conclusion should tie together your analysis and emphasize the significance of understanding and supporting individuals with autism. You might also want to highlight areas where further research or development is needed or the potential for societal changes to improve the lives of those with autism.

Final Review and Editing

After completing your essay, it's important to review and edit your work. Ensure that your arguments are clearly articulated and supported by evidence. Check for grammatical accuracy and ensure that your essay flows logically from one point to the next. Consider seeking feedback from peers or experts in the field to refine your essay further. A well-crafted essay on autism will not only inform but also engage readers in considering the complexities of this condition and the collective efforts required to support those affected by it.

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Autism Spectrum Disorder

What is asd.

Autism spectrum disorder (ASD) is a neurological and developmental disorder that affects how people interact with others, communicate, learn, and behave. Although autism can be diagnosed at any age, it is described as a “developmental disorder” because symptoms generally appear in the first 2 years of life.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) , a guide created by the American Psychiatric Association that health care providers use to diagnose mental disorders, people with ASD often have:

• Difficulty with communication and interaction with other people
• Restricted interests and repetitive behaviors
• Symptoms that affect their ability to function in school, work, and other areas of life

Autism is known as a “spectrum” disorder because there is wide variation in the type and severity of symptoms people experience.

People of all genders, races, ethnicities, and economic backgrounds can be diagnosed with ASD. Although ASD can be a lifelong disorder, treatments and services can improve a person’s symptoms and daily functioning. The American Academy of Pediatrics recommends that all children receive screening for autism. Caregivers should talk to their child’s health care provider about ASD screening or evaluation.

What are the signs and symptoms of ASD?

The list below gives some examples of common types of behaviors in people diagnosed with ASD. Not all people with ASD will have all behaviors, but most will have several of the behaviors listed below.

Social communication / interaction behaviors may include:

• Making little or inconsistent eye contact
• Appearing not to look at or listen to people who are talking
• Infrequently sharing interest, emotion, or enjoyment of objects or activities (including infrequent pointing at or showing things to others)
• Not responding or being slow to respond to one’s name or to other verbal bids for attention
• Having difficulties with the back and forth of conversation
• Often talking at length about a favorite subject without noticing that others are not interested or without giving others a chance to respond
• Displaying facial expressions, movements, and gestures that do not match what is being said
• Having an unusual tone of voice that may sound sing-song or flat and robot-like
• Having trouble understanding another person’s point of view or being unable to predict or understand other people’s actions
• Difficulties adjusting behaviors to social situations
• Difficulties sharing in imaginative play or in making friends

Restrictive / repetitive behaviors may include:

• Repeating certain behaviors or having unusual behaviors, such as repeating words or phrases (a behavior called echolalia)
• Having a lasting intense interest in specific topics, such as numbers, details, or facts
• Showing overly focused interests, such as with moving objects or parts of objects
• Becoming upset by slight changes in a routine and having difficulty with transitions
• Being more sensitive or less sensitive than other people to sensory input, such as light, sound, clothing, or temperature

People with ASD may also experience sleep problems and irritability.

People on the autism spectrum also may have many strengths, including:

• Being able to learn things in detail and remember information for long periods of time
• Being strong visual and auditory learners
• Excelling in math, science, music, or art

What are the causes and risk factors for ASD?

Researchers don’t know the primary causes of ASD, but studies suggest that a person’s genes can act together with aspects of their environment to affect development in ways that lead to ASD. Some factors that are associated with an increased likelihood of developing ASD include:

• Having a sibling with ASD
• Having older parents
• Having certain genetic conditions (such as Down syndrome or Fragile X syndrome)
• Having a very low birth weight

How is ASD diagnosed?

Health care providers diagnose ASD by evaluating a person’s behavior and development. ASD can usually be reliably diagnosed by age 2. It is important to seek an evaluation as soon as possible. The earlier ASD is diagnosed, the sooner treatments and services can begin.

Diagnosis in young children

Diagnosis in young children is often a two-stage process.

Stage 1: General developmental screening during well-child checkups

Every child should receive well-child check-ups with a pediatrician or an early childhood health care provider. The American Academy of Pediatrics recommends that all children receive screening for developmental delays at their 9-, 18-, and 24- or 30-month well-child visits, with specific autism screenings at their 18- and 24-month well-child visits. A child may receive additional screening if they have a higher likelihood of ASD or developmental problems. Children with a higher likelihood of ASD include those who have a family member with ASD, show some behaviors that are typical of ASD, have older parents, have certain genetic conditions, or who had a very low birth weight.

Considering caregivers’ experiences and concerns is an important part of the screening process for young children. The health care provider may ask questions about the child’s behaviors and evaluate those answers in combination with information from ASD screening tools and clinical observations of the child. Read more about screening instruments   on the Centers for Disease Control and Prevention (CDC) website.

If a child shows developmental differences in behavior or functioning during this screening process, the health care provider may refer the child for additional evaluation.

Stage 2: Additional diagnostic evaluation

It is important to accurately detect and diagnose children with ASD as early as possible, as this will shed light on their unique strengths and challenges. Early detection also can help caregivers determine which services, educational programs, and behavioral therapies are most likely to be helpful for their child.

A team of health care providers who have experience diagnosing ASD will conduct the diagnostic evaluation. This team may include child neurologists, developmental pediatricians, speech-language pathologists, child psychologists and psychiatrists, educational specialists, and occupational therapists.

The diagnostic evaluation is likely to include:

• Medical and neurological examinations
• Assessment of the child’s cognitive abilities
• Assessment of the child’s language abilities
• Observation of the child’s behavior
• An in-depth conversation with the child’s caregivers about the child’s behavior and development
• Assessment of age-appropriate skills needed to complete daily activities independently, such as eating, dressing, and toileting

Because ASD is a complex disorder that sometimes occurs with other illnesses or learning disorders, the comprehensive evaluation may include:

• Blood tests
• Hearing test

The evaluation may lead to a formal diagnosis and recommendations for treatment.

Diagnosis in older children and adolescents

Caregivers and teachers are often the first to recognize ASD symptoms in older children and adolescents who attend school. The school’s special education team may perform an initial evaluation and then recommend that a child undergo additional evaluation with their primary health care provider or a health care provider who specialize in ASD.

A child’s caregivers may talk with these health care providers about their child’s social difficulties, including problems with subtle communication. For example, some children may have problems understanding tone of voice, facial expressions, or body language. Older children and adolescents may have trouble understanding figures of speech, humor, or sarcasm. They also may have trouble forming friendships with peers.

Diagnosis in adults

Diagnosing ASD in adults is often more difficult than diagnosing ASD in children. In adults, some ASD symptoms can overlap with symptoms of other mental health disorders, such as anxiety disorder or attention-deficit/hyperactivity disorder (ADHD).

Adults who notice signs of ASD should talk with a health care provider and ask for a referral for an ASD evaluation. Although evaluation for ASD in adults is still being refined, adults may be referred to a neuropsychologist, psychologist, or psychiatrist who has experience with ASD. The expert will ask about:

• Social interaction and communication challenges
• Sensory issues
• Repetitive behaviors
• Restricted interests

The evaluation also may include a conversation with caregivers or other family members to learn about the person’s early developmental history, which can help ensure an accurate diagnosis.

Receiving a correct diagnosis of ASD as an adult can help a person understand past challenges, identify personal strengths, and find the right kind of help. Studies are underway to determine the types of services and supports that are most helpful for improving the functioning and community integration of autistic transition-age youth and adults.

What treatment options are available for ASD?

Treatment for ASD should begin as soon as possible after diagnosis. Early treatment for ASD is important as proper care and services can reduce individuals’ difficulties while helping them build on their strengths and learn new skills.

People with ASD may face a wide range of issues, which means that there is no single best treatment for ASD. Working closely with a health care provider is an important part of finding the right combination of treatment and services.

A health care provider may prescribe medication to treat specific symptoms. With medication, a person with ASD may have fewer problems with:

• Irritability
• Repetitive behavior
• Hyperactivity
• Attention problems
• Anxiety and depression

Read more about the latest medication warnings, patient medication guides, and information on newly approved medications at the Food and Drug Administration (FDA) website  .

Behavioral, psychological, and educational interventions

People with ASD may be referred to a health care provider who specializes in providing behavioral, psychological, educational, or skill-building interventions. These programs are often highly structured and intensive, and they may involve caregivers, siblings, and other family members. These programs may help people with ASD:

• Learn social, communication, and language skills
• Reduce behaviors that interfere with daily functioning
• Increase or build upon strengths
• Learn life skills for living independently

Other resources

Many services, programs, and other resources are available to help people with ASD. Here are some tips for finding these additional services:

• Contact your health care provider, local health department, school, or autism advocacy group to learn about special programs or local resources.
• Find an autism support group. Sharing information and experiences can help people with ASD and their caregivers learn about treatment options and ASD-related programs.
• Record conversations and meetings with health care providers and teachers. This information may help when it’s time to decide which programs and services are appropriate.
• Keep copies of health care reports and evaluations. This information may help people with ASD qualify for special programs.

How can I find a clinical trial for ASD?

Clinical trials are research studies that look at new ways to prevent, detect, or treat diseases and conditions. The goal of clinical trials is to determine if a new test or treatment works and is safe. Although individuals may benefit from being part of a clinical trial, participants should be aware that the primary purpose of a clinical trial is to gain new scientific knowledge so that others may be better helped in the future.

Researchers at NIMH and around the country conduct many studies with patients and healthy volunteers. We have new and better treatment options today because of what clinical trials uncovered years ago. Be part of tomorrow’s medical breakthroughs. Talk to your health care provider about clinical trials, their benefits and risks, and whether one is right for you.

To learn more or find a study, visit:

• NIMH’s Clinical Trials webpage : Information about participating in clinical trials
• Clinicaltrials.gov: Current Studies on ASD  : List of clinical trials funded by the National Institutes of Health (NIH) being conducted across the country

Where can I learn more about ASD?

Free brochures and shareable resources.

• Autism Spectrum Disorder : This brochure provides information about the symptoms, diagnosis, and treatment of ASD. Also available  en español .
• Digital Shareables on Autism Spectrum Disorder : Help support ASD awareness and education in your community. Use these digital resources, including graphics and messages, to spread the word about ASD.

Federal resources

• Eunice Kennedy Shriver National Institute of Child Health and Human Development  
• National Institute of Neurological Disorders and Stroke  
• National Institute on Deafness and Other Communication Disorders  
• Centers for Disease Control and Prevention   (CDC)
• Interagency Autism Coordinating Committee  
• MedlinePlus   (also available en español  )

Research and statistics

• Science News About Autism Spectrum Disorder : This NIMH webpage provides press releases and announcements about ASD.
• Research Program on Autism Spectrum Disorders : This NIMH program supports research focused on the characterization, pathophysiology, treatment, and outcomes of ASD and related disorders.
• Statistics: Autism Spectrum Disorder : This NIMH webpage provides information on the prevalence of ASD in the U.S.
• Data & Statistics on Autism Spectrum Disorder   : This CDC webpage provides data, statistics, and tools about prevalence and demographic characteristics of ASD.
• Autism and Developmental Disabilities Monitoring (ADDM) Network   : This CDC-funded program collects data to better understand the population of children with ASD.
• Biomarkers Consortium - The Autism Biomarkers Consortium for Clinical Trials (ABC-CT)   : This Foundation for the National Institutes of Health project seeks to establish biomarkers to improve treatments for children with ASD.

Last Reviewed:  February 2024

Unless otherwise specified, the information on our website and in our publications is in the public domain and may be reused or copied without permission. However, you may not reuse or copy images. Please cite the National Institute of Mental Health as the source. Read our copyright policy to learn more about our guidelines for reusing NIMH content.

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Article Contents

Introduction, increase in prevalence of autism spectrum disorder, clinical presentation, dsm-5 changes in autism spectrum criteria, implications of changes in dsm-5 diagnostic criteria for autism spectrum disorder, gender related differences in autism presentation, aetiology of asd, controversial risk factors, controversial treatments and interventions, early diagnosis and intervention, future directions, conclusions, conflict of interest statement.

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Autism spectrum disorder

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Lisa Campisi, Nazish Imran, Ahsan Nazeer, Norbert Skokauskas, Muhammad Waqar Azeem, Autism spectrum disorder, British Medical Bulletin , Volume 127, Issue 1, September 2018, Pages 91–100, https://doi.org/10.1093/bmb/ldy026

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This article is based on key recent published literature including international guidelines and relevant reviews and meta-analyses. Authors have also supplemented this material with their own clinical experience.

There is an agreement that autism spectrum disorder (ASD) have a strong hereditary component. There is also a consensus that the reported prevalence estimates have increased in the last 5 years. There is strong support for using the broader spectrum disorder conceptualization of the DSM-5.

Higher public awareness of ASD has generated several controversial theories of causation. We review a number of environmental risk factors receiving media attention including: vaccines, mercury, heavy metal exposure and Selective Serotonin Uptake Inhibitors (SSRIs). Popular yet controversial treatment interventions are discussed. Early diagnostic screening tools are also addressed.

There is increasing scientific interest in identifying biomarkers of autism with potential for early diagnosis, prognostic indicators and predictive treatment responses. We review evidence from genetics, neuroimaging and eye tracking as candidate biomarkers.

Family studies point to a strong hereditary component in the aetiology of autism. However these studies have not established 100% concordance rates, suggesting a role for environmental factors. The gene–environment interplay has not received enough attention in scientific research. This represents an important new avenue for research in ASD.

Autism spectrum disorder (ASD) is one the most common neurodevelopmental disorders, 1 characterized by persistent impairment in reciprocal communication and social interactions as well as restricted repetitive pattern of behaviours, interests or activities. 2 Kanner 3 wrote the first published description of autism in 1943 and after one year, Hans Asperger, a paediatrician from University of Vienna wrote about a group of children with almost similar pattern of behaviours as Kanner’s. The disorder is evident in all racial, ethnic and socioeconomic groups. 4 The diagnostic process of ASD is complex and recent changes in diagnostic criteria and how the disorder is conceptualized has initiated a discussion among professionals, policy makers as well as patients and their families. 5 In order to ensure best standards of care for these individuals, it is important for clinicians to have a better understanding of the disorder. This review provides a broader understanding of research findings, highlights current areas of agreement and controversies, clinical implications as well as critical issues for the research.

There has been a dramatic increase in the prevalence of autism spectrum disorders, with current estimates of 1 in 68 children in the United States having ASD. 4 This figure is ~30% higher than what was reported in 2012 by the Center for Disease Control as 1 in 88 children having autism. However, it is unclear whether these numbers represent a true increase in prevalence, or are the result of increased awareness, differences in study methodology, or inclusion of subthreshold cases.

Autism is currently conceptualized as a spectrum disorder with significant variations in patients’ social, communicative and intellectual abilities. Symptoms lead to significant impairment in multiple domains of adaptive functioning. Individuals suffering from ASD need varying levels of psychosocial support to achieve relative independence, and in some cases, may need continuous care.

Social communication

Depending on age and intellectual abilities, children diagnosed with autism have a varying degree of communication deficits. These deficits range from speech delays, monotonous speech, echolalia, pronoun reversal, poor comprehension to a complete lack of spoken language. Nonverbal communication is also impaired and may include poor eye contact, difficulties in understanding facial expressions and descriptive gestures, to name a few.

Another important feature of individuals with ASD is deficits in socio-emotional reciprocity. These individuals are less likely to initiate conversation, show less interest in peer interactions and overall find it difficult to adjust their behaviour according to different social situations.

Restricted repetitive behaviours

Individuals with ASD have a varying presentation of restricted and repetitive behaviours. Repetitive behaviours may include simple stereotypical motor behaviour (e.g. hand flapping, finger flicking), repetitive use of objects (e.g. lining up toys), or repetitive speech (echolalia). Restricted behaviours may present as resistance to change or highly restricted fixated interests, which are abnormal in intensity or focus. Further, some children with ASD my present hyper and hyposensitivity to various sensory stimuli, presenting an extreme response to various sounds, lights or smells, or a decreased reaction to pain.

Associated clinical features

Individuals with ASD often have comorbid intellectual disability and also are prone to emotional difficulties such as anxiety or depression.

Comparison of changes in DSM-5 with DSM IV-TR in the diagnostic criteria of autism spectrum disorder

Differences in DSM-5 criteria for ASD in comparison to DSM-IV 6 have led to debates regarding the impact on the prevalence of the disorder, as well as the diagnosis, and subsequently clinical practice.

The DSM-5 taxonomy offers more stringent criteria for a diagnosis of ASD. 7 The literature raises concern that individuals who used to get the diagnosis of Asperger’s disorder, or Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS) under DSM-IV, are now less likely to meet criteria for the ASD diagnosis by using DSM-5 and therefore will not be eligible for services. 8 Studies also support the notion that young children and females 9 may be at higher risk of being underdiagnosed according to the DSM-5 criteria. 10 – 12 These results are of concern as children who are less impaired are more likely to benefit from early intervention, may now be least likely to qualify for such services.

It is however important to note before the publication of DSM-5, there was a growing consensus among clinicians that subcategories of pervasive developmental disorders in DSM IV cannot be reliably diagnosed. 9 , 13 Thus, despite the concerns of being a stringent criteria, efforts to conceptualize autism as a broad spectrum of disorders in the DSM-5 had met with less criticism by professionals. Several groups investigating the validity of shifting from a triadic model to a two-factor model (integration of impaired social interaction and limited social communication into one category) have also yielded support for it. 9 , 14

There are no significant differences in ASD core symptomatology between males and females. However, research consistently shows that females tend to have more severe symptoms, more associated intellectual disability, as well as higher risk of comorbid psychiatric problems. 15

There is a consensus in the literature that autism is caused by both genetic and environmental factors. Although family studies support a strong genetic component in the aetiology of idiopathic autism, concordance rates are not 100%, indicating that environmental factors also contribute to ASD. 16

Unproven risk factors cited in the literature

Measles, mumps and rubella

Few subjects in the field of autism have garnered greater attention and controversy than that of vaccines and their potential causal link to autism. The issue was first brought forward in 1998 after an article published in the Lancet 20 in which authors postulated a causal association between the measles, mumps and rubella (MMR) vaccine and the development of autism. The study involved a group of 12 children with a prior diagnosis of autism who had also received the MMR vaccine before being diagnosed with autism. In their investigation, the authors concluded that the children were found to have an unrecognized form of inflammatory bowel disease along with small traces of the measles virus that matched the strain of measles in the vaccine. These findings led to the interpretation that the MMR vaccine, which contains a live virus, had caused a measles infection in the gastrointestinal system which in turn led to a ‘leaky gut.’ Autism was hypothesized to be the result of toxins entering the blood stream via the gut and affecting the nervous system.

The outcome of this publication gained significant media attention, however an overwhelming body of scientific evidence has since been put forth refuting a relationship between ASD and MMR, 21 , 22 yet the issue remains controversial. The initial article published in Lancet on this topic was retracted in 2010 citing that ‘several elements’ of 1998 paper ‘are incorrect, contrary to the findings of an earlier investigation’.

Mercury and thimerosal

Another issue that added fuel to the vaccination controversy was thimerosal. Thimerosal, a mercury-based vaccine preservative is frequently found in combined vaccines, including diphtheria-tetanus-pertussis (DTP). Thimerosal contains 50% ethyl mercury, which is similar to methylmercury, which at high doses can be toxic to humans. 23 The controversy with thimerosal was not related to the MMR vaccine, given this vaccine never contained ethyl mercury. However, public scepticism with vaccination led to the viewpoint that high levels of thimerosal could lead to autism in children. A vast amount of scientific data on the topic has overwhelmingly disproven this claim. 24 Despite the lack of evidence and steps taken by public health officials to counteract these claims, this controversy has had significant consequences on childhood immunity and infectious disease control.

Heavy metal exposure

One meta-analyses 25 has examined metal concentrations in children with ASD. The heavy metals most commonly studied in this population have been cadmium, lead, arsenic and aluminium. There is little evidence to support a link between aluminium and ASD, whereas the evidence concerning the others is conflicting. The authors conclude that while there is evidence suggesting heavy metal exposure as a risk factor for the development of autism, data to conclusively support these claims is still lacking.

Air pollution is speculated to have neurological consequences including inflammation and oxidative damage in the brain that, in turn, leads to abnormal neural development. There is also some research suggesting that residing near a freeway or highway during the latter stages of pregnancy could increase the risk of a child developing autism. 26 Again, conclusive evidence supporting this claim is lacking.

Selective serotonin reuptake inhibitors

The evidence for a link between prenatal maternal selective serotonin reuptake inhibitors (SSRI) antidepressants exposure and ASD is relatively new and controversial and mainly relies on animal and preclinical studies. 27

The challenge of developing a universal theory on the aetiology of autism, along with variations in the developmental trajectory are some of the factors that account for the wide range of interventions proposed to, and endorsed by, families of children with ASD. At times, families sometimes turn to interventions which lack empirical validity or have even been found to be harmful to the child development. 28

In recent years, dietary interventions including gluten-free or casein-free diets (GFCF) have received a significant amount of interest from parents and researchers alike. In Europe, according to one report, 13.5% of families of children with ASD 28 have tried this dietary restriction. The rationale for this approach appears to stem from the ‘Opioid-Excess Theory’, 20 , 29 according to which some individuals do not produce sufficient gluten- and casein-related digestive enzymes. Without enough of these enzymes, gluten and casein-related peptides do not get adequately metabolized and cross the brain–blood barrier. Symptoms of ASD are believed to be the result of these peptides attaching to opioid neuro-receptors, which in turn disrupts the central nervous system. However, support for this theory, the underlying mechanism, and method of treatment is limited.

The ScanBrit study 30 examined the effects of a GFCF diet in Danish children and found positive changes in symptom presentation following this intervention. However, there were several limitations to this study, including the lack of a placebo group and a high attrition rate. In contrast, two recent systematic reviews 31 , 32 have since shown no significant differences in symptom relief in children with ASD following a GFCF diet.

Dietary supplements are another popular nutritional approach considered by parents and caregivers of children with ASD. These include mineral supplementation (e.g. calcium, zinc, iron), as well as folic acid. Vitamin D supplementation has received significant attention because of its impact on neural developmental, anti-inflammatory properties and effects on detoxification pathways. However, evidence supporting dietary and vitamin D supplementation is again limited and inconsistent. 33 , 34

Hyperbaric oxygen

Hyperbaric oxygen therapy (HBOT) provides a higher concentration of oxygen by delivering oxygen to a chamber with elevated atmospheric pressure. The rationale for HBOT in individuals with autism includes its potential to heighten cerebral perfusion, reduce inflammation and oxidative stress. 35 Advocates of HBOT believe that improvements in these underlying pathophysiological mechanisms will lead to improvements in autistic symptoms. Evidence supporting its effectiveness in relieving symptoms of ASD is mixed at best. The few randomized controlled studies 36 that have been conducted have shown no evidence to support the benefit of HBOT in children with ASD, with some identifying adverse events in the hyperbaric oxygen group (minor-grade ear barotrauma). The United States Food and Drug Administration (USFDA) 37 has published a warning for parents cautioning them against the use of HBOT in treating symptoms of ASD.

Chelation therapy

Chelation therapy involves the administration of several chemical substances to bind and then remove specific metals from the person’s body. It is estimated that between 7% and 8% of children with ASD in the United States 38 and 1–3% of children with ASD in Europe 28 undergo this form of therapy. However, one randomized clinical trial comparing multiple doses of chelating agents have found no evidence to suggest that oral chelating agents had any effect on ASD symptomatology. 39 Moreover, serious adverse side effects have been reported including hypocalcaemia and impaired renal function in individuals undergoing chelation therapy.

Pharmacological treatments

Medications are sometime needed to treat the comorbid symptoms of irritability, aggression, and hyperactivity in individuals of ASD. The FDA has approved two atypical antipsychotic medications, risperidone and aripiprazole for this purpose. 40 , 41 Although evidence has suggested short-term improvements in the behaviour of children with ASD, long-term benefits and pros and cons of this strategy are still being debated.

SSRIs are also often prescribed to treat comorbid symptoms in ASD, but clinical trials have yet to demonstrate their effectiveness. A review of nine randomized controlled-trials assessed various SSRIs including fluoxetine and citalopram 42 but failed to show a positive result in symptoms reduction.

Autism is a clinical diagnosis, made on the presentation and history of the individual and in spite of a very active hunt for biomarkers, no laboratory test has been found. The literature on early diagnosis and treatment is in agreement that there is an inverse relationship between age at diagnosis and a positive prognosis, which makes early detection by health care providers critical. A 10-year study spanning from 2004 to 2014 examined diagnostic trends in the UK 43 and found no statistical change in improving early detection during this period, with the average age at diagnosis remaining at 55 months. This was despite parents noting their first concern about their child development much earlier than the time when the child was diagnosed with ASD.

The American Academy of Pediatrics 44 , 45 has recommended that paediatricians use autism screening tools, such as the Modified Checklist for Autism in Toddlers (M-CHAT) and the Social Communication Questionnaire (SCQ) at the 18 and 24-month check-up visits. A newer, improved two-step revision of the M-CHAT with Follow-up Interview (M-CHAT/F), has been developed, and is reliable and sensitive in identifying toddlers at high, medium and low risk for ASD. 46 Data are still lacking to determine if an early detection has in fact improved following its implementation.

Early detection has a positive impact on prognosis, in large part due to the fact that those children are able to benefit from early intervention. A substantial amount of scientific literature is derived from data looking at the efficacy of Applied Behaviour Analysis (ABA). ABA is an intensive treatment programme, developed in the 1960s, based on using learning principles, such as positive reinforcement to help children develop appropriate behaviours. Over the last five decades, there has been accruing evidence documenting the effectiveness of ABA in treating ASD. 47 There is also evidence that those children who received earlier and more intensive ABA therapy, were more likely to have a positive prognosis in later childhood and adulthood. 48

Biological markers or biomarkers are defined as ‘biological variables associated with the disease of interest and measurable directly in a given patient or his/her biomaterials using sensitive and reliable quantitative procedures’. 49 The identification of early biomarkers of autism is important as it can be used in providing earlier, more reliable diagnoses, and helps to predict prognosis and response to specific interventions.

As noted earlier, there is strong support for a hereditary component to the presentation of ASD with higher concordance rates of autism in monozygotic twins than dizygotic twins. Some studies are also finding higher rates in families with two or more children diagnosed with autism, with rates approaching 50% affected. However, to date, no consistent genetic variant has been identified. Moreover, given its varied clinical and behavioural manifestations, it has been estimated that there are over 500 distinct genetic variants that may be related to ASD, 50 which makes it difficult to identify the target genes accurately.

Neuroimaging

Head circumference and grey matter thickness is under investigation as a relevant diagnostic indicator, given findings of accelerated brain growth and brain size in ASD children. Whereas newer neuroimaging techniques have helped to elucidate findings on the pathophysiology of ASD, the current scientific evidence on the subject is not adequate to establish reliable neuroimaging biomarkers. 51

Eye tracking

One promising technique is using the eye-tracking technology under the assumption that infants and toddlers with ASD prefer geometric images as compared to social images. One such study 52 examined a subset of children with ASD who fixated on the geometric images and concluded that visual preference might potentially be used as an early indicator in identifying subtypes with more severe symptoms and likely negative prognosis.

A common feature of autism research is that studies mostly consist of small samples and do not portray the full heterogeneity that is present in ASD. Given the various pathophysiological pathways that have been proposed to account for the development of this disorder, it is doubtful that a single biomarker is responsible for ASD. Furthermore, the heterogeneous features of ASD mean that different ASD patients have different requirements when it comes to treatments and interventions.

One large scale investigation aiming to address this issue is the EU‑AIMS Longitudinal European Autism Project (LEAP). LEAP is a worldwide, multidisciplinary study 52 that will include ASD and control participants across childhood and into adulthood collecting data on genomics, prenatal environmental risk factors, magnetic resonance imaging (MRI), functional MRI (fMRI), electroencephalogram (EEG) and biochemical biomarkers. The study holds promise not only in its potential to identify markers of autism but also to provide clinicians with predictive value in determining symptom progress and treatment response, which will also open up the possibility of targeted treatments.

As noted earlier, while there is a strong hereditary component thought to be involved in the aetiology of autism, environmental factors are also believed to play a role in its development. Some of the processes thought to be involved includes metabolic processes such as oxidative stress, immune function and inflammation. These processes are believed to be derived from environmental influences such as the parent’s immune functioning, pollutants, diet and other risk factors as listed above. The gene–environment interaction has received less attention than basic genetics, but future research using a developmental framework and taking into account the interplay between genes and their environment represents yet another scientific approach.

ASD is a complex and heterogeneous neurodevelopmental disorder. In the last decades, there has been a steep rise in public awareness on ASD that has also coincided with a rise in prevalence. Whether the rising prevalence is a true reflection of an increase in rates of ASD or due to other confounding factors, these findings highlight the need for further research into ASD, particularly with regards to its aetiology, treatments and interventions. Evidence from biomarker studies offers promising insight into early identification and targeted treatments, but research is still in its infancy. Supporting and empowering families with children diagnosed with ASD and helping highlight their children’s strengths can also help make a difference in these families’ lives. 53

The authors have no potential conflicts of interest.

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Kočovská E , Fernell E , Billstedt E , et al.  . Vitamin D and autism: clinical review . Res Dev Disabil 2012 ; 33 : 1541 – 50 .

Ghanizadeh A . Hyperbaric oxygen therapy for treatment of children with autism: a systematic review of randomized trials . Med Gas Res 2012 ; 2 : 13 , doi:10.1186/2045-9912-2-13 .

Xiong T , Chen H , Luo R , et al.  . Hyperbaric oxygen therapy for people with autism spectrum disorder (ASD) . Cochrane Database Syst Rev 2016 ; 10:CD010922 .

Food and Drug Administration . Hyperbaric Oxygen Therapy: Don’t Be Misled . https://www.fda.gov/forconsumers/consumerupdates/ucm364687.htm (14 September 2017, date last accessed).

Brent J . Commentary on the abuse of metal chelation in patients with autism spectrum disorders . J Med Toxicol 2013 ; 13 : 370 – 2 .

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• biological markers
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• selective serotonin re-uptake inhibitors
• diagnostic and statistical manual
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• Autism spectrum disorder

Autism spectrum disorder is a condition related to brain development that impacts how a person perceives and socializes with others, causing problems in social interaction and communication. The disorder also includes limited and repetitive patterns of behavior. The term "spectrum" in autism spectrum disorder refers to the wide range of symptoms and severity.

Autism spectrum disorder includes conditions that were previously considered separate — autism, Asperger's syndrome, childhood disintegrative disorder and an unspecified form of pervasive developmental disorder. Some people still use the term "Asperger's syndrome," which is generally thought to be at the mild end of autism spectrum disorder.

Autism spectrum disorder begins in early childhood and eventually causes problems functioning in society — socially, in school and at work, for example. Often children show symptoms of autism within the first year. A small number of children appear to develop normally in the first year, and then go through a period of regression between 18 and 24 months of age when they develop autism symptoms.

While there is no cure for autism spectrum disorder, intensive, early treatment can make a big difference in the lives of many children.

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Some children show signs of autism spectrum disorder in early infancy, such as reduced eye contact, lack of response to their name or indifference to caregivers. Other children may develop normally for the first few months or years of life, but then suddenly become withdrawn or aggressive or lose language skills they've already acquired. Signs usually are seen by age 2 years.

Each child with autism spectrum disorder is likely to have a unique pattern of behavior and level of severity — from low functioning to high functioning.

Some children with autism spectrum disorder have difficulty learning, and some have signs of lower than normal intelligence. Other children with the disorder have normal to high intelligence — they learn quickly, yet have trouble communicating and applying what they know in everyday life and adjusting to social situations.

Because of the unique mixture of symptoms in each child, severity can sometimes be difficult to determine. It's generally based on the level of impairments and how they impact the ability to function.

Below are some common signs shown by people who have autism spectrum disorder.

Social communication and interaction

A child or adult with autism spectrum disorder may have problems with social interaction and communication skills, including any of these signs:

• Fails to respond to his or her name or appears not to hear you at times
• Resists cuddling and holding, and seems to prefer playing alone, retreating into his or her own world
• Has poor eye contact and lacks facial expression
• Doesn't speak or has delayed speech, or loses previous ability to say words or sentences
• Can't start a conversation or keep one going, or only starts one to make requests or label items
• Speaks with an abnormal tone or rhythm and may use a singsong voice or robot-like speech
• Repeats words or phrases verbatim, but doesn't understand how to use them
• Doesn't appear to understand simple questions or directions
• Doesn't express emotions or feelings and appears unaware of others' feelings
• Doesn't point at or bring objects to share interest
• Inappropriately approaches a social interaction by being passive, aggressive or disruptive
• Has difficulty recognizing nonverbal cues, such as interpreting other people's facial expressions, body postures or tone of voice

Patterns of behavior

A child or adult with autism spectrum disorder may have limited, repetitive patterns of behavior, interests or activities, including any of these signs:

• Performs repetitive movements, such as rocking, spinning or hand flapping
• Performs activities that could cause self-harm, such as biting or head-banging
• Develops specific routines or rituals and becomes disturbed at the slightest change
• Has problems with coordination or has odd movement patterns, such as clumsiness or walking on toes, and has odd, stiff or exaggerated body language
• Is fascinated by details of an object, such as the spinning wheels of a toy car, but doesn't understand the overall purpose or function of the object
• Is unusually sensitive to light, sound or touch, yet may be indifferent to pain or temperature
• Doesn't engage in imitative or make-believe play
• Fixates on an object or activity with abnormal intensity or focus
• Has specific food preferences, such as eating only a few foods, or refusing foods with a certain texture

As they mature, some children with autism spectrum disorder become more engaged with others and show fewer disturbances in behavior. Some, usually those with the least severe problems, eventually may lead normal or near-normal lives. Others, however, continue to have difficulty with language or social skills, and the teen years can bring worse behavioral and emotional problems.

When to see a doctor

Babies develop at their own pace, and many don't follow exact timelines found in some parenting books. But children with autism spectrum disorder usually show some signs of delayed development before age 2 years.

If you're concerned about your child's development or you suspect that your child may have autism spectrum disorder, discuss your concerns with your doctor. The symptoms associated with the disorder can also be linked with other developmental disorders.

Signs of autism spectrum disorder often appear early in development when there are obvious delays in language skills and social interactions. Your doctor may recommend developmental tests to identify if your child has delays in cognitive, language and social skills, if your child:

• Doesn't respond with a smile or happy expression by 6 months
• Doesn't mimic sounds or facial expressions by 9 months
• Doesn't babble or coo by 12 months
• Doesn't gesture — such as point or wave — by 14 months
• Doesn't say single words by 16 months
• Doesn't play "make-believe" or pretend by 18 months
• Doesn't say two-word phrases by 24 months
• Loses language skills or social skills at any age

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Autism spectrum disorder has no single known cause. Given the complexity of the disorder, and the fact that symptoms and severity vary, there are probably many causes. Both genetics and environment may play a role.

• Genetics. Several different genes appear to be involved in autism spectrum disorder. For some children, autism spectrum disorder can be associated with a genetic disorder, such as Rett syndrome or fragile X syndrome. For other children, genetic changes (mutations) may increase the risk of autism spectrum disorder. Still other genes may affect brain development or the way that brain cells communicate, or they may determine the severity of symptoms. Some genetic mutations seem to be inherited, while others occur spontaneously.
• Environmental factors. Researchers are currently exploring whether factors such as viral infections, medications or complications during pregnancy, or air pollutants play a role in triggering autism spectrum disorder.

No link between vaccines and autism spectrum disorder

One of the greatest controversies in autism spectrum disorder centers on whether a link exists between the disorder and childhood vaccines. Despite extensive research, no reliable study has shown a link between autism spectrum disorder and any vaccines. In fact, the original study that ignited the debate years ago has been retracted due to poor design and questionable research methods.

Avoiding childhood vaccinations can place your child and others in danger of catching and spreading serious diseases, including whooping cough (pertussis), measles or mumps.

Risk factors

The number of children diagnosed with autism spectrum disorder is rising. It's not clear whether this is due to better detection and reporting or a real increase in the number of cases, or both.

Autism spectrum disorder affects children of all races and nationalities, but certain factors increase a child's risk. These may include:

• Your child's sex. Boys are about four times more likely to develop autism spectrum disorder than girls are.
• Family history. Families who have one child with autism spectrum disorder have an increased risk of having another child with the disorder. It's also not uncommon for parents or relatives of a child with autism spectrum disorder to have minor problems with social or communication skills themselves or to engage in certain behaviors typical of the disorder.
• Other disorders. Children with certain medical conditions have a higher than normal risk of autism spectrum disorder or autism-like symptoms. Examples include fragile X syndrome, an inherited disorder that causes intellectual problems; tuberous sclerosis, a condition in which benign tumors develop in the brain; and Rett syndrome, a genetic condition occurring almost exclusively in girls, which causes slowing of head growth, intellectual disability and loss of purposeful hand use.
• Extremely preterm babies. Babies born before 26 weeks of gestation may have a greater risk of autism spectrum disorder.
• Parents' ages. There may be a connection between children born to older parents and autism spectrum disorder, but more research is necessary to establish this link.

Complications

Problems with social interactions, communication and behavior can lead to:

• Problems in school and with successful learning
• Employment problems
• Inability to live independently
• Social isolation
• Stress within the family
• Victimization and being bullied

More Information

• Autism spectrum disorder and digestive symptoms

There's no way to prevent autism spectrum disorder, but there are treatment options. Early diagnosis and intervention is most helpful and can improve behavior, skills and language development. However, intervention is helpful at any age. Though children usually don't outgrow autism spectrum disorder symptoms, they may learn to function well.

• Autism spectrum disorder (ASD). Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/autism/facts.html. Accessed April 4, 2017.
• Uno Y, et al. Early exposure to the combined measles-mumps-rubella vaccine and thimerosal-containing vaccines and risk of autism spectrum disorder. Vaccine. 2015;33:2511.
• Taylor LE, et al. Vaccines are not associated with autism: An evidence-based meta-analysis of case-control and cohort studies. Vaccine. 2014;32:3623.
• Weissman L, et al. Autism spectrum disorder in children and adolescents: Overview of management. https://www.uptodate.com/home. Accessed April 4, 2017.
• Autism spectrum disorder. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://dsm.psychiatryonline.org. Accessed April 4, 2017.
• Weissman L, et al. Autism spectrum disorder in children and adolescents: Complementary and alternative therapies. https://www.uptodate.com/home. Accessed April 4, 2017.
• Augustyn M. Autism spectrum disorder: Terminology, epidemiology, and pathogenesis. https://www.uptodate.com/home. Accessed April 4, 2017.
• Bridgemohan C. Autism spectrum disorder: Surveillance and screening in primary care. https://www.uptodate.com/home. Accessed April 4, 2017.
• Levy SE, et al. Complementary and alternative medicine treatments for children with autism spectrum disorder. Child and Adolescent Psychiatric Clinics of North America. 2015;24:117.
• Brondino N, et al. Complementary and alternative therapies for autism spectrum disorder. Evidence-Based Complementary and Alternative Medicine. http://dx.doi.org/10.1155/2015/258589. Accessed April 4, 2017.
• Volkmar F, et al. Practice parameter for the assessment and treatment of children and adolescents with autism spectrum disorder. Journal of the American Academy of Child and Adolescent Psychiatry. 2014;53:237.
• Autism spectrum disorder (ASD). Eunice Kennedy Shriver National Institute of Child Health and Human Development. https://www.nichd.nih.gov/health/topics/autism/Pages/default.aspx. Accessed April 4, 2017.
• American Academy of Pediatrics policy statement: Sensory integration therapies for children with developmental and behavioral disorders. Pediatrics. 2012;129:1186.
• James S, et al. Chelation for autism spectrum disorder (ASD). Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD010766.pub2/abstract;jsessionid=9467860F2028507DFC5B69615F622F78.f04t02. Accessed April 4, 2017.
• Van Schalkwyk GI, et al. Autism spectrum disorders: Challenges and opportunities for transition to adulthood. Child and Adolescent Psychiatric Clinics of North America. 2017;26:329.
• Autism. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed April 4, 2017.
• Autism: Beware of potentially dangerous therapies and products. U.S. Food and Drug Administration. https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm394757.htm?source=govdelivery&utm_medium=email&utm_source=govdelivery. Accessed May 19, 2017.
• Drutz JE. Autism spectrum disorder and chronic disease: No evidence for vaccines or thimerosal as a contributing factor. https://www.uptodate.com/home. Accessed May 19, 2017.
• Weissman L, et al. Autism spectrum disorder in children and adolescents: Behavioral and educational interventions. https://www.uptodate.com/home. Accessed May 19, 2017.
• Huebner AR (expert opinion). Mayo Clinic, Rochester, Minn. June 7, 2017.

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Home — Essay Samples — Nursing & Health — Autism — Why Autism Awareness is Important

Why Autism Awareness is Important

• Categories: Autism Psychological Disorders

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Autism Spectrum Disorder

Autism spectrum disorder (ASD) is a developmental and neurological disability that describes a constellation of early-appearing and repetitive sensory-motor behaviours and social communication deficits caused by differences in the brain. Individuals with ASD have different ways of paying attention, moving and learning. Autism spectrum disorder (ASD) is associated with a strong genetic component but can also be caused by other factors, and the symptoms can appear as early as two years. According to  the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) , people with ASD often have symptoms that affect their ability to function in work, school, and other areas of their lives, repetitive behaviors and restricted interests, difficulties interacting with people and communication.  The outlook of ASD today is different compared to the past as the people suffering from the condition can live, read and speak comfortably after therapy and training while becoming free from the symptoms. Various studies about ASD have been conducted, and their findings have been significant in the clinical diagnosis and treatment of the disorder.

According to Hodges et al. (2020), clinical diagnosis of ASD involves a ‘gold standard to assess behavioural, historical, and parent-report information to determine the diagnosis. In DSM-5, the clinical diagnosis of ASD must follow a criterion whereby the symptoms must be present in the early developmental period. Nonetheless, all signs and symptoms of ASD might not manifest until social demands exceed limited capacities (Hodges et al., 2020). Another symptom that can help in the clinical diagnosis of ASD is the unusual interest in sensory aspects of the environment or the hyper- or hypo reactivity to sensory input, fixated and hyper restricted interests that are not normal in focus or intensity (Hodges et al., 2020). Young et al., (2018), includes that clinical diagnosis involves other signs and symptoms such as ritualized patterns of verbal or nonverbal behaviour, inflexible adherence to routines, Insistence on sameness, repetitive and stereotyped speech, use of objects and motor movements. In other words, any healthcare provider should establish whether the patient lacks social and emotional reciprocity, failure to develop peer relationships appropriate at their current stage of development when clinically diagnosing ASD. The body gesture and postures, facial expressions, and eye-to-eye gaze should also give the clinician a hint when diagnosing ASD.

ASD is associated with speech-language effects/impacts whereby the patient experiences delay in speech development language. In particular, autistic patients especially children experience challenges and difficulties in understanding spoken language. Vogindroukas et al. (2022) argues that some children suffering from ASD experience challenges across diverse language sub-systems including morphology, phonology, syntax, semantics, grammar, and pragmatics in written and oral languages while can demonstrate exceptional language abilities like linguistic creativity. All these assertions have been supported by Reindal et al. (2021) who elaborates that pragmatic language impairments are common in neurodevelopmental disorders such as ASD. Nonetheless, language and speech impairment vary depending on other developmental domains, the intellectual level of the patient, and an individual’s age of a child thus any healthcare provider in charge of such patients should consider those factors when intervening for any ASD patient (Reindal et al., 2021; Vogindroukas et al., 2022). Intervention for ASD patients may involve the development of programs that help the autistic children in developing spoken language and understanding communication through writing, gestures, facial expressions, eye contact and speech.

Crowe et al. (2021) conducted meta-analyses, systematic reviews, and mega-review of literature reviews to evaluate the effectiveness of using augmentative and alternative communicating (AAC) interventions for children suffering from ASD and found that the devices can be an important support for helping ASD patients with communication challenges. In particular, the AAC technology, with built-in speech generating capacity helps the child to understand what is being said and used by the child to express their thoughts. other benefits of using the AAC devices include increasing the quality of work in school and general life, literacy development, augment communication, language development and improves speech or the AAC users (Crowe et al., 2021). The AAC devices can be used to help in developmental skills like pragmatic skills, syntax, length of sentences and vocabulary because it is adaptable and personalized.

Autism affects other areas of a child’s development. Kiani et al., 2019; Lyall et al., 2017& Ratcliffe et al., 2015) concluded that autism affects a child’s cognitive ability, skills and strengths like execution of motor of fine and gross motor skills, memorizing vast amounts of information, attention to detail and theory of mind because of the delay in mental development compared to other children. On the flip side, Rai et al. (2018) conducted a population-based cohort study of 223 842 participants with a nested sibling comparison, individuals with autism spectrum disorders, particularly those without intellectual disability to establish whether they were prone to cognitive challenges in future. According to the study’s result, most patients who suffer from ASD are likely to develop mental challenges such as anxiety and depression in future because of the cognitive impairment and developmental challenges associated with the condition.

In addition to the cognitive challenges, autism is connected to social and emotional impacts on the life of a child. Jahromi et al. (2021) outlines that children with autism have a difficult time recognizing and regulating emotions. It is daunting for them to make responsible decisions and have social awareness. Consequently, social emotional learning (SEL) is the only way that can help children with autism to build social relationships and develop an awareness of emotions. Some of the students face challenges with academics thus they drop out of school early. The assertion has been suported by Dijkhuis et al. (2020) who explains that most autism spectrum disorders (ASDs) students attending higher education drop out prematurely because they cannot catchup with the other students. Another reason causing the students to drop out of school is because of the premature development in working memory and mental flexibility which slows their ability to execute mental functioning and cognitive based performances.

Lastly, the health characteristics associated with ASD are divided into two categories, namely restricted or repetitive behaviours or interests and social communication and interaction skills. Examples of social communication and social interaction characteristics include failure to play simple interactive games, not showing any facial interactions, not responding to names by 9 months of age, and avoiding eye contact. Other characteristics are having obsessive interests, getting upset about minor changes, continuous reputation of words and phrases.

Autism spectrum disorder (ASD) is a condition that affects the neurological and cognitive development of a child thus delaying their growth in diverse ways. In particular, patients diagnosed with ASD have challenges with communication, execution of cognitive functions; fine and motor skills thus they show different ways of paying attention, moving and learning. Genetics are thought to be one of the main causation factors for ASD even though there are other factors that lead to the development of ASD. Studies show that using augmentative and alternative communication (AAC) interventions for children suffering from ASD can help ASD patients with communication challenges. In particular, children who use the AAC devices tend to communicate better and have a normal social life with the people.

Crowe, B., Machalicek, W., Wei, Q., Drew, C., & Ganz, J. (2021). Augmentative and alternative communication for children with intellectual and developmental disability: A mega-review of the literature.  Journal of Developmental and Physical Disabilities , 1-42.

Dijkhuis, R., de Sonneville, L., Ziermans, T., Staal, W., & Swaab, H. (2020). Autism symptoms, executive functioning and academic progress in higher education students.  Journal of Autism and Developmental Disorders ,  50 (4), 1353-1363.

Hodges, H., Falko, C., & Soares, N. (2020). Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation. Translational pediatrics, 9(Suppl 1), S55.

Jahromi, L. B., Kirkman, K. S., Friedman, M. A., & Nunnally, A. D. (2021). Associations between emotional competence and prosocial behaviors with peers among children with autism spectrum disorder.  American journal on intellectual and developmental disabilities ,  126 (2), 79-96.

Kiani, R., Bhaumik, S., Tyrer, F., Bankart, J., Miller, H., Cooper, S. A., & Brugha, T. S. (2019). The relationship between symptoms of autism spectrum disorder and visual impairment among adults with intellectual disability.  Autism Research ,  12 (9), 1411-1422.

Lyall, K., Croen, L. A., Sjödin, A., Yoshida, C. K., Zerbo, O., Kharrazi, M., & Windham, G. C. (2017). Polychlorinated biphenyl and organochlorine pesticide concentrations in maternal mid-pregnancy serum samples: association with autism spectrum disorder and intellectual disability.  Environmental health perspectives ,  125 (3), 474-480.

Ratcliffe, B., Wong, M., Dossetor, D., & Hayes, S. (2015). The association between social skills and mental health in school-aged children with autism spectrum disorder, with and without intellectual disability.  Journal of autism and developmental disorders ,  45 (8), 2487-2496.

Rai, D., Heuvelman, H., Dalman, C., Culpin, I., Lundberg, M., Carpenter, P., & Magnusson, C. (2018). Association between autism spectrum disorders with or without intellectual disability and depression in young adulthood.  JAMA network open ,  1 (4), e181465-e181465.

Reindal, L., Nærland, T., Weidle, B., Lydersen, S., Andreassen, O. A., & Sund, A. M. (2021). Structural and pragmatic language impairments in children evaluated for autism spectrum disorder (ASD).  Journal of Autism and Developmental Disorders , 1-19.

Young, H., Oreve, M. J., & Speranza, M. (2018). Clinical characteristics and problems diagnosing autism spectrum disorder in girls.  Archives de Pédiatrie ,  25 (6), 399-403.

Vogindroukas, I., Stankova, M., Chelas, E. N., & Proedrou, A. (2022). Language and speech characteristics in Autism.  Neuropsychiatric Disease and Treatment ,  18 , 2367-2377.

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• Published: 28 May 2021

Advances in autism research, 2021: continuing to decipher the secrets of autism

• Julio Licinio   ORCID: orcid.org/0000-0001-6905-5884 1 &
• Ma-Li Wong 1  

Molecular Psychiatry volume  26 ,  pages 1426–1428 ( 2021 ) Cite this article

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• Autism spectrum disorders
• Neuroscience

We are proud to publish this Special Issue focused on autism, a topic that has been exceedingly important for Molecular Psychiatry since our inception. It is not too bold a statement to say that we were a fundamental contributor to bringing autism to the forefront of the national discourse. A Pubmed search reveals 403 articles published in Molecular Psychiatry since our founding in 1996. Our first autism article by Vincent et al., published in July 1996, examined the fragile X syndrome gene (FMR1) for mutations in autistic individuals, using single-stranded conformational polymorphism analysis; those authors identified three new FMR1 polymorphisms and identified specific and significant association findings with autism [ 1 ].

In late 2001–early 2002 we received four exciting papers with findings on the genetics of autism that were published together in our March 2002 issue, with an accompanying editorial [ 2 , 3 , 4 , 5 , 6 ]. We issued then a press release that was picked up by Time magazine and served as the basis for their unprecedented May 6, 2002 cover story on autism, featuring as that iconic magazine’s cover a young boy who was visibly autistic [ 7 ]. That was the first time that a person with autism was the cover of a national magazine. The magazine’s cover displayed in big yellow letters “Inside the world of autism” and it had a subtitle stating “More than one million Americans may have it, and the number of new cases is exploding. What scientists have discovered. What families should know.” The full story, by Nash [ 8 ], was entitled: “The Secrets of Autism,” with the following subtitle: “The number of children diagnosed with autism and Asperger’s in the U.S. is exploding. Why?” Time ’s cover article was so successful that their editors expanded that from a single issue into an entire series on autism over multiple issues. That Time series effectively made autism emerge as a mainstream topic of kitchen table conversations across America. As that effort was triggered by our press release and four articles on autism, it is reasonable to boast that Molecular Psychiatry launched the national conversation on autism.

The four papers highlighted in our March 2002 issue were within the first 20 articles that we published on this topic. Now, 383 papers later, we have a much more substantial body of work that further unravels the secrets of autism, the culmination of which is this autism Special Issue, with 26 truly superb papers on autism [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 ]. These extraordinary articles cover essentially all aspects of this disorder, from the training of specialists, to the interface with other disorders, such as polycystic ovarian syndrome and Alzheimer’s disease, and in-depth analyses of genetics, structural and functional imaging, as well as neuroscience, including postmortem brain studies, transcriptome of induced pluripotent stem cell models, assessments of the role of vitamin D, and studies highlighting the contributions of inflammatory mediators to autism.

We have had for over three decades a particular interest on the interface of immune mediators and psychiatric disorders [ 35 ]. It is very rewarding to see the interface of immune mediators and psychiatry evolve from a hypothesis, that we and others explored decades ago, into a broad and established area within psychiatric neuroscience. As we have developed a new model of analysis of the simultaneous contributions of multiple genes and environmental factors to a psychiatric phenotype [ 36 ], were also encouraged to see studies looking at the polygenic risk for autism in the context of childhood trauma, life-time self-harm, and suicidal behavior and ideation [ 30 ], as well in comparison to several other psychiatric disorders [ 32 ].

One paper in this issue, by Frye et al., is highly usual, and particularly intriguing: it investigates the role of the mitochondrion, in the influence of prenatal air pollution exposure on neurodevelopment and behavior in 96 children with autism spectrum disorder [ 22 ]. Second and third trimester average and maximal daily exposure to fine air particulate matter of diameter ≤2.5 µm (PM 2.5 ) was obtained from the Environmental Protection Agency’s Air Quality System. Mediation analysis found that mitochondrial respiration linked to energy production accounted for 25% and 10% of the effect of average prenatal PM 2.5 exposure on neurodevelopment and behavioral symptoms, respectively. Those results suggest that prenatal exposure to PM 2.5 disrupts neurodevelopment and behavior through complex mechanisms, including long-term changes in mitochondrial respiration and that patterns of early development need to be considered when studying the influence of environmental agents on neurodevelopmental outcomes.

We are honored to have initiated the national conversation on autism twenty years ago and we believe that the 403 autism papers published to date in Molecular Psychiatry , including, but not limited to those highlighted in this Special Issue, report major advances in a key area of molecular psychiatry. It is particularly rewarding to see that these articles cover the full spectrum of research translation [ 37 ], from molecules to society.

In future issues, Molecular Psychiatry will continue to publish outstanding advances in autism research.

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Licinio, J., Wong, ML. Advances in autism research, 2021: continuing to decipher the secrets of autism. Mol Psychiatry 26 , 1426–1428 (2021). https://doi.org/10.1038/s41380-021-01168-0

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The Development of Expressive Language of Autism Spectrum Disorder Students from Their Teachers' Perspective

• Maryam Bazuhair
• Published in Proceedings of The… 5 August 2024
• Education, Psychology
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“It’s not just the focus in the first 10 pieces,” the owner said. “It’s being able to maintain that kind of a focus when you’re doing No. 400 and No. 401.”

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Reporting from Mesa, Ariz.

As part of his interview for a job at FTS American Manufacturing in Mesa, Max Cain was asked to take a table clock apart and then put it back together.

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Not every person on the autism spectrum would make a good watch technician, Mr. Naik said. But, “there’s a sliver that really identifies well with the work we do,” he continued, because they can concentrate on a task for a long period of time.

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A multi-model approach defines function altering MECP2 missense variants identified in individuals with autism spectrum disorder

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MECP2 is commonly mutated in Rett syndrome, where MECP2s function as a DNA cytosine methylation reader is believed critical. MECP2 variants are also catalogued in individuals with autism spectrum disorder (ASD), including nine missense variants with no known clinical significance. To assess these nine as risk alleles for ASD, we developed MECP2 variant function assays using yeast, Drosophila and human cell lines. We calibrated these assays with known reference pathogenic and benign variants. Our data predict that four ASD variants are loss of function (LoF) and five are functional. Protein destabilization or nuclear delocalization offers insight into the altered function of a number of these variants. Notably, yeast and Drosophila lack DNA methylation, yet all Rett reference pathogenic and ASD variants in the methyl DNA binding domain that we analyzed proved to be LoF, suggesting a clinically-relevant role for non-methyl DNA-binding by MECP2.

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Camussi, D.; Naef, V.; Brogi, L.; Della Vecchia, S.; Marchese, M.; Nicoletti, F.; Santorelli, F.M.; Licitra, R. Delving into the Complexity of Valproate-Induced Autism Spectrum Disorder: The Use of Zebrafish Models. Cells 2024 , 13 , 1349. https://doi.org/10.3390/cells13161349

Camussi D, Naef V, Brogi L, Della Vecchia S, Marchese M, Nicoletti F, Santorelli FM, Licitra R. Delving into the Complexity of Valproate-Induced Autism Spectrum Disorder: The Use of Zebrafish Models. Cells . 2024; 13(16):1349. https://doi.org/10.3390/cells13161349

Camussi, Diletta, Valentina Naef, Letizia Brogi, Stefania Della Vecchia, Maria Marchese, Ferdinando Nicoletti, Filippo M. Santorelli, and Rosario Licitra. 2024. "Delving into the Complexity of Valproate-Induced Autism Spectrum Disorder: The Use of Zebrafish Models" Cells 13, no. 16: 1349. https://doi.org/10.3390/cells13161349

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