What Is Autism Spectrum Disorder (ASD)?

Level 1: Requiring Support 

• Noticeable difficulties in social communication and interaction
• Difficulty in initiating social interactions and maintaining a back-and-forth conversation, and a tendency to offer responses that others find unusual or unexpected when others try to engage
• Inflexibility in behavior or difficulty coping with change
• Frustration or distress when asked to switch between activities

Level 2: Requiring Substantial Support 

• Noticeable challenges in both verbal and nonverbal communication
• Limited interest in or ability to initiate social interactions; responses that are minimal, unusual, or unexpected
• Inflexibility in behavior or difficulty coping with change
• Intense focus on a restricted set of interests
• Repetitive behaviors that are frequent enough to be noticeable to casual observers and often interfere with their ability to manage daily activities in various settings

Level 3: Requiring Very Substantial Support 

• Severe difficulties in verbal and nonverbal communication skills that cause significant challenges with daily life or major problems in daily functioning
• Very limited initiation of social interactions and minimal response to others; nonverbal or have very few words that others can easily understand
• Extreme inflexibility of behavior and intense difficulty coping with change
• A restricted set of interests or repetitive behaviors that significantly interfere with their ability to function

• Making limited eye contact or none at all
• Not responding to their name or making facial expressions to show different emotions by 9 months old
• Uses few to no gestures, such as waving hello or goodbye, by age 1
• Doesn’t share interests, such as showing you an object they like, by 15 months
• Doesn’t point to things that interest them by 18 months
• Doesn’t pick up on others’ upset or hurt feelings by age 2
• Doesn’t play “pretend” (such as imagining they’re a superhero) by age 4
• Doesn’t act, dance, or sing for you by age 5

• Delayed, limited, or no speech
• Seemingly limited awareness of their surroundings; for example, doesn’t respond when their name is called
• Speaks in an accent others find unusual, speaks very quickly or slowly, or has differences in intonation (such as sounding monotone)
• Difficulty judging pauses or turn-taking in conversations
• Talks extensively about their own interests, but doesn’t ask much about others’ interests
• Is more honest or direct in conversation than others expect (rather than telling a “polite lie,” for example)
• Has challenges in recognizing or interpreting the emotions and perspectives of others, or finds it hard to express their own feelings in conventional ways
• Difficulty judging whether someone is joking in a friendly way or trying to bully them
• Repeats words or phrases they’ve heard (echolalia), sometimes without immediate relevance to the conversation
• Engages in repetitive physical movements, like hand-flapping, rocking, or spinning (also known as stimming)
• Has sensory processing issues; is either more or less sensitive than others to particular sounds, lights, textures, smells, or tastes
• Loses skills they once had, such as previously acquired speech or social skills (known as regression)

• A sibling with ASD
• Older parents
• Certain genetic conditions, including fragile X syndrome, Down syndrome, or Rett syndrome
• A very low birth weight
• Premature birth (before 26 weeks of pregnancy)
• Male sex (ASD is diagnosed more often in boys than girls)

Treatment for autism typically includes a combination of behavioral therapies, dietary approaches, medications, and complementary and alternative medicine approaches that best meet the needs of the individual.

There are no medications that cure autism — or make all its symptoms disappear. In some instances, however, medications can help someone manage the disorder and improve symptoms that can co-occur with autism.

Behavioral and Developmental Therapies 

A big part of support for people with ASD is therapy to help them learn new skills and manage challenges in their daily lives. Some of the most common and well-researched approaches include:

• Applied behavior analysis (ABA): ABA uses positive reinforcement to teach important skills and reduce challenging behaviors. The goal is to improve social, communication, and learning skills.

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• Speech and language therapy: Many people with ASD struggle with communication, whether that involves understanding others or expressing themselves. Speech therapists can help your child build and improve communication skills, whether through speech, gestures, signs, pictures, or electronic communication devices.

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• Occupational therapy: This form of therapy helps people with ASD learn skills so they can live as independently as possible, such as how to eat, bathe, dress, and interact with others. It may involve sensory integration therapy, which helps people with sensory processing issues, as well as physical therapy, which helps improve physical skills some people with ASD may struggle with, like movements of the body, torso, or fingers.

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Educational Therapies

Educational Support and Services

• Individuals With Disabilities Education Act (IDEA) This law ensures that eligible children with disabilities receive a Free Appropriate Public Education (FAPE). This means public schools must provide special education and related services to meet a child’s unique needs at no cost to the parents.

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• Individual Family Services Plan (IFSP) For eligible children with disabilities under age 3, IDEA requires early intervention services through an IFSP, which outlines the services a child will receive. It focuses on the infant or toddler’s needs, as well as the needs and concerns of other family members regarding the child.

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• Individualized Education Program (IEP) If a school-age child is found eligible for special education services under IDEA, a team including the parents, teachers, specialists, and sometimes the student develops an IEP. This is a legally binding document that outlines the child’s learning goals and the services the school will provide.

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Medication Options 

• Antipsychotics Antipsychotic medications may help reduce irritability, aggression, hyperactivity, or withdrawal among people with ASD. Risperidone and aripiprazole are approved by the U.S. Food and Drug Administration (FDA) for these symptoms in people with ASD.
• Antidepressants Some doctors may recommend antidepressants called selective serotonin reuptake inhibitors (SSRIs) for managing anxiety, repetitive behaviors, aggression, irritability, or tantrums, as well as improving eye contact. Another type of antidepressant, called tricyclic antidepressants, may be helpful for managing depressive symptoms or obsessive-compulsive tendencies.
• Anti-Anxiety Medication These medications may help manage anxiety or panic disorders, a common co-occurring condition in people with ASD.
• Stimulants Doctors may prescribe stimulant medication to help reduce symptoms of hyperactivity, improve focus, or manage executive function issues, especially among people with mild symptoms of ASD.
• Anticonvulsants If the person with ASD also has seizures, their doctor may prescribe anticonvulsant (or anti-seizure) medications to manage them. About one-third of people with ASD have seizures, epilepsy, or another seizure disorder.

Complementary and Integrative Therapies 

• Melatonin: Some research suggests that melatonin may help with insomnia, a common issue for people with ASD, but more research is needed to confirm this.

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• Music or art therapy: Some people with ASD may find therapies like music or art therapy beneficial. These approaches can offer ways to express feelings, improve social interaction in a therapeutic setting, boost self-esteem, or alleviate anxiety.

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• Exercise: Physical activity can help support overall health, as well as improve self-esteem and social interaction, which in turn helps boost language development.

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• Setting a sleep schedule and sticking to it: Sleep disturbances are very common in people with ASD.

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  Healthy sleep habits and naps when necessary can help.
• Maintaining a balanced diet: While no specific diet “treats” ASD, maintaining a balanced diet with a wide variety of nutritious foods can help support overall health.

• Difficulties with school and learning
• Challenges in finding and maintaining employment
• Social isolation
• Increased stress within the family
• Higher risk of being bullied or victimized

• Sleep disorders
• Gastrointestinal and immune function disorders
• Epilepsy
• Anxiety
• Depression
• ADHD
• Disruptive, aggressive, or self-injurious behaviors

The Takeaway 

• ASD is a lifelong neurodevelopmental condition, and its symptoms and severity vary from person to person.
• If you think you or your child has symptoms of autism, reach out to a professional such as a psychiatrist or neurologist for an evaluation.
• There’s no cure for ASD, but many evidence-based treatments can help people manage symptoms, develop essential life skills, and have a better quality of life.
• Early diagnosis and intervention can make a significant difference in the outlook of ASD.