Most parents of ASD children suspect that something is wrong by the time the child is 18 months old and seek help by the time the child is age 2. Children with ASD typically have problems in:

• Pretend play
• Social interactions
• Verbal and nonverbal communication

Some children seem normal before age 1 or 2 and then suddenly regress and lose language or social skills they had previously gained.

Symptoms can vary from moderate to severe.

A person with autism may:

• Be overly sensitive in sight, hearing, touch, smell, or taste (for example, they may refuse to wear “itchy” clothes and become distressed if they are forced to wear the clothes)
• Be very distressed when routines are changed
• Perform repeated body movements
• Show unusual attachments to objects

Communication problems may include:

• Cannot start or maintain a social conversation
• Communicates with gestures instead of words
• Develops language slowly or not at all
• Does not adjust gaze to look at objects that others are looking at
• Does not refer to self correctly (for example, says “you want water” when the child means “I want water”)
• Does not point to direct others’ attention to objects (normally occurs in the first 14 months of life)
• Repeats words or memorized passages, such as commercials

Social interaction:

• Does not make friends
• Does not play interactive games
• Is withdrawn
• May not respond to eye contact or smiles, or may avoid eye contact
• May treat others as if they are objects
• Prefers to spend time alone, rather than with others
• Shows a lack of empathy

Response to sensory information:

•  Does not startle at loud noises
• Has heightened or low senses of sight, hearing, touch, smell, or taste
• May find normal noises painful and hold hands over ears
• May withdraw from physical contact because it is overstimulating or overwhelming
• Rubs surfaces, mouths or licks objects
• Seems to have a heightened or low response to pain

Play:

• Does not imitate the actions of others
• Prefers solitary or ritualistic play
• Shows little pretend or imaginative play

Behaviors:

• Acts up with intense tantrums
• Gets stuck on a single topic or task
• Has a short attention span
• Has very narrow interests
• Is overactive or very passive
• Shows aggression to others or self
• Shows a strong need for sameness
• Uses repetitive body movements

Treatment :

At this time, there is no cure for ASD. An early, intensive, appropriate treatment program will greatly improve the outlook for most young children with ASD. Most programs build on the interests of the child in a highly structured schedule of constructive activities.

The best treatment plan may use a combination of techniques, including:

• Applied behavior analysis (ABA)
• Medications
• Occupational therapy
• Physical therapy
• Speech-language therapy

APPLIED BEHAVIORAL ANALYSIS (ABA)

This program is for younger children. It can be effective in some cases. ABA uses one-on-one teaching that reinforces the practice of various skills. The goal is to get the child close to normal developmental functioning.

ABA programs are usually done in a child’s home under the supervision of a behavioral psychologist. These programs can be very expensive and have not been widely adopted by school systems. Parents often must seek funding and staffing from other sources, which can be hard to find in many communities.

TEACCH

Another program is called the Treatment and Education of Autistic and Related Communication Handicapped Children (TEACCH). TEACCH was developed as a statewide program in North Carolina. It uses picture schedules and other visual cues that help the child work independently and organize and structure their environments.

Though TEACCH tries to improve a child’s adaptation and skills, it also accepts the problems associated with ASD. Unlike ABA programs, TEACCH programs do not expect children to achieve typical development with treatment.

MEDICINE

There is no medicine that treats ASD itself. But medicines are often used to treat behavior or emotional problems that people with ASD may have, including:

• Aggression
• Anxiety
• Attention problems
• Extreme compulsions that the child cannot stop
• Hyperactivity
• Impulsiveness
• Irritability
• Mood swings
• Outbursts
• Sleep difficulty
• Tantrums

Currently, only risperidone is approved to treat children ages 5 through 16 for the irritability and aggression that can occur with ASD. Other medicines that may also be used include mood stabilizers and stimulants.

DIET

Some children with ASD appear to respond to a gluten-free or casein-free diet. Gluten is found in foods containing wheat, rye, and barley. Casein is found in milk, cheese, and other dairy products. Not all experts agree that dietary changes will make a difference, and not all studies of this method have shown positive results.

If you are considering these or other dietary changes, talk to both a doctor who specializes in the digestive system (gastroenterologist) and a registered dietitian. You want to be sure that the child is still receiving enough calories, nutrients, and a balanced diet.

OTHER APPROACHES :

Beware that there are widely publicized treatments for ASD that do not have scientific support, and reports of miracle cures that do not live up to expectations. If your child has ASD, it may be helpful to talk with other parents of children with ASD and ASD specialists. Follow the progress of research in this area, which is rapidly developing.