Autism. It's such a scary word — and a poorly understood one. No parent wants to even think about the possibility that their child might be autistic because the idea is so terrifying.
But because autism, a developmental disorder of the brain, is so poorly understood, most people don't know the signs. This means that most children aren't diagnosed until the elementary school years, even though signs of autism typically appear before age 3. The late diagnosis means valuable time is lost before treatment begins.
So, the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) have launched the Act Early Campaign. the campaign teaches parents and caregivers the early signs of autism so they can get children help as early as possible.
Autism is one of a group of developmental problems that doctors call Autism Spectrum Disorders (ASD). The CDC estimates that between 1 in 100 and 1 in 300, with an average of 1 in 150, children in the United States have an ASD. The numbers are rising, too. Doctors aren’t sure if it’s because there are really more cases of autism or because people are getting better at diagnosing it. Both may be true.
We don't yet know what causes autism. There are probably many factors, including genetics and the environment, that work together in different ways in each person who is affected.
Doctors use the word "spectrum" in the name for autism disorders because no two people with autism are alike, and problems can range from mild to severe. There are three different kinds of ASD: autistic disorder, Asperger's syndrome and pervasive developmental disorder.
People with an ASD tend to have problems in three areas:
The best way to truly know if a child has an ASD such as autism is through a careful and thorough medical, neurological, and developmental examination by an experienced doctor or team of professionals.
The first step, though, is for parents and caregivers to be watchful for early signs of developmental problems by learning about normal development. This is the major theme of the Act Early campaign, which offers an interactive tool on its Web site that lists important developmental milestones for children ages 3 months to 5 years. For example, a 2-year-old should:
If the parent or caregiver of a 2-year-old notices that he or she isn't doing all of these things, they should call their doctor for an evaluation. The child may not have an ASD. But any time children aren't meeting milestones, they deserve a closer look.
Right now, there is no cure for an ASD and no one treatment approach that is right for every person. However, there are many ways to help people with ASDs.
Experts agree that the earlier a child is identified, the better. They also agree that a structured program that specializes in ASDs can make a difference for many. The most widely accepted — and best studied — form of treatment is "behavioral management," in which desirable behaviors (such as better communication and social interactions) are reinforced and less desirable ones (such as tantrums or repetitive behaviors) are reduced. The best programs teach children communication and social skills using simple steps and lots of positive reinforcement, and get parents involved.
There are other treatment approaches as well, including diets and medications. Some of these have been studied more than others. The Autism Society of America and the National Institute for Mental Health (NIMH) suggest that parents evaluate any possible treatment option or program very carefully by asking lots of questions.
With treatment, patience and love, people with ASDs can lead happy, meaningful lives. The sooner we stop letting the word "autism" scare us and educate ourselves about the signs of an ASD, the sooner we can make a difference.
Claire McCarthy, M.D., is an assistant professor in pediatrics at Harvard Medical School, an attending physician at Children's Hospital of Boston, and medical director of the Martha Eliot Health Center, a neighborhood health service of Children's Hospital. She is a senior medical editor for Harvard Health Publications.