The statistics speak for themselves. Autism Spectrum Disorder (ASD) affects 1 in 110 children nationwide and 1 in 94 children in New Jersey. But what exactly is a spectrum disorder? The National Institute of Mental Health describes ASD as a group of developmental brain disorders, with a range of symptoms and levels of disability. The most common of those symptoms are social impairment, difficulty with communication and certain repetitive behaviors.
"Autism is a neurological disorder in which individuals have difficulty expressing themselves and interacting with others in ways most of us take for granted," Suzanne Buchanan, Psy.D., clinical director of Autism New Jersey, explains. "Individuals on the autism spectrum can be mildly to severely affected by social, communication and behavioral challenges."
Sometimes called pervasive developmental disorders, or PDDS, there are five distinct disorders involved. Those include the two most common: autistic disorder, or classic autism, and Asperger's syndrome. In addition to autism and Asperger's, there are three other disorders on the spectrum. Those are pervasive developmental disorder not otherwise specified, Rett syndrome and childhood disintegrative disorder (CDD).
Unlike autism and Asperger's syndrome, the other three disorders on the spectrum are less common. Rett syndrome, which is seen more often in girls, affects only 1 in every 10,000 to 22,000 girls. CDD is even rarer, affecting only 1 or 2 out of 100,000 children. Both of those disorders include a regression in development.
Children whose symptoms place them somewhere on the spectrum but who do not fit a specific category are said to have pervasive developmental disorder not otherwise specified. In all five disorders, the symptoms are quite similar and a diagnosis must be made by a professional.
Whether children are mildly or severely impaired by their symptoms, early intervention is extremely important. Sometimes people will minimize the first signs of ASD, assuming children will catch up in their development. But the earlier the diagnosis, the better the chances for reducing, or even preventing, some of the more severe disabilities associated with a spectrum disorder.
The American Academy of Pediatrics recommends well-child screenings at 18 and 24 months. They should include a developmental screening test with a specific screening for ASD. A screening is not a diagnosis, but rather a tool that will either reassure parents or help them recognize the need for early interventions. There are a number of screening methods that might be used, including Checklist of Autism in Toddlers (CHAT), Social Communication Questionnaire (SCQ) and Communication and Symbolic Behavior Scales (CSBS). Screening for mild ASD or Asperger's syndrome in older children may be done using other screening methods, such as Autism Spectrum Screening Questionnaire (ASSQ) and Childhood Asperger Syndrome Test (CAST).
An important component in the screening process, however, is input from parents. A parent's own experiences and records of the child's milestones can offer valuable information.
When ASD is suspected, a comprehensive evaluation follows and should include assessments by a team of specialists to determine whether other conditions might be causing the child's symptoms. ASD is a complex disorder that can be seen with additional conditions. For example, if the child is not responding when called by name, a hearing test can determine whether it is due to a hearing loss. Comprehensive testing includes an assessment of the child's cognitive abilities, language and behaviors, including the level of age-appropriate skills. Children with developmental delays should also be screened for lead poisoning. Other screenings tools can include brain imaging and gene tests.
Whatever route parents choose, getting intervention early is essential to ensuring the best possible opportunities for the child.
Autism New Jersey
Autism Family Services of New Jersey