Autism Spectrum Disorders - FAQ

Should a child have a formal diagnosis of autism before he or she is referred for early intervention?

No. Cognitive, social, and adaptive outcomes are better for individuals on the autism spectrum when intervention is initiated early. In some areas, limited access to developmental specialists may result in a delay of several months between referral and formal diagnosis. When a child is referred for a formal diagnostic evaluation, simultaneous referrals should be made to early intervention as well as speech and occupational therapy as appropriate to address the particular challenges of the individual child.

What are the roles of risperidone and aripiprazole in the treatment of autism?

No medication has been found to treat the core symptoms of autism. Risperidone and aripiprazole have been approved by the US Food and Drug Administration to treat the symptoms of aggression and irritability in children with autism over 5 years of age. Before using it for this purpose, however, clinicians must consider the underlying etiology of the problem behavior. This may include pain, poor communication skills, mood disorder, and anxiety disorders. Once determined, the cause of the behavior may be treated appropriately. Only when this is unsuccessful is it appropriate to target the symptom rather than the cause. See the Treatment and Management section of this Module.

Our pediatrician is concerned about our child's development and has recommended a formal autism evaluation. Would there be any harm in waiting to see if he outgrows his language and social delays?

Yes. Research has shown that children on the autism spectrum have the best outcomes when they are identified early with appropriate behavioral, language, and educational interventions.

Will the use of sign language or Picture Exchange Communication System (PECS) impair my child's ability to use spoken language in the future?

No. The use of nonverbal communication systems such as PECS and sign language provides a valuable method of communication for individuals on the autism spectrum and often facilitates the acquisition of spoken language.

My child has some characteristics of autism but enjoys being around people and in particular is attached to me. Does this mean that he does not have autism?

No. There is a misconception that individuals with autism are aloof and do not attach to anyone. Some children on the autism spectrum form particularly strong connections to a caregiver and experience severe anxiety and disruptive behavior when separated from this attachment figure. Some children with autism will seek and enjoy interactions with other individuals; it is the atypical quality of these interactions that is characteristic of autism.

What is the difference between autism and PDD-NOS?

The term Pervasive Developmental Disorder is often used by professionals to refer to children with autism and related disorders. At times it is used interchangeably to refer to autism spectrum disorders. The term Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) is a separate diagnosis applied to the child with some characteristics of an ASD who does not meet full criteria for Autistic Disorder or Asperger Syndrome. They may meet criteria for autism in the social or communication domain and may show some impairment in the other domains. It could also apply to a child with global developmental delay who demonstrates impairment in some but not all of the three developmental domains affected in autism spectrum disorders. Finally, a child may be given the diagnosis of PDD-NOS if they meet criteria for autistic disorder but do not have a clear history of language delay or regression.

What causes autism spectrum disorders?

The causes of autism are not completely understood. There appears to be a complex interaction between genetic factors and environmental factors playing a causal role. For a comprehensive review of the genes known to be associated with ASDs, see the Online Menelian Inheritance in Man website. Autism (OMIM)

How are autism spectrum disorders diagnosed?

Autism spectrum disorders are diagnosed by a clinician or team of clinicians who specialize in child development. These providers may include pediatricians, child psychiatrists, psychologists, and speech and language pathologists. A diagnosis is made when a detailed history and careful observation of a child's behavior and interaction patterns indicate that he or she meets criteria for an autism spectrum disorder. The following files provide the criteria used to diagnose Autistic Disorder and Asperger Syndrome.DSM-IV Diagnostic Criteria for Autism ( 970 KB) DSM-IV Diagnostic Criteria for Asperger Syndrome ( 968 KB)