Autism Spectrum Disorder

ASD: What Is Autism Spectrum Disorder?

What is ASD? Autism is a complex developmental disorder that can cause social, communication, and behavior challenges in the roughly 1 in every 68 children it affects. Learn more the signs of ASD in children and adults here.

By ADDitude Editors Verified Updated on July 10, 2024
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ASD: What Is Autism Spectrum Disorder?

  • Autism Spectrum Disorder (ASD) is a complex developmental disorder that impacts one’s ability to communicate and interact socially.
  • ASD is characterized in part by repetitive behaviors or language and restricted interests.
  • ASD occurs on a continuum of severity from mild challenges to difficulty with everyday life.

Autism Spectrum Disorder (ASD) is a complex neurobiological disorder that is characterized by difficulty communicating and relating socially to others, alongside a need to engage in repetitive behaviors or language. Some common early signs are delayed speech, restricted interests, not responding when called by name, and avoiding eye contact.

ASD occurs on a broad continuum. Some people with ASD experience only mild challenges. For others, the condition interferes with everyday life.

Approximately 1 in 36 children in the U.S. has ASD, which is about four times more common among boys than girls. 1  Early detection and treatment using a combination of educational and behavioral interventions and medication is critical to the social, academic, and professional success of people with ASD.

Read on to learn more about ASD and its management. Consult with a physician if you recognize the symptoms below in yourself or your child.

ASD: Symptoms of Autism Spectrum Disorder

Per The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), ASD is characterized by the following symptoms, grouped into two clusters:

ASD Symptom: Deficits in Social Communication and Interaction

  • Social-emotional reciprocity challenges, ranging from a lack of back-and forth conversation to reduced sharing of interests, emotions, or affect. Some autistic individuals may have trouble initiating or responding in social interactions.
  • Deficits in nonverbal communicative behaviors, ranging from lack of eye-contact and trouble understanding body cues to lack of facial expressions when communicating.
  • Trouble developing, maintaining, and understanding relationships, ranging from difficulties engaging in imaginative play to challenges in adjusting to varying social situations.

ASD Symptom: Restricted, Repetitive Behavior and Interests

  • Stereotyped or repetitive motor movements, use or objects, or speech (e.g., flapping arms, lining up toys or flipping objects, echolalia, idiosyncratic phrases).
  • Insistence on sameness, inflexible adherence to routines, or ritualized patterns of behavior (e.g., extreme distress at small
    changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat same food every day).
  • Highly restricted, fixated interests.
  • Sensory processing differences (e.g., apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).

To merit an ASD diagnosis, an individual must show all symptoms in the former cluster and at least two in the latter. Symptoms must also be present in early childhood, though they may not become apparent until later in life due to masking and compensatory behaviors.

[Get This Free Download: Autism Evaluation Checklist]

What Does High-Functioning Autism Look Like?

The DSM-5-TR outlines three severity levels for ASD — level one (requiring support) to level three (requiring substantial support). Those with so-called “high-functioning autism” may fall under level one. These individuals generally require lower support needs across all domains of life. They may have greater verbal fluency and developed compensatory behaviors (i.e., masking) to meet demands of daily living.

But the term “high-functioning” may be offensive to some individuals. According to the Autistic Self Advocacy Network, “functioning labels don’t help autistic people get what we need, because they don’t show how autistic people need help with different things.”

The advocacy group notes that descriptors like “non-speaking” or “autistic people with intellectual disabilities” may be more helpful and respectful than using functional labels.

ASD: How Is Autism Evaluated?

There isn’t a single test for autism. Developmental monitoring and screening through well-child visits can reveal if a child is showing early signs of ASD. In addition, providers use a range of diagnostic tools, from screeners and direct observations to family interviews, to evaluate for ASD. Popular evaluation tools include the Modified Checklist for Autism in Toddlers (M-CHAT-R/F), the Childhood Autism Rating Scale, Second Edition (CARS2), and the Autism Diagnostic Observation Schedule-Second Edition (ADOS-2), among others. Multiple medical professionals may be involved in the evaluation process, from developmental pediatricians and child psychiatrists to pediatric neurologists.

Adult autism assessments also comprise clinical interviews, observations, and detailed developmental histories. The ADOS-2, which includes observation of the patient’s non-verbal communication and other social skills and repetitive behaviors, is a suitable diagnostic tool for adults. An Adaptive Behavior Assessment, which looks at skills needed in everyday life to achieve independence, is another useful measure. Across all ages, the ASD evaluation will include psychiatric assessments to rule out conditions that overlap with autism, including anxiety disorder, ADHD, and OCD, or identify comorbid conditions.

ASD: Managing Autism Spectrum Disorder

There are two main types of treatment for ASD:

  • educational and behavioral interventions
  • medication

Educational and behavioral interventions help children and adults manage ASD symptoms to improve daily functioning and quality of life. Applied Behavior Analysis (ABA) is a widely used but controversial approach for ASD that focuses on encouraging desired behaviors and reducing undesired ones. Other forms of ABA like discrete trial training (DTT) and pivotal response treatment (PRT) are available. Some individuals may benefit from occupational therapy, speech-language therapy, sensory integration therapy, and similar interventions. Cognitive behavioral therapy (CBT) can also help individuals with ASD cope with high levels of anxiety and treat co-occurring conditions like depression. CBT can be adapted for individuals with social communication and intellectual limitations.

There are no medications specifically for core autism symptoms of social and communication deficits. Some medications, however, are commonly used to treat certain symptoms associated with ASD.2

  • Antipsychotics like risperidone and aripripazole are FDA approved to treat irritability associated with autism.
  • Antidepressant and anxiety medications can help manage mood, anxious thoughts and repetitive behaviors.
  • Stimulants can target symptoms like hyperactivity, impulsivity, inattention, and distractibility. (Stimulants are also indicated for ADHD, which commonly co-occurs with autism.)

ASD: Learn More About Autism

ASD: Sources

1 Maenner MJ, Warren Z, Williams AR, et al. Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2020. MMWR Surveill Summ 2023;72(No. SS-2):1–14. DOI: http://dx.doi.org/10.15585/mmwr.ss7202a1.

2 Hyman, S. L., Levy, S. E., Myers, S. M., & COUNCIL ON CHILDREN WITH DISABILITIES, SECTION ON DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS (2020). Identification, Evaluation, and Management of Children With Autism Spectrum Disorder. Pediatrics, 145(1), e20193447. https://doi.org/10.1542/peds.2019-3447