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Autism spectrum disorders (ASD) can affect the way a child sees the world and make it hard to connect with others. A child may also do certain things over and over again or have intense interests. ASD can look very different from one child to another; one could be agitated and irritable while another may be aloof and detached. It is important to note that ASD includes the word spectrum because the severity of autism falls on a continuum, with some children showing mild symptoms and others having much more severe symptoms. These problems usually last for a child’s lifetime and can often be detected before a child reaches school age. Finding help early on for these children can make huge differences in how they act later in life.

The American Psychiatric Associated recently released the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition, with changes related to ASD. The term “Pervasive Development Disorder” and previous diagnoses that fell into that category are no longer used. These include:

  • Asperger’s disorder (Asperger syndrome)
  • Childhood disintegrative disorder (CDD)
  • Pervasive developmental disorder not otherwise specified (PDD-NOS)

This means that anyone who has been given a previous diagnosis of any of the above mentioned disorders would simply be a given diagnosis of Autism Spectrum Disorder, with severity specifier.



There are three levels of severity on the autism spectrum:

  • Level 1 – “Requiring support”
    • May be able to speak in full sentences but still has difficulty starting conversations and picking up on social cues. Can be inflexible with routine and switching activities.
  • Level 2 – “Requiring substantial support”
    • May have social impairments that are apparent even with supports in place. May use simple sentences and has limited communication. Has difficulty coping with change. Expresses other restricted or repetitive behaviors.
  • Level 3 – “Requiring very substantial support”
    • May have severe communication deficits including limited speech and response. Has extreme difficulty coping with change. Expresses other restricted or repetitive behaviors that noticeably interfere with daily functioning.


Scientists are still not sure what the exact causes of ASD are, but studies show that genes (e.g., having a family member with these problems) and environment (e.g., exposure to toxins, complications during pregnancy) may play important roles. Some people believe that these problems are related to vaccines, but the scientific research in this area overwhelmingly does not support this assertion. Parents should make sure that check-ups with their child’s pediatrician include screening for ASD, especially during the first 3 years. If a child is suspected to have these problems, a comprehensive evaluation should be done by a team who will look at the child’s thinking skills, language, and daily living skills. Early treatment that usually includes key family members and a team of professionals can reduce or prevent more serious disabilities.



Children with ASD may show some of the following signs depending on their diagnosis:

Social interaction and communication problems:

  • Persistent lack of social communication
  • Difficulty starting or holding conversations
  • Make little eye contact, facial expressions, or gestures
  • Don’t try to share their enjoyment of things with others
  • May respond unusually to attention or affection, or not pick up on social cues
  • Difficulty understanding their own feelings

Restricted range of activities, repetitive behaviors or intense interests:

  • Overly focused on parts of objects or specific topics
  • Awkward, repetitive gestures, body postures or facial expressions (e.g., hand flapping or walking in specific patterns)
  • Repetition of certain words or phrases
  • Insistence on routine/very resistant to change (e.g., mealtimes, routes to school)
  • Experience extreme distress from small changes
  • Under or overreacting to certain sights, sounds smells, textures, and tastes

Other behaviors parents may notice:

  • Hyperactivity, short attention span, disruptive or impulsive behavior, aggressiveness, self-harm, or temper tantrums
  • Unusual eating or sleeping habits

If your child has difficulties specifically in communicating but does not show restricted, repetitive patterns of behavior, your child may be evaluated for Social Pragmatic Communication Disorder, a new DSM-5 diagnosis. Social Pragmatic Communication Disorder is characterized by difficulty following social communication rules and/or not knowing how to change communication to match the context or setting the interaction is taking place in.



  • ASD affects as many as 1 in 68 children (CDC, 2014)
  • It is four to five times more common in boys than girls
  • Onset is usually in the first 3 years of life
  • About 3% of youth served by the Hawaii Department of Health and 7% of special education students have ASD diagnosis
  • Children with ASD are at high risk of having learning disabilities, depression, anxiety, or ADHD



  • Want to know about some basic suggestions for autism assessment and treatment by a leading professional? Connie Kasery, Professor of Education and Psychiatry from the Center of Autism Research and Treatment at UCLA, offers some advice to families. She touches upon how to get a good assessment, evidenced-based treatments, treatments not recommended, and skills that are important to practice at home. Please click here to watch the video.




See What Works:

Goal Setting

Communication Skills
Social Skills

Intensive Behavioral Treatment
Intensive Communication Treatment


Local support groups

Other sites that discuss evidence based treatment for autism:

Other Resources about Autism Spectrum Disorder:

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