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Autism Spectrum Disorder

What is ASD?
Autism spectrum disorder (ASD) is a neurological and developmental disorder
that affects how people interact with others, communicate, learn, and
behave. Although autism can be diagnosed at any age, it is described as a
“developmental disorder” because symptoms generally appear in the first 2
years of life.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-

5), a guide created by the American Psychiatric Association that health care
providers use to diagnose mental disorders, people with ASD often have:

 Difficulty with communication and interaction with other people

 Restricted interests and repetitive behaviors
 Symptoms that affect their ability to function in school, work, and other
areas of life

Autism is known as a “spectrum” disorder because there is wide variation in

the type and severity of symptoms people experience.

People of all genders, races, ethnicities, and economic backgrounds can be

diagnosed with ASD. Although ASD can be a lifelong disorder, treatments and
services can improve a person’s symptoms and daily functioning. The
American Academy of Pediatrics recommends that all children receive
screening for autism. Caregivers should talk to their child’s health care
provider about ASD screening or evaluation.

What are the signs and symptoms of ASD?

The list below gives some examples of common types of behaviors in people
diagnosed with ASD. Not all people with ASD will have all behaviors, but most
will have several of the behaviors listed below.
Social communication / interaction behaviors may
include:

 Making little or inconsistent eye contact

 Appearing not to look at or listen to people who are talking
 Infrequently sharing interest, emotion, or enjoyment of objects or
activities (including infrequent pointing at or showing things to others)
 Not responding or being slow to respond to one’s name or to other
verbal bids for attention
 Having difficulties with the back and forth of conversation
 Often talking at length about a favorite subject without noticing that
others are not interested or without giving others a chance to respond
 Displaying facial expressions, movements, and gestures that do not
match what is being said
 Having an unusual tone of voice that may sound sing-song or flat and
robot-like
 Having trouble understanding another person’s point of view or being
unable to predict or understand other people’s actions
 Difficulties adjusting behaviors to social situations
 Difficulties sharing in imaginative play or in making friends

Restrictive / repetitive behaviors may include:

 Repeating certain behaviors or having unusual behaviors, such as

repeating words or phrases (a behavior called echolalia)
 Having a lasting intense interest in specific topics, such as numbers,
details, or facts
 Showing overly focused interests, such as with moving objects or parts
of objects
 Becoming upset by slight changes in a routine and having difficulty
with transitions
 Being more sensitive or less sensitive than other people to sensory
input, such as light, sound, clothing, or temperature

People with ASD may also experience sleep problems and irritability.

People on the autism spectrum also may have many strengths, including:

 Being able to learn things in detail and remember information for long
periods of time
 Being strong visual and auditory learners
 Excelling in math, science, music, or art

What are the causes and risk factors for ASD?

Researchers don’t know the primary causes of ASD, but studies suggest that
a person’s genes can act together with aspects of their environment to affect
development in ways that lead to ASD. Some factors that are associated with
an increased likelihood of developing ASD include:
  Having a sibling with ASD
 Having older parents
 Having certain genetic conditions (such as Down syndrome or Fragile X
syndrome)
 Having a very low birth weight

How is ASD diagnosed?

Health care providers diagnose ASD by evaluating a person’s behavior and
development. ASD can usually be reliably diagnosed by age 2. It is important
to seek an evaluation as soon as possible. The earlier ASD is diagnosed, the
sooner treatments and services can begin.

Diagnosis in young children

Diagnosis in young children is often a two-stage process.

Stage 1: General developmental screening during well-child

checkups

Every child should receive well-child check-ups with a pediatrician or an early

childhood health care provider. The American Academy of Pediatrics
recommends that all children receive screening for developmental delays at
their 9-, 18-, and 24- or 30-month well-child visits, with specific autism
screenings at their 18- and 24-month well-child visits. A child may receive
additional screening if they have a higher likelihood of ASD or developmental
problems. Children with a higher likelihood of ASD include those who have a
family member with ASD, show some behaviors that are typical of ASD, have
older parents, have certain genetic conditions, or who had a very low birth
weight.

Considering caregivers’ experiences and concerns is an important part of the

screening process for young children. The health care provider may ask
questions about the child’s behaviors and evaluate those answers in
combination with information from ASD screening tools and clinical
observations of the child. Read more about screening instruments on the
Centers for Disease Control and Prevention (CDC) website.

If a child shows developmental differences in behavior or functioning during

this screening process, the health care provider may refer the child for
additional evaluation.

Stage 2: Additional diagnostic evaluation

It is important to accurately detect and diagnose children with ASD as early

as possible, as this will shed light on their unique strengths and challenges.
Early detection also can help caregivers determine which services,
educational programs, and behavioral therapies are most likely to be helpful
for their child.
A team of health care providers who have experience diagnosing ASD will
conduct the diagnostic evaluation. This team may include child neurologists,
developmental pediatricians, speech-language pathologists, child
psychologists and psychiatrists, educational specialists, and occupational
therapists.

The diagnostic evaluation is likely to include:

 Medical and neurological examinations

 Assessment of the child’s cognitive abilities
 Assessment of the child’s language abilities
 Observation of the child’s behavior
 An in-depth conversation with the child’s caregivers about the child’s
behavior and development
 Assessment of age-appropriate skills needed to complete daily
activities independently, such as eating, dressing, and toileting

Because ASD is a complex disorder that sometimes occurs with other

illnesses or learning disorders, the comprehensive evaluation may include:

 Blood tests
 Hearing test

The evaluation may lead to a formal diagnosis and recommendations for

treatment.

Diagnosis in older children and adolescents

Caregivers and teachers are often the first to recognize ASD symptoms in
older children and adolescents who attend school. The school’s special
education team may perform an initial evaluation and then recommend that
a child undergo additional evaluation with their primary health care provider
or a health care provider who specialize in ASD.

A child’s caregivers may talk with these health care providers about their
child’s social difficulties, including problems with subtle communication. For
example, some children may have problems understanding tone of voice,
facial expressions, or body language. Older children and adolescents may
have trouble understanding figures of speech, humor, or sarcasm. They also
may have trouble forming friendships with peers.

Diagnosis in adults

Diagnosing ASD in adults is often more difficult than diagnosing ASD in

children. In adults, some ASD symptoms can overlap with symptoms of other
mental health disorders, such as anxiety disorder or
attention-deficit/hyperactivity disorder (ADHD).

Adults who notice signs of ASD should talk with a health care provider and
ask for a referral for an ASD evaluation. Although evaluation for ASD in adults
is still being refined, adults may be referred to a neuropsychologist,
psychologist, or psychiatrist who has experience with ASD. The expert will
ask about:

 Social interaction and communication challenges

 Sensory issues
 Repetitive behaviors
 Restricted interests

The evaluation also may include a conversation with caregivers or other

family members to learn about the person’s early developmental history,
which can help ensure an accurate diagnosis.

Receiving a correct diagnosis of ASD as an adult can help a person

understand past challenges, identify personal strengths, and find the right
kind of help. Studies are underway to determine the types of services and
supports that are most helpful for improving the functioning and community
integration of autistic transition-age youth and adults.

What treatment options are available for ASD?

Treatment for ASD should begin as soon as possible after diagnosis. Early
treatment for ASD is important as proper care and services can reduce
individuals’ difficulties while helping them build on their strengths and learn
new skills.

People with ASD may face a wide range of issues, which means that there is
no single best treatment for ASD. Working closely with a health care provider
is an important part of finding the right combination of treatment and
services.

Medication

A health care provider may prescribe medication to treat specific symptoms.

With medication, a person with ASD may have fewer problems with:

 Irritability
 Aggression
 Repetitive behavior
 Hyperactivity
 Attention problems
 Anxiety and depression

Read more about the latest medication warnings, patient medication guides,
and information on newly approved medications at the Food and Drug
Administration (FDA) website .

Behavioral, psychological, and educational interventions

People with ASD may be referred to a health care provider who specializes in
providing behavioral, psychological, educational, or skill-building
interventions. These programs are often highly structured and intensive, and
they may involve caregivers, siblings, and other family members. These
programs may help people with ASD:

 Learn social, communication, and language skills

 Reduce behaviors that interfere with daily functioning
 Increase or build upon strengths
 Learn life skills for living independently

Other resources

Many services, programs, and other resources are available to help people
with ASD. Here are some tips for finding these additional services:

 Contact your health care provider, local health department, school, or

autism advocacy group to learn about special programs or local
resources.
 Find an autism support group. Sharing information and experiences can
help people with ASD and their caregivers learn about treatment
options and ASD-related programs.
 Record conversations and meetings with health care providers and
teachers. This information may help when it’s time to decide which
programs and services are appropriate.
 Keep copies of health care reports and evaluations. This information
may help people with ASD qualify for special programs.

How can I find a clinical trial for ASD?

Clinical trials are research studies that look at new ways to prevent, detect,
or treat diseases and conditions. The goal of clinical trials is to determine if a
new test or treatment works and is safe. Although individuals may benefit
from being part of a clinical trial, participants should be aware that the
primary purpose of a clinical trial is to gain new scientific knowledge so that
others may be better helped in the future.

Researchers at NIMH and around the country conduct many studies with
patients and healthy volunteers. We have new and better treatment options
today because of what clinical trials uncovered years ago. Be part of
tomorrow’s medical breakthroughs. Talk to your health care provider about
clinical trials, their benefits and risks, and whether one is right for you.

To learn more or find a study, visit:

 NIMH’s Clinical Trials webpage: Information about participating in

clinical trials
 Clinicaltrials.gov: Current Studies on ASD : List of clinical trials funded
by the National Institutes of Health (NIH) being conducted across the
country
Where can I learn more about ASD?
Free brochures and shareable resources

 Autism Spectrum Disorder: This brochure provides information

about the symptoms, diagnosis, and treatment of ASD. Also
available en español.
 Digital Shareables on Autism Spectrum Disorder: Help support
ASD awareness and education in your community. Use these digital
resources, including graphics and messages, to spread the word about
ASD.

Federal resources

 Eunice Kennedy Shriver National Institute of Child Health and

Human Development
 National Institute of Neurological Disorders and Stroke
 National Institute on Deafness and Other Communication
Disorders
 Centers for Disease Control and Prevention (CDC)
 Interagency Autism Coordinating Committee
 MedlinePlus (also available en español )

Research and statistics

 Science News About Autism Spectrum Disorder: This NIMH

webpage provides press releases and announcements about ASD.
 Research Program on Autism Spectrum Disorders: This NIMH
program supports research focused on the characterization,
pathophysiology, treatment, and outcomes of ASD and related
disorders.
 Statistics: Autism Spectrum Disorder: This NIMH webpage provides
information on the prevalence of ASD in the U.S.
 Data & Statistics on Autism Spectrum Disorder : This CDC
webpage provides data, statistics, and tools about prevalence and
demographic characteristics of ASD.
 Autism and Developmental Disabilities Monitoring (ADDM)
Network : This CDC-funded program collects data to better
understand the population of children with ASD.
 Biomarkers Consortium - The Autism Biomarkers Consortium
for Clinical Trials (ABC-CT) : This Foundation for the National
Institutes of Health project seeks to establish biomarkers to improve
treatments for children with ASD.

Last Reviewed: February 2024

Unless otherwise specified, the information on our website and in our

publications is in the public domain and may be reused or copied without
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