DEAR MAYO CLINIC: My 2-year-old niece has had several issues since birth, and she is behind in her communications and attention. I wonder if she may be on the autism spectrum. Before I mention it to my sister, can you explain autism and how it is best treated?
ANSWER: Autism is one of a group of serious developmental problems called autism spectrum disorder that appears in early childhood — usually before age 3. Though symptoms and severity vary, all autism spectrum disorders affect children's ability to communicate and interact with others.
Children with autism generally have problems in three crucial areas of development: social interaction, language and behavior. Some children show signs of autism in early infancy. Other children may develop normally for the first few months or years of life, but then they suddenly become withdrawn or aggressive, or lose language skills they had already acquired.
Catching autism spectrum disorder early can improve quality of life. By recognizing the early signs and symptoms, you can help children learn, grow and thrive.
Some children show signs of autism spectrum disorder in early infancy, such as reduced eye contact, lack of response to their name or indifference to caregivers. Others develop normally for the first few months or years of life, but then they suddenly become withdrawn or aggressive, or lose language skills they had already acquired. Signs usually are seen by age 2.
Children with autism spectrum disorder are likely to have a unique pattern of behavior and level of severity — from low-functioning to high-functioning.
Some children with the disorder have difficulty learning, and some have signs of lower-than-normal intelligence. Other children have normal to high intelligence. While they learn quickly, they have trouble communicating and applying what they know in everyday life, and adjusting to social situations. Because children can have a unique mixture of symptoms, severity sometimes can be difficult to determine. Severity generally is based on the level of impairments and how those impairments affect functional ability.
Children with autism spectrum disorder may have problems with communication skills and social interaction. Common signs include:
Children with autism spectrum disorder may have limited, repetitive patterns of behavior, interests or activities, including:
Some children with the disorder become more engaged with others and show fewer disturbances in behavior as they mature. Those with the least severe problems eventually may lead normal or near-normal lives. Others, however, continue to have difficulty with language or social skills, and the teen years can bring worse behavioral and emotional problems.
Based on the signs and symptoms, if you believe your niece may have autism spectrum disorder, discuss this with your sister and encourage her to ask about developmental testing.
While there is no cure for autism, intensive, early diagnosis and treatment can make a big difference in the lives of many children with the disorder.
The ultimate goal of treatment is to increase children's ability to function, reduce symptoms, and help children's development and learning. Autism symptoms and severity differ greatly. Thus, treatment options for children diagnosed with autism also vary. Typically, treatment options can include individualized behavioral interventions, speech and occupational therapy, medications and other therapies that include the whole family.
Regardless of your niece's diagnosis, remind your sister that you are there for her and encourage her to talk to her health care provider about the treatment options that best suit her child's needs. — Dr. Tanushree Singhal, Pediatric and Adolescent Medicine, Mayo Clinic Health System, Eau Claire, Wisconsin