A person with autism standing at the center of a circle while observing people interacting outside the circle.

Artwork by Taniya Pramanik

A person with autism standing at the center of a circle while observing people interacting outside the circle.

Understanding Autism Spectrum Disorder

Medically reviewed by

Written by Aditi Sahu

A human fetus develops at its own pace which can be slightly different from others. However, almost all humans have the same general developmental milestones and learn the same set of skills in nearly the same amount of time. By milestones we mean-

  • Learning the language
  • Communication
  • Socializing 
  • Cognitive Skills like 
  • Physical skills like crawling, walking 
  • Motor skills 

Understanding the Autism Spectrum Disorder Symptoms

All of these combined progresses the brain’s development. Although in case one of these fails to develop in the expected time period it leads to a possible neurodevelopmental disorder. Especially if skills like socializing and communication don’t proceed as normally it can result in ‘isolation’- that is where ‘autism’ derives its name from. ‘Auto’ means ‘self’, thus autism refers to a condition where somebody might be removed from social interaction and communication leaving them alone or isolated. Before 2013, the Diagnostic and Statistical Manual for Mental Disorders (4th edition); or the DSM- IV; described autism as one of several pervasive developmental disorders ( short- PDDs) which included- 

  1. Autism: removed from social interaction and communication
  2. Asperger Syndrome: some characteristics of autism; language and cognition not as affected
  3. Childhood Disintegrative Disorder: late onset of developmental delays; normal initial development; lose the developed skills between 2-10 years of age
  4. Not Otherwise Specified (also knowns as PDD-NOS): catch-all category; some traits from any of the above disorders

However, researchers found that the diagnosis’ of these pervasive developmental disorders were not consistent across different hospitals and clinics. There were no fixed signs or patterns that could be observed since the symptoms were ‘similar’ yet differed to some degree in each case. So the new DSM - V removed these terms and replaced them with autism spectrum disorder or shortly called ASD. This is similar for Autism Spectrum Disorder in ICD 10 as well. ASD encompasses all four categories but uses a scale or a ‘spectrum’ that differentiate based on the severity of two major aspects:

Social communication and interaction deficit 

There are four subcategories that clinicians look for to identify deficits

Social reciprocity

This refers to how a child responds or reciprocates in social interactions. For instance, a child who prefers to be alone and takes no interest in social games could possibly be a deficit.

Joint attention:

Humans have a natural tendency to share what they find interesting. An example of impairment in this area would be a child not sharing their interests or amusement in an object with their parent.

Non-verbal communication:

This refers to a child who finds it difficult to express gestures (aka non-verbal communication) or is unable to perceive a similar nature of communication. An appropriate example would be a child not putting his arm up to show he wants to be picked up or at times would fail to understand that his parent is upset, even though his parent might be frowning or standing with their arms crossed.

Social relationships:

This is when children face trouble in developing and maintaining relationships so maybe the child might have a hard time making friends. In case they are able to make friends but then the child’s behaviour tends to drive the friends away.  

Restrictive or repetitive behavior/ interest/ activities 

This category is fairly broad and includes a whole bunch of behavioural traits- some being more well known. Some such characteristics of autism spectrum disorder include:

  1. Lining up toys in a ritualistic manner 
  2. Flapping one’s hands 
  3. Imitating words or phrases 
  4. Being fixed on certain routines, like taking the same route to school 
  5. Unusually fixating patterns of interest, or having deep knowledge of how the mobile phone works.

Children with autism spectrum disorder (ASD) might exhibit one or more of these deficits and vary in how severe the deficit is. Keeping that in mind, it is important to know that each child with ASD is going to have a different spectrum of symptoms and deficits. Typically clinicians will try to observe these behaviours in the child looking for these possible insufficiencies since these behaviours are often more well known by the child’s caretakers (parents, guardians, or teachers) than they are by the doctor. A meaningful diagnosis relies heavily on listening to what others are observing at home or in school or in social interactions. They might be given severity scores in each area which can help determine how much support the child will need.

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What causes ASD?

Genetic : 

Generally speaking, Autism Spectrum Disorders are thought to have a genetic cause that ultimately affects brain development- especially the areas of the brain that deal with social and communication behaviours. 

Environmental aspects: 

There are a number of environmental triggers that are yet to be examined but currently, there are no clear factors that have been identified. 

Having said that, there are certain factors that have been seen to put a newborn at a higher risk of developing autism, such as-

  1. Male children tend to have a higher chance of being autistic than females. 
  2. Having genetic conditions such as Down Syndrome, Fragile X Syndrome or Rett Syndrome. 
  3. Having older parents 
  4. Extremely premature babies- those born before 26 weeks of gestation may be at a higher risk. 

Diagnosis :

There is no one way a clinician may identify ASD in a child. Generally, specialists recommend genetic testing for Fragile X or Down Syndrome or Rett Syndrome. They also heavily rely on the observations noted by parents, guardians, family members, teachers etc. They also put the child through the following autism spectrum disorder test :

  • Hearing 
  • Speech 
  • Language 
  • Developmental Level 
  • Social interactions and behaviour


Book screening with our director of triage,  Kamlesh Verma

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Treatments for Autism 

Since the behaviour and challenges differ from one individual with autism to other there is no permanent cure for the condition. There can be only treatment and counselling methods specifically and carefully tailored for the autistic individual based on the severity and deficits which includes things like:

  • Specialized education programs and behaviour therapy 
  • Communication therapy 
  • Educational Therapy 
  • Family Therapy 
  • Speech Therapy 
  • Occupational Therapy 

The core symptoms of ASD cannot be improved with medication, although antidepressant drugs can help control anxiety or antipsychotics in case of severe behavioural problems. All these treatment methods are designed to help the child maximize the quality of their life and become more functionally independent. An early diagnosis and starting with treatments at a fairly early stage can tremendously help in the child’s positive development. Autism Spectrum Disorder help for parents and children is available at Cadabams! Reach out to us today!

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