Autism spectrum disorder

What is autism?

Autism spectrum disorder (ASD), or autism, is a neurodevelopmental difference in how a person's brain works, shaping how they communicate, socialize, and experience the world. It is a spectrum, which means autistic people have a wide range of strengths, challenges, and support needs. Signs usually appear early in childhood.

Autism is not a disease, and it cannot be “cured.” Many autistic people and their families describe it as part of who they are rather than something to fix. Providers use autism spectrum disorder as the diagnosis, and many in the community prefer identity-first language, like “autistic person.”

About 1 in 31 children in the U.S. is autistic. Older labels like Asperger's disorder and PDD-NOS are no longer used, and they all fall under autism spectrum disorder today. Autism can co-occur with conditions like ADHD, anxiety, or OCD, which is one reason a thorough evaluation matters.

What are the signs of autism?

Autism shows up differently in every person and changes with age, but its characteristics fall into two main groups. Many children do some of these things at times; with autism, they are more consistent and shape daily life.

Signs in social communication and interaction affect how a person connects with others.

• Limited eye contact, or difficulty reading body language and social cues
• One-sided conversations, or difficulty with back-and-forth interaction
• Trouble understanding others' feelings or points of view
• Difficulty building friendships with peers

Restricted and repetitive behaviors affect how a person acts and responds to the world.

• Repeating words, phrases, or movements, like hand-flapping or rocking
• A strong preference for routines, and distress when they change
• Intense, highly focused interests
• Strong reactions to sounds, textures, or other sensory input

Signs often appear in toddlerhood, though some autistic people, especially those who mask their traits, are not identified until adolescence or adulthood. Recognizing the pattern is the first step toward the right support.

What contributes to autism?

There is no single cause of autism. Experts believe it comes from a combination of genetics and factors around pregnancy and birth. Autism is not caused by parenting or by vaccines. Knowing the common contributing factors can help make sense of a diagnosis.

Genetic factors

• Many gene variations linked to autism, which can be inherited or appear for the first time
• A family history, since autism often runs in families

Pregnancy and birth factors

• Being born prematurely, or reduced oxygen during pregnancy or delivery
• Certain conditions or medication exposures during pregnancy
• Older parental age at the time of pregnancy

These factors can raise the likelihood of autism, but they do not determine it. Autism is a natural part of human variation, not something a family did wrong.

How is autism supported?

There is no cure for autism, and it does not need one. Support focuses on helping autistic people build on their strengths and navigate challenges, and starting early, ideally before age 3, tends to help the most.

Behavioral and developmental therapies like behavioral therapy and social skills training can help autistic children develop communication and daily-living skills at their own pace.

Speech and language therapy supports both spoken and nonverbal ways of connecting with others, which can help those who find communication challenging.

Support for co-occurring conditions matters when anxiety, ADHD, or OCD show up alongside autism. Approaches like cognitive behavioral therapy (CBT) and, sometimes, medication can help with those specific challenges.

Educational and family support rounds things out. School accommodations and family guidance help create environments where autistic people can thrive, at home and in the classroom.

Support looks different for everyone, and the goal is not to change who a person is but to help them live fully as themselves.

When should you seek an evaluation?

If you notice signs like limited eye contact, delayed or unusual communication, or intense routines in your child, it is a good idea to talk to your pediatrician. The American Academy of Pediatrics recommends autism screening at the 18-month and 24-month visits, and early support makes a meaningful difference. Adults who recognize these traits in themselves can also seek an evaluation.

Autistic people can face higher rates of anxiety or depression, so if you or your child is struggling with low mood or thoughts of self-harm, reach out for support, and in a crisis call or text 988, the Suicide and Crisis Lifeline. Autism is a difference, not a deficit, and with understanding and support autistic people thrive. Whenever you feel ready, help is available.