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Understanding Autism

As Autism Awareness Month approaches (in April), the Kids First Pediatrics team wants to share some info about Autism Spectrum Disorder in Children from healthychildren.org.


Autism spectrum disorder (ASD) is a developmental disability that can affect a child's social skills, communication and behavior. Because most children with ASD will sit, crawl and walk on time, you may not notice delays in social and communication skills right in the first year of life.

Looking back, many parents can recall early differences in interaction and communication. See What are the Early Signs of Autism?

Children with ASD and their families can be healthy and resilient

More research is needed to understand the course of development for children who are diagnosed with ASD. However, recent studies show that many children with an ASD diagnosis are healthy and doing well in mid-childhood. Some children, while not very common, may progress so much with intervention that they may no longer meet the criteria for a diagnosis of ASD.

How common is ASD?

Approximately 1 in 44​ children are diagnosed with ASD by the time they are 8 years old, according to the U.S. Centers for Disease Control and Prevention. Boys are diagnosed with ASD about 4 times more often than girls.

The number of children reported to have ASD has increased since the early 1990s; the increase could be caused by many factors.

  • Many families are more aware of ASD.

  • Pediatricians are doing more screening for ASD, as recommended by the American Academy of Pediatrics. Children are identified earlier, which is a good thing.

  • Schools are more aware, and children are receiving more appropriate special education services.

  • There have been many changes in how ASD is defined and diagnosed.

Changes in how ASD is defined & diagnosed

Doctors use a book called Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) to assist in diagnosing ASD. In the past, only children with the most severe ASD symptoms were diagnosed. But in 2013, the diagnostic criteria for autism spectrum disorder changed. This was based on the research literature and clinical experience in the 19 years since the DSM-IV was published in 1994. Now, children with milder symptoms are being identified and helped.

Several conditions used to be considered autism spectrum disorders in the DSM. Those conditions were:

  • Autistic disorder

  • Pervasive developmental disorder—not otherwise specified (PDD-NOS)

  • Asperger syndrome

  • Childhood Disintegrative Disorder

With publication of the fifth edition of the DSM in 2013, the terms listed above are no longer used and these conditions are now grouped in the broader category of autism spectrum disorder or ASD. Many people may self-identify as having Asperger Syndrome, but professionals should no longer use this terminology when making a diagnosis.

The benefits of early identification of autism

Each child with ASD has different needs. The sooner ASD is identified, the sooner an early intervention program directed at the child's symptoms can begin.

The AAP recommends that all children be screened for ASD at their 18- and 24-month well-child checkups. Research shows that starting an intervention program as soon as possible can improve outcomes for many children with ASD.

In addition, children with ASD may have other medical problems that need further evaluation and treatment. These may include seizures, problems with sleep, gastrointestinal problems (feeding problems, abdominal pain, constipation, diarrhea) and behavioral health problems such as anxiety, ADHD, irritability, and aggression​. Some of these medical conditions may place children with ASD at increased risk for more severe illness and complications from COVID-19​.

COVID-19 & ASD

COVID-19 has impacted all of us throughout the world in many ways. Parents may have been worried about the safety of taking their children to the pediatrician for well-child visits. This may have impacted the frequency and timeliness of screening for autism and other developmental delays. Early identification and entry into early intervention services may have suffered as a result.

Remember to schedule your child's well-child visit with Kids First Pediatrics, especially if you have any concerns about your child's development or behavior.

In addition, school, support, activities, and routines may have also been disrupted during​ the pandemic. Due to school closures and the absence of in-person interaction, teachers may be less able to recognize social and communication differences in their students; another opportunity for early identification to be missed. Access to school services and therapies has been more difficult for many families. And while school closures and virtual learning is a change for all children, for children with ASD, this sort of change in routine can be very difficult.

​During this time of change and uncertainty, it's even more important to stay connected. Reach out to peer support organizations, such as Family to Family Health Information Centers, for local information specific to children with special health care needs and disabilities.


Kids First Pediatrics of Raleigh & Clayton screen kids for ASD, and work with kids who have ASD. Have questions about screening or treatment? Give us a call. Raleigh: 919-250-3478, Clayton: 919-267-1499.

*This article is informational but is not a substitute for medical attention or information from your provider.

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