Autism Spectrum Disorder (ASD)

In simple terms, Autism Spectrum Disorder (ASD) is a developmental disability. People with autism tend to have issues with social communication and interaction. They may also have restricted, repetitive behaviors or interests. ⁴

If your child has ASD, they may have “difficulty navigating some part of the social world,” says pediatric neuropsychologist David Black, Ph.D., director of the Center for Assessment and Treatment in Chevy Chase, Maryland. “That could be reading social cues or understanding why people are doing what they’re doing, like interpreting someone’s reaction.”

“This difficulty in reading, understanding and interpreting social interactions can be significant. It may interfere with daily life. And it cannot be explained by something else, such as a language disorder,” Black says.
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ASD is a “spectrum” disorder, meaning that the symptoms may range from mild to severe. The disorder will present itself differently in different people, through a wide range of symptoms. As a starting point, the CDC offers a list of ASD signs and symptoms.

Examples of social communication and social interaction issues related to ASD, according to the CDC, may include: ⁵
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Examples of restricted or repetitive behaviors/interests related to ASD, according to the CDC, may include: ⁵
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Other symptoms related to ASD cited by the CDC may include: ⁵
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Your child’s doctor should be your first point of contact. During well-child visits, the pediatrician tracks developmental milestones, which are typical achievements most children reach by certain ages, though there’s some natural variation. “Development can differ significantly from child to child,” says Black. “Your pediatrician’s role is to guide you through what’s generally considered normal.”

The pediatrician will also check for any medical issues that could affect your child’s behavior or temperament, like neurological conditions or seizures.

The American Academy of Pediatrics advises that all children be screened for ASD at their 18- and 24-month checkups, or whenever a parent has concerns. Keep in mind that screening is not the same as a diagnosis. ⁶

If the screening is positive, further evaluation will be necessary. Your pediatrician may suggest seeing a specialist, such as a developmental pediatrician or psychologist. ⁶ These specialists often work in teams, which may include a speech-language pathologist and occupational therapist.

For children 3 and under, it’s often recommended to begin with your state’s early intervention program, which offers required evaluations under the Individuals with Disabilities Education Act. ⁷
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During a formal evaluation, the assessment team will engage with your child in an age-appropriate, structured manner, using various tools. ⁸ For younger children, part of the process involves play, allowing the team to assess your child's development. ^{6, 8} They’ll also observe how you interact with your child, and depending on the child’s age, they may meet with your child separately. ^{7, 8}

The team will conduct a comprehensive developmental assessment, focusing on language and social skills. “In a play-based evaluation, the team will observe how your child plays alone or with others, how they initiate and respond to social interactions, and how they communicate needs both verbally and nonverbally,” says Black.

For instance, when evaluating a 2-year-old, Black would look for milestones such as imitating others or showing interest in peers, as well as curiosity and engagement in simple back-and-forth play.

You’ll also be interviewed about your child’s behavior in different settings and with various people. The team will gather insights on your child's temperament and any concerns you may have.
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The next step is to discuss an individualized plan with a developmental specialist that targets your child’s strengths and challenges. Treatment options vary based on your child's needs. For example, if communication is a challenge, speech therapy may be recommended, while Applied Behavior Analysis (ABA) can address behavioral issues by identifying triggers and teaching alternative ways to communicate. ⁸

“With early intervention, many challenges can improve significantly,” says Black, making it easier to manage social, communication, and sensory difficulties.

If you suspect your child has autism, know that there is plenty of support available. Start by talking to your child’s pediatrician to better understand and manage the condition.
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