Diagnosing and Treating Autism Spectrum Disorders at Children's Hospital Colorado

What are autism spectrum disorders?

Autism spectrum disorders (often called "autism" or "autistic disorder") are characterized by impairment in communication skills, social interaction and behavior. Autism spectrum disorders (ASD) cause severe impairment in a child's thinking, feeling, language and the ability to relate to others. The disorders usually become apparent before age three and last throughout a person's life, although the core symptoms can vary greatly across individuals.

Autistic disorder (commonly known as autism) is the most severe form of ASD, while other conditions along the spectrum include a milder form known as Asperger syndrome, the rare condition called Rett syndrome, and developmental disorders not otherwise specified.

ASD impairments include delays or problems in three core areas:

• Language and communication – verbal (spoken) and non-verbal (unspoken, such as pointing, eye contact or smiling) communication
• Social behavior – social interactions such as sharing emotions, understanding how others think and feel, and holding a conversation
• Behaviors concerning objects or routines – routines or repetitive behaviors (repeating words, rocking, tapping, twirling), obsessively following routines or schedules, playing with toys or objects in repetitive and sometimes inappropriate ways, or having very specific and inflexible ways of arranging items

Why choose Children's Hospital Colorado for autism spectrum disorders?

At Children's Hospital Colorado, we’re always pioneering new ways of curing and treating kids, in many cases offering the most advanced and effective care years before it becomes available at other hospitals. For kids with autism spectrum disorders and other developmental delays, the Neuropsychiatric Special Care (NSC) program at Children’s is one of the few programs in the country that provides a hospital-based level of crisis care.

Children with an ASD and those with an intellectual disability have higher rates of psychiatric diagnoses compared to other populations. This combination of developmental delays and psychiatric symptoms is why tests and treatment requires specialized care in hospital settings – making our NSC program the best choice for kids. For more information about the NSC program, please call 720-777-3191.

Signs and symptoms of autism spectrum disorders

Common ASD symptoms include:

• Poor eye contact
• Not responding to one's name
• Problems with attention and shared interests
• Underdeveloped skills in pretend play and imitation
• Problems with non-verbal communication and language

Other "red flag" behaviors may also be present (signifying the need for your child to be screened for an ASD), such as:

• Lack of positive affect (big smiles) and expressions of joy by six months
• Does not babble, point, or make meaningful gestures (such as pointing or waving good-bye) by one year
• Does not speak one word by 16 months
• Does not combine two words by two years
• Does not respond to name
• Loses language or social skills
• Doesn't know how to play with toys
• Excessively lines up toys or other objects
• Attachment to one particular toy or object
• At times seems to be hearing impaired

How is an autism spectrum disorder diagnosed?

Although there are many concerns about labeling a child with an ASD, the earlier the diagnosis is made, the earlier needed interventions can begin. When evaluating a child, clinicians at Children's Hospital Colorado rely on behavioral characteristics to make a diagnosis. Some of the characteristic behaviors of ASD may be apparent in the first few months of a child's life, or they may appear at any time during the early years.

For diagnosis, problems in at least one of the areas of communication, socialization or play must be present before the age of three. The diagnosis requires a two-stage process. The first stage involves developmental screening during "well child" check-ups; the second stage entails a comprehensive evaluation by a multidisciplinary team. As part of this process, children are diagnosed with an ASD based on a specific set of behavioral criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV TR). We use two specific "gold standard" measures to help to correctly identify autism: Autism Diagnostic Interview-Revised and Autism Diagnostic Observation Schedule.

Treatment options

Unfortunately there is no cure for autism spectrum disorders; however, the goal of ASD treatment at Children's Hospital Colorado is to promote social, adaptive and behavioral functioning. Treatments derived from the behavioral learning theory have the strongest research support; this type of treatment works to reinforce appropriate behaviors and reduce unwanted behaviors, while also suggesting what caregivers should do to prevent problem behaviors. Medication can also be used to treat some of the symptoms associated with ASD.

A variety of healthcare providers from different disciplines at Children’s work together to help kids with autism. For example, our speech-language therapists help children with autism improve their ability to communicate and interact with others and develop their speech and language skills; occupational therapists help autistic kids find ways to acquire and successfully perform everyday tasks at home and in the community; and physical therapists design activities and exercises to build motor control and to improve posture and balance.

Who gets autism spectrum disorders, and can they be prevented?

ASDs occur equally in all racial, ethnic, and social groups.  However three populations are at higher-than-normal risk for autism, including:

• Boys – Statistics show that boys are three- to four-times more likely to be affected by autism than girls.
• Siblings of those with autism – Among families that have one child with autism, recurrence of autism is 2% to 8% in another sibling.
• People with certain developmental or genetic disorders – For certain disorders, including Fragile X syndrome, mental retardation and tuberous sclerosis, autism is common in addition to the primary symptoms of the disorder.

Additional resources at Children's Hospital Colorado

Neuropsychiatric Special Care (NSC) Program

Hearing, Speech and Learning

Occupational Therapy Department

Neurodevelopmental and Behavioral Unit 

Special Care Clinic