Understanding Autism: A Comprehensive Guide for Parents

I get messages almost weekly, but now more so than ever: “What causes autism?” “How do I know if my child has it?” As a pediatrician and a mom, I want to lay out the current, evidence-based facts because there’s a lot of noise right now. This guide will explain what autism is, how it arises (based on research), how it’s diagnosed, what treatments and supports are effective, and what you can do as a parent. Always check with your child’s pediatrician or developmental specialist about your specific concerns. This is for educational purposes.

What Is Autism Spectrum Disorder (ASD)?

Autism Spectrum Disorder is a neurodevelopmental condition. It affects how people communicate, socialize, behave, and interact with the world.

The Spectrum of Autism

“Spectrum” means there’s a wide variation in how autism presents. For some children, differences are quite subtle, while for others, support needs are greater. Diagnostic criteria are in the DSM-5: they include difficulties in social communication and interaction, as well as restricted, repetitive patterns of behavior, interests, or activities.

What Causes Autism?

We don’t have a single cause. The science suggests multiple factors work together — genetic, environmental, and biological. Here are some key points:

• Genetic Risk: If a family has one autistic child, the risk is higher for another. Studies point to multiple genes, gene variants, and sometimes rare single gene disorders (e.g., fragile X syndrome) influencing risk.

• Environmental and Prenatal Factors: These may increase risk but do not guarantee autism. Examples include advanced parental age, prenatal exposure to pollution, certain maternal health conditions (like diabetes or immune issues), and prematurity or low birth weight.

• Vaccines: Important to note, vaccines have been extensively studied. Decades of research show no credible evidence linking vaccines to causing autism.

  
  

How is Autism Diagnosed?

Screening and diagnosis are structured so children can start getting help early. According to the AAP and other guidelines:

• Developmental Surveillance: This occurs at all well-child visits. Ask: Do they respond to their name? Do they point to objects? Do they make eye contact? Do they play alongside others?

• Standardized Screening Tools: The AAP recommends specific autism screening at 18 months and 24 months of age. Tools like the Modified Checklist for Autism in Toddlers (M-CHAT-R) are common.

• Thorough Diagnostic Evaluation: If screening suggests risk, a more thorough evaluation is recommended. This often includes a multidisciplinary team: developmental specialists, speech therapists, psychologists, and sometimes medical geneticists. Tools like ADOS/ADOS-2 or similar observation methods, developmental history, and standardized cognitive/language assessments are used.

  
  

What Treatments & Supports Help?

There is no cure for autism, but many interventions, supports, and strategies help children thrive. Here’s what the evidence supports (referencing the AAP):

| Type of Intervention | What It Is / Why It Helps |

|------------------------------------------|-------------------------------------------------------------------------------------------|

| Early Intervention Therapies | Starting supports early (as soon as risk is identified) improves communication, learning, and social skills. |

| Behavioral Interventions (ABA, etc.)| Applied Behavior Analysis, structured behavioral therapy, and play-based therapy can reduce challenging behaviors and build skills. AAP guidelines include these. |

| Speech Therapy | Many children with ASD benefit significantly from speech/language therapy to develop expressive and receptive language. |

| Occupational Therapy | Helps with fine motor skills, daily living skills, and sensory processing differences. |

| Coexisting Conditions Management | Many autistic kids also have sleep differences, gastrointestinal issues, anxiety, or ADHD. Addressing these improves quality of life. |

| Educational Supports | IEPs (Individualized Education Programs), special education services, and peer interaction programs. |

How Parents Can Help

While waiting for evaluations or working through treatment, here are some ways you can support your child:

• Talk to Your Pediatrician: If you have concerns, they know which screening tools to use and can refer you.

• Support Your Child’s Strengths: Build playtime, allow choice, and encourage repetitive interests in ways that promote skills.

• Support Communication: Simplify language, give extra processing time, and use visual supports.

• Create Routines: Structure and predictability can lower anxiety.

• Seek Support: Look for parent support groups, autism organizations, and trusted books or websites.

  
  

When To Seek Help / Red Flags

Here are signs that warrant earlier evaluation:

• Lack of response to name by 9-12 months

• No pointing or showing objects by 14-15 months

• Little or no social smiling or back-and-forth gestures

• Delayed speech or losing previously acquired speech

• Repetitive behaviors (rocking, hand flapping) or intense fixations

• Sensory differences (over/under sensitivity to sound or texture)

  
  

Recent Updates & Truths To Clear Up Myths

• ASD is on the rise: Statistically, but much of that is due to better screening, broader definitions, and more awareness. It’s not necessarily a new epidemic, but we cannot discredit environmental and genetic changes that may be occurring over time.

• Novel Treatments: There is increasing interest in novel treatments for specific subgroups (for example, leucovorin for children with cerebral folate deficiency). However, this is not a cure and is only a potential option for rare cases and under medical supervision.

• Avoid Misinformation: Claims linking vaccines to autism or suggesting one single environmental cause are not supported by current science.

  
  

Final Thoughts

Autism doesn’t “look” the same in every child, and it doesn’t mean limitation. With early detection, the right therapies, supportive environments, and families who love fiercely, children with autism can grow, learn, and thrive. If you believe your child may have signs of autism or if there are behaviors that worry you, trust your instincts. Talk to your pediatrician, get screenings, and explore supports as early as possible.

Disclaimer: This information is for educational purposes only. It does not substitute for personalized medical advice, diagnosis, or treatment. Always consult your child’s healthcare provider for concerns or before starting or changing any intervention plan.

-Dr. O 💛