Autism Spectrum Disorder (ASD)
What is autism?
Autism spectrum disorder (ASD) is a condition that affects how the brain develops and how it makes sense of the world. People often use the shorter name “autism” instead of ASD.
There are 2 main features of autism:
- Communication: Your child has differences in how they communicate and interact with other people (social communication) compared with other children their age.
- Behavior: Your child may have narrow or specific interests, actions they repeat over and over, difficulty with changes in routines or sensory challenges .
A diagnosis of being “on the autism spectrum” means your child has autistic traits in both of these areas — communication and behavior. Their experience and behavior could be very different from another child with autism. Every child has unique strengths and challenges.
The spectrum is not a straight line, like a scale, from less autistic to more autistic. It’s more accurate to think of the spectrum as a color wheel. Imagine each autistic trait is 1 color on the wheel. Autistic children may need different levels of support for each trait, or color. For example, your autistic child might need more support about their preference for routine. Another autistic child may need less support in that area. Each person’s autism spectrum is a unique pattern of areas where they do and don’t need support.
Support and services can help children with autism build on their strengths and learn new skills. The earlier children get care, the more likely we can help their development and success later on. For example, if your autistic child is not talking, teaching them other ways to communicate will help them share their needs and probably feel less frustrated.
Talking about autism
Autism is a medical diagnosis, and it can also be thought of as an identity — which means it is just who someone is. The words we use to talk about autism can reflect this.
- Some people prefer person-first language, such as “I am a person with autism” or “My child with autism is an amazing artist.” Person-first language helps us not define people by their disability.
- Identity-first language is becoming more common. Examples are “I am autistic,” or “My autistic child is an amazing artist.” Some people feel proud to be labeled as autistic. This language shows that disability is part of their identity.
Everyone can choose to talk about their autism diagnosis in the way that feels right to them.
What causes autism?
The exact causes of autism aren’t clear yet. In fact, the causes for 1 child may be different from the causes for another child. Research suggests that, for some children at least, autism happens because of changes in genes that affect the brain. There are some genetic conditions with known links to autism. In most children with autism, there is no clear genetic cause.
Factors in a child’s experience or environment, like being exposed to certain substances before birth or being born early, may also play a part. Most researchers believe multiple factors are involved.
The way you parent does not cause autism. Vaccines do not cause autism.
What’s special about Seattle Children’s Autism Center?
Seattle Children’s Autism Center is known nationally for innovative research and high-quality care for children and teens with autism. We provide diagnostic evaluations. We offer a wide range of treatments and services. And we will connect you with support and resources.
The experts you need are here
- At Seattle Children’s, a team with special training in autism will care for your child. That team includes , , , , , and .
- We have the expertise to address the full range of autism-related concerns, from common to rare, for example, feeding challenges or developmental differences (PDF) due to alcohol during pregnancy.
- Our family resource team offers families information, referrals and support at every stage. We teach skills to turn activities that are overwhelming (like grocery shopping) into routines. We also help families get through periods of change, like starting school and becoming an adult.
- Because your child may have many healthcare needs, the Autism Center team works closely with specialists across Seattle Children’s. Children with autism may also get care from providers in Psychiatry and Behavioral Medicine, Gastroenterology and Hepatology, Sleep Medicine and the Gender Clinic, among others.
Care from early childhood through young adulthood
- Working with your child early (early intervention) helps your child do better later in life (have better outcomes). We do diagnostic evaluations for children as young as 15 months. And we have programs to help young children build important skills that will serve them later, like our Applied Behavior Analysis (ABA) Early Intervention Program.
- Everyone on our team is specially trained to understand and meet the specific needs of children and teens with autism. Our experts tailor care to your child’s age, development, strengths and challenges. We adapt our care over time as their needs change.
- As your child with autism becomes a teen and young adult, they and your whole family will go through transitions. Some examples are aging out of high school, deciding if they will live on their own and starting care with providers who focus on adult health. The Autism Center provides adult transition services to help you figure out what’s next.
- The Alyssa Burnett Adult Life Center offers year-round classes and activities for adults 18 or older with autism or other to build social skills and promote lifelong learning.
Resources for your child and family
- We offer several classes for families that are free, open to anyone and do not require a referral. Two examples are Autism 101 about autism basics and Conversations About Autism with experts and young adults with autism ().
- For families with a referral, our class called Accessing Treatment, Learning and Support (ATLAS) (PDF) provides an overview and discussion of ways to find support and services in the community and at Seattle Children’s Autism Center. After taking ATLAS, you can access many other Autism Center classes. Learn about all our classes on the treatments and services page.
- Find more Seattle Children’s autism resources on our Patient and Family Education page.
Research to improve care
- Seattle Children’s experts research autism to better understand its causes and the best ways to diagnose and treat it. Your child may be able to take part in 1 of our current studies.
- We work with SPARK: Simons Foundation Powering Autism Research for Knowledge Study, which matches people with studies. This helps researchers learn more about autism-linked genes and develop better therapies.
- Our Autism Blog often reports on our research.
- Learn more about Autism Center research and clinical trials.
What are the symptoms of autism?
Autistic children and teens have differences in social communication as well as restricted interests and repetitive behaviors. This can take many different forms, and no 2 autistics are the same.
Here are examples of common autism symptoms. Your child may have only some of these, or they may have different ones. Your child’s age matters. Some of these behaviors are common in healthy, babies or younger toddlers but not in older toddlers, school-age kids or young adults.
Examples of differences in social communication
- Not looking you in the eye or holding eye contact
- Not reacting when you say their name
- Not making a range of facial expressions that show their feelings, like being happy or angry
- Not understanding other people’s expressions, feelings or intentions
- Not engaging with people in common ways, like waving or other gestures, pointing to something interesting, playing with other children, taking turns talking or making sounds, making and keeping friends or working with others in a group
- Not pretending or playing “make believe”
- Not trying to get your attention by singing, dancing or acting
- Not understanding different tones of voice (which suggest feelings or meaning)
Examples of restricted interests and repetitive behaviors
- Putting things in a certain order, like lining up their toys, and being upset if you change it
- Always playing with their toys in the same way instead of playing differently at different times
- Having a strong interest in 1 topic, type of object or part of an object, especially something unusual for their age
- Having a strong need for routines, like eating the same foods or taking the same route, and getting very upset by change, even a small change; having trouble trying new things
- Perceiving things as being clearly 1 way or another (“black and white” thinking) with no in between (“gray area”)
- Repeating words or sounds (echolalia)
- Repeating movements of their body, like flapping their hands, rocking back and forth, spinning around or walking on their toes or repeating movements with an object, like spinning the wheels or flipping the levers on a toy
- Reacting to the sound, smell, taste, look or texture of something (sensory input) in ways you would not usually expect (very strong or very weak reaction or avoiding sensory input)
Other conditions linked with autism
Many people with autism can speak, but others cannot. With therapy, they may learn to communicate in other ways, like using gestures, sign language, pictures, written words or electronic devices.
Autistic people can have a range of intellectual abilities, like thinking, remembering and being able to do typical day-to-day activities of living, like getting dressed.
Some other conditions are more common in people with autism, including anxiety, depression, attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), , feeding problems, constipation or other problems and sleep problems. Not every person with autism has these conditions.
Autism symptoms may be mild and hard to notice (the person can cover up or mask them). Or they can be severe and easy to notice. Children may also have many strengths that come from being autistic, such as excellent memory, attention to detail, knowing how something works after seeing it once (visual skills), honesty, directness and the ability to closely follow a routine once they learn it.
Your child’s healthcare team can explain which of your child’s features, experiences or behaviors may relate to autism.
How is autism diagnosed?
There is no test, like a blood test or brain scan, to tell if your child has autism.
Your child’s healthcare team will talk with you and ask questions about your child’s development and behavior. We will observe and interact with your child to look for certain patterns. We will also consider your child’s history so far. For example, has your child reached common milestones for their age? Or have they lost abilities or interests they used to have?
If a child has clear signs and symptoms, we can diagnose autism in children as young as 18 months old. For those with more subtle signs, the concerns may not be noticeable until they are school age.
How is autism treated?
Seattle Children’s Autism Center provides care for children with autism as well as support and resources for your family.
Our goals are to support your child’s abilities to do what they want and need to do at home, school and in the community so they can live their best life. We do not support treatments that try to take away a person’s autism or make them “no longer autistic.”
Because the symptoms of autism can vary so much, there is no single treatment plan for everyone. We design your child’s treatment just for them. Some children need only a little support. They can learn to live and thrive on their own. Others need more support — in some cases, lifelong support across many areas of life. Your child’s support needs may change over time.
Starting therapies for autism early is more likely to help with brain development, learning, communication, social skills and other challenges.
After we determine your child has autism, we give you a diagnostic report that recommends treatments.
Treatment may involve 1 or more of the following:
- Applied behavior analysis (ABA) – to teach and increase helpful behaviors and reduce behaviors that get in the way of daily life. The Autism Center has an ABA Early Intervention Program and offers therapies for challenging behaviors.
- Speech and language therapy – to improve communication and understanding, whether your child speaks or uses other methods like sign language, pictures or electronic devices (augmentative and alternative communication, or AAC).
- Feeding care – to help children who struggle with eating or drinking.
- Occupational therapy – to build skills that help your child complete tasks and be more independent. It can also help you better understand your child’s sensory needs and how to support them.
- Specialized teaching methods – to help your child learn in school using techniques that work best for people with autism.
- Social interventions – to improve connections with other people. We teach your child tools that build their social and emotional skills. We practice for real-life situations together.
- Medicines – to help with agitation and irritability that might go along with autism.
- Mental health therapy – to treat anxiety, depression, obsessive-compulsive disorder (OCD) or other concerns.
- Other treatments – to address other physical or mental health conditions, like , sleep problems, constipation or attention deficit hyperactivity disorder (ADHD), that are more common in people with autism.
- – to meet the needs of adolescents and teens and their families. We partner with our Gender Clinic. Gender diversity is more common in people with autism.
- Education and support – to help you learn about autism and understand the diagnosis and treatments. We help you find resources that match your needs. And we help you advocate for your child. We can also connect you with other families who have autistic children.
- Adult transition services – to prepare teens and young adults for the next stage of life based on their goals and needs on topics like health, socializing, , ongoing education, employment, transportation and housing.
Are there Seattle Children’s research studies or clinical trials for autism?
Researchers at Seattle Children’s are studying autism to improve diagnosis and treatment for children everywhere and help families. Learn about our current studies.
Learn more about how to get services at the Autism Center.
Providers, see how to refer a patient.
- Augmentative and Alternative Communication
- Autism Center
- Alyssa Burnett Adult Life Center
- Gender Clinic
- Occupational Therapy
- Patient and Family Education
- Speech and Language Services
Paying for Care
Learn about paying for care at Seattle Children’s, including coverage, billing and financial assistance.