Autism Part 1 of 3: What is Autism?

Intellectual and Developmental Disabilities 5

The Nurse Practitioner Show™ with Dr. Rachel Silva, DNP

Autism is a neurodevelopmental disability with a biological basis. The symptoms of autism are usually evident before a child is two years of age (Centers for Disease Control and Prevention [CDC], 2014). Autism consists of two primary signs: (a) impaired social communication and (b) impaired behaviors have restricted, repetitive, and stereotypes patterns of behavior language skills (American Psychiatric Association, 2013).

The meaning of the word autism or autistic derives from the Greek word “auto” or self, referring to extreme withdrawal from socialization. Understanding autism has evolved over the years. In the 1940’s, Dr. Leo Kanner of John Hopkins University, initially declared etiology to derive as a result of children escaping reality due to emotionally cold, distant, inflexible and detached parents, primarily mothers. In the 1970’s scientific discovery revealed a genetic link and neurologic basis resulting in improvement with behavioral therapy. This led to the diagnosis of autism being added to the Diagnostic and Statistical Manual 3rd edition (DSM-III) in 1980.

During the 1990’s Dr. Andrew Wakefield led a group of researchers in the United Kingdom correlating the Measles, Mump, Rubella (MMR) vaccine to the onset of autism. This led to much controversy with parents refusing to vaccinate their children due to Dr. Wakefield’s publication in the scholarly journal entitled The Lancet. The Institute of Medicine (IOM) further researched Dr. Wakefield’s claims and discovered he unethically conducted his research by selecting particular subjects who had lawyers with interest in lawsuits against the vaccination companies. Although his research was discovered to be fraudulent and his research publication in The Lancet was retracted, the correlation between vaccination and autism without research evidence still exists within society (Holaday, 2012). Well-known celebrities have accessed popular mainstream media platforms to share their personal experiences and opinions on the causes of autism. When relying on messages of an important health topic without utilizing evidence from scientific literature it contributes to confusion and distrust of the healthcare delivery system, which can negatively impact listeners and result in negative consequences for society as a whole.

Every individual with autism is unique and displays their own unique signs and symptoms of autism. There is saying that goes “if you meet one individual with autism, that’s exactly it. You’ve met only one individual with autism, because no two individuals with autism are alike.” There is no textbook answer to list the exact signs or symptoms of every individual with autism, the signs and symptoms can range from mild to severely disabling. The most common age for a diagnosis of autism is 4 years of age. This is unfortunate because symptoms usually are evident before 2 years of age. The earlier a child receives early intervention services, the earlier a child can receive early intervention services.

What are the signs to observe before a child is 2 years of age? These are developmental milestones. Although parents frequently observe for physical milestones such as sitting up, walking, etc., we must also observe for developmental milestones. The developmental milestones to observe before 2 years of age are:

  • 6 months – no smiling or happy facial expressions
  • 9 months – no reciprocal sharing with another person’s sounds, smiles or facial expressions
  • 12 months – no reciprocal sharing between another person by pointing, reaching, showing, or waving
  • 16 months – no words
  • 24 months – no meaningful two-word phrases (that is not imitated or repeated, must have meaningful purpose)
  • At any age – loss of speech, babbling or social skills

If a parent or caregiver has any concern or notices any of the above symptoms, notify the child’s pediatric physician or nurse practitioner for further evaluation. In addition, a child does not need a formal diagnosis by a healthcare provider for a parent or caregiver to request an early intervention evaluation. The purpose is identify children early in need of early intervention services; therefore, a child does not need a diagnosis of autism for evaluation through your state (in the United States). To locate your state’s contact information to request early intervention evaluation go here.

Stay tuned for more information on autism in upcoming blog articles and podcasts during the month of April for more information. To find your mobile device to subscribe to The Nurse Practitioner Show™ podcast go to To read the blog episode in this autism series click Autism Part 2 of 3: What Happens After an Autism Diagnosis?

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