• Autism is found in every country and region of the world
• In addition to the loss of personal potential, the cost of health and educational services exceeds $3 billion each year (National Institute of Mental Health, 2000)
• Emerging in early childhood, autism affects 1 or 2 people in every thousand and is 3 to 4 times more common in boys than girls (National Institute of Mental health)
• Autism is the third most common disability
  
• According to Centers for Disease Control and Prevention (2007), the estimated occurrence may be as high as 1 in 150 individuals
• Children with ASD usually have delayed development in at least 3 of the following 4 domains:
  Communication
  Play
  Social interaction
  Self care
• These children often display severe challenging behaviors including self-stimulatory behavior and self-injurious behavior.
• Each child is unique and presents with a unique set of presenting clinical issues
• Communication
  40% are mute/nonverbal
  echolalia
  monotone
  jargon
  delays

Social Interaction

• Abnormal relationships
• Difficulty relating to self, environment, and other people
• Stereotyped behaviors include
  – rituals and routines
  – insistence on sameness
• Abnormal sensory responses include
  – hypersensitivity
  – hyposensitivity

Warning Signs: Communication Development

• Uses very few words
  – By 2, children should be communicating verbally quite well
  – By 2 and ˝ years, children should be communicating in short sentences
• Was speaking, but has largely stopped using words
• Instead of asking for items, the child leads the adult to items he/she wants, gestures, and/or cries
• Does not follow verbal directions
• Does not imitate sounds or words
• The child speaks, but does so rapidly, quietly, or in some other stylized manner
• Extremely skilled with letters or numbers but is not otherwise talking
• Engages in highly repetitive or stereotyped speech that serves little purpose

Warning Signs: Play Development

• Does not engage in imitative play
• Does not want to play with others, adults or children
• The child is difficult to play with
• Engages in highly repetitive play
• Repetitively turns pages in books, does puzzles, etc.
• Shows an excessive fascination with certain objects or activities
• Engages in strange repetitive hand movements
• Looks out of the corner of their eye at items of interest
• Tilts their head to listen carefully to sounds
• Does not role play with trucks or dolls
• Resists using crayons or markers

Warning Signs: Social Development

• Throws tantrums for excessively long periods of time
• Cannot be easily confronted
• Adults in the child’s life know what certain events will result in extreme tantrum and go to extreme lengths to avoid them
• Does not snuggle easily
• Arches his/her back and cries when picked up
• Tenses strangely when happy
• Extremely fearful of certain sounds, people, or places
• Does not acknowledge others beyond a brief glance
• Prefers adults over children
• Hurts him/herself during tantrums

Warning Signs: Self-Care Development

• Cannot be left alone without fear of a dangerous behavior occurring
• Climbs dangerously, eats dangerous items, bolts into traffic, breaks things, and hurts children or animals
• Does not seem to feel pain
• Does not sleep through the night
• Resists certain food textures
• Difficult to dress or bathe
• Insists on a very particular diet
• You go through extreme lengths to put the child to bed
• Was slow to begin walking