Data shows that more children in the United States are being diagnosed with autism.

DEAR MAYO CLINIC: My 2 year old niece has had several problems since birth and is behind in communication and attention. I wonder if she might be on the autism spectrum. Before I tell my sister about this, can you explain autism and the best way to treat it?

ANSWER: Autism is one of a group of serious developmental problems called autism spectrum disorders that appear in early childhood — usually before the age of 3. Although symptoms and severity vary, all autism spectrum disorders affect children’s ability to communicate and interact with others.

Children with autism typically have problems in three critical areas of development: social interaction, language, and behavior. Some children show signs of autism in early childhood. Other children may develop normally for the first few months or years of life, but then suddenly become withdrawn or aggressive, or lose the language skills they have already acquired.

Early detection of autism spectrum disorder can improve quality of life. By recognizing the early signs and symptoms, you can help children learn, grow and develop.

Signs of autism

Some children show signs of autism spectrum disorder in early childhood, such as reduced eye contact, lack of response to names, or indifference to caregivers. Others develop normally for the first few months or years of life, but then they suddenly become withdrawn or aggressive, or lose the language skills they have already acquired. Symptoms usually appear by age 2.

Children with autism spectrum disorder are likely to have a unique pattern of behavior and range in difficulty from low-functioning to high-functioning.

Early detection of autism spectrum disorder can improve quality of life.

Some children with this disorder have learning difficulties, and some show signs of below-normal intelligence. Other children have average to high intelligence. Although they learn quickly, they have problems with communication, applying knowledge in everyday life and adjusting to social situations. Because children can have a unique mix of symptoms, the severity can sometimes be difficult to determine. The degree of severity usually depends on the level of impairment and how the impairment affects functional abilities.

Problems with communication

Children with autism spectrum disorder may have problems with communication skills and social interaction. Common symptoms include:

  • Sometimes doesn’t respond to their name or doesn’t seem to hear you.
  • Resists hugs and cuddles and seems to prefer to play alone.
  • Poor eye contact and lack of facial expression.
  • Absence of speech, speech delay, or loss of previous ability to speak words or sentences.
  • Inability to initiate or continue a conversation.
  • Talking with an abnormal tone or rhythm and possibly using a singing voice or robotic speech.
  • Repeating words or phrases verbatim but not understanding how to use them.
  • Does not seem to understand simple questions or instructions.
  • Not expressing emotions or feelings and having an idea of ​​other people’s feelings.
  • Not showing or bringing objects to divide the interest.
  • Inappropriate approach to social interactions by being passive, aggressive or disruptive.
  • Difficulty recognizing nonverbal cues, such as interpreting other people’s facial expressions, body posture, or tone of voice.

Behavioral problems

Children with autism spectrum disorder may have limited, repetitive patterns of behavior, interests, or activities, including:

  • Performing repetitive movements such as clapping, rocking, or spinning.
  • Doing things that could lead to self-harm, such as biting or head banging.
  • Developing certain routines or rituals and getting upset at the slightest change.
  • Problems with coordination, strange movement patterns, and strange, stiff, or exaggerated body language.
  • Fascination with the details of an object, such as the wheels of a toy car, but not understanding the general purpose or function of the object.
  • Unusual sensitivity to light, sound, or touch, but indifference to pain or temperature.
  • Do not engage in make-believe, pretend play, or co-op play with other children.
  • Fixating on an object or activity with abnormal intensity or focus.
  • Want to eat only a few certain foods or avoid foods with a certain texture.

Some children with this disorder become more social and less disruptive as they grow older. Those with the least severe problems can eventually lead normal or near-normal lives. Others, however, continue to struggle with language or social skills, and adolescence can bring worse behavioral and emotional problems.

Based on the signs and symptoms, if you think your niece may have an autism spectrum disorder, discuss it with your sister and encourage her to ask about developmental testing.


Although there is no cure for autism, intensive early diagnosis and treatment can make a big difference in the lives of many children with the disorder.

The ultimate goal of treatment is to improve children’s ability to function, reduce symptoms, and help children develop and learn. Autism symptoms and severity vary greatly. Therefore, treatment options for children diagnosed with autism also vary. Typically, treatment options may include individualized behavioral interventions, speech and occupational therapy, medication, and other treatments that involve the entire family.

Regardless of your niece’s diagnosis, remind your sister that you are there for her and encourage her to talk to her health care provider about treatment options that are best for her child’s needs.

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