2. Autism, or autism spectrum disorder (ASD), refers to a broad range of conditions characterized by challenges with
social skills, repetitive behaviors, speech and nonverbal communication. According to the Centers for Disease Control,
autism affects an estimated 1 in 59 children in the United States today.
We know that there is not one autism but many subtypes, most influenced by a combination of genetic and
environmental factors. Because autism is a spectrum disorder, each person with autism has a distinct set of strengths
and challenges. The ways in which people with autism learn, think and problem-solve can range from highly skilled to
severely challenged. Some people with ASD may require significant support in their daily lives, while others may need
less support and, in some cases, live entirely independently.
Several factors may influence the development of autism, and it is often accompanied by sensory sensitivities and
medical issues such as gastrointestinal (GI) disorders, seizures or sleep disorders, as well as mental health challenges
such as anxiety, depression and attention issues.
Indicators of autism usually appear by age 2 or 3. Some associated development delays can appear even earlier, and
often, it can be diagnosed as early as 18 months. Research shows that early intervention leads to positive outcomes
later in life for people with autism.

4. Autism’s core symptoms are
social communication challenges and
restricted, repetitive behaviors.
In autism, these symptoms
begin in early childhood (though they may go
unrecognized)
persist and
interfere with daily living.
Specialized healthcare providers diagnose autism
using a checklist of criteria in the two categories
above. They also assess symptomseverity.
Autism’s severity scale reflects how much support a
person needs for daily function.
Many people with autism have sensory
issues. These typically involve over- or under-
sensitivities to sounds, lights, touch, tastes, smells,
pain and other stimuli.
Autism is also associated with high rates of
certain physical and mental health conditions.

6. Social communication challenges
Children and adults with autism have difficulty with verbal and non-verbal communication. For example, they may
not understand or appropriately use:
Spoken language (around a third of people with autism are nonverbal)
Gestures
Eye contact
Facial expressions
Tone of voice
Expressions not meant to be taken literally
Additional social challenges can include difficulty with:
Recognizing emotions and intentions in others
Recognizing one’s own emotions
Expressing emotions
Seeking emotional comfort from others
Feeling overwhelmed in social situations
Taking turns in conversation
Gauging personal space (appropriate distance between people)
Restricted and repetitive behaviors
Restricted and repetitive behaviors vary greatly across the autism spectrum. They can include:
Repetitive body movements (e.g. rocking, flapping, spinning, running back and forth)
Repetitive motions with objects (e.g. spinning wheels, shaking sticks, flipping levers)
Staring at lights or spinning objects
Ritualistic behaviors (e.g. lining up objects, repeatedly touching objects in a set order)
Narrow or extreme interests in specific topics
Need for unvarying routine/resistance to change (e.g. same daily schedule, meal menu, clothes, route to school)

8. The information below is not meant to diagnose or treat. It should not take the place of consultation with a qualified healthcare
professional.
One of the most common questions asked after a diagnosis of autism, is what caused the disorder.
We know that there’s no one cause of autism. Research suggests that autism develops from a combination of genetic and nongenetic,
or environmental, influences.
These influences appear to increase the risk that a child will develop autism. However, it’s important to keep in mind that increased
risk is not the same as cause. For example, some gene changes associated with autism can also be found in people who don’t have the
disorder. Similarly, not everyone exposed to an environmental risk factor for autism will develop the disorder. In fact, most will not.
Autism’s genetic risk factors
Research tells us that autism tends to run in families. Changes in certain genes increase the risk that a child will develop autism. If a
parent carries one or more of these gene changes, they may get passed to a child (even if the parent does not have autism). Other
times, these genetic changes arise spontaneously in an early embryo or the sperm and/or egg that combine to create the embryo.
Again, the majority of these gene changes do not cause autism by themselves. They simply increase risk for the disorder
Autism’s environmental risk factors
Research also shows that certain environmental influences may further increase – or reduce – autism risk in people who are genetically
predisposed to the disorder. Importantly, the increase or decrease in risk appears to be small for any one of these risk factors:
Increased risk
Advanced parent age (either parent)
Pregnancy and birth complications (e.g. extreme prematurity [before 26 weeks], low birth weight, multiple pregnancies
Pregnancies spaced less than one year apart
Decreased risk
Prenatal vitamins containing folic acid, before and at conception and through pregnancy
No effect on risk
Vaccines. Each family has a unique experience with an autism diagnosis, and for some it corresponds with the timing of their child’s
vaccinations. At the same time, scientists have conducted extensive research over the last two decades to determine whether there is
any link between childhood vaccinations and autism. The results of this research is clear: Vaccines do not cause autism. The American
Academy of Pediatrics has compiled a comprehensive list of this research.
Differences in brain biology
How do these genetic and nongenetic influences give rise to autism? Most appear to affect crucial aspects of early brain development.
Some appear to affect how brain nerve cells, or neurons, communicate with each other. Others appear to affect how entire regions of
the brain communicate with each other. Research continues to explore these differences with an eye to developing treatments and
supports that can improve quality of life.

10. What Is Asperger Syndrome?
What Is Asperger Syndrome?
Asperger syndrome, or Asperger’s, is a previously used diagnosis on the autism spectrum. In 2013, it became
part of one umbrella diagnosis of autism spectrum disorder (ASD) in the Diagnostic and Statistical Manual of
Mental Disorders 5 (DSM-5).
Typical to strong verbal language skills and intellectual ability distinguish Asperger syndrome from other forms
of autism.
It generally involves:
Difficulty with social interactions
Restricted interests
Desire for sameness
Distinctive strengths
Strengths can include:
Remarkable focus and persistence
Aptitude for recognizing patterns
Attention to detail
Challenges can include:
Hypersensitivities (to lights, sounds, tastes, etc.)
Difficulty with the give and take of conversation
Difficulty with nonverbal conversation skills (distance, loudness, tone, etc.)
Uncoordinated movements, or clumsiness
Anxiety and depression
The tendencies described above vary widely among people. Many learn to overcome their challenges by
building on strengths.
Though the diagnosis of Asperger syndrome is no longer used, many previously diagnosed people still identify
strongly and positively with being an “Aspie.”

12. Therapies and services
Find the following services near you using the Autism Speaks Resource Guide.
Cognitive behavioral therapy can help address anxiety and other personal challenges.
Social skills training classes can help with conversational skills and understanding social
cues.
Speech therapy can help with voice control.
Physical and occupational therapy can improve coordination.
Psychoactive medicines can help manage associated anxiety, depression and attention
deficit and hyperactivity disorder (ADHD).
How has our understanding evolved?
1944: Austrian pediatrician Hans Asperger described four strikingly similar young
patients. They had normal to high intelligence. But they lacked social skills and had
extremely narrow interests. The children also shared a tendency to be clumsy.
1981: British psychiatrist Lorna Wing published a series of similar case studies. In it, she
coined the term “Asperger syndrome.”
1994: Asperger syndrome listed in the Diagnostic and Statistical Manual of Mental
Disorders (DSM-4).
2003: Asperger syndrome and other previously separate types of autism folded into one
umbrella diagnosis of “autism spectrum disorder” in DSM-5.

14. Autism Facts and Figures
Prevalence
In 2018 the CDC determined that approximately 1 in 59 children is diagnosed
with an autism spectrum disorder (ASD).
1 in 37 boys
1 in 151 girls
Boys are four times more likely to be diagnosed with autism than girls.
Most children were still being diagnosed after age 4, though autism can be
reliably diagnosed as early as age 2.
31% of children with ASD have an intellectual disability (intelligence quotient
[IQ] <70), 25% are in the borderline range (IQ 71–85), and 44% have IQ scores in
the average to above average range (i.e., IQ >85).
Autism affects all ethnic and socioeconomic groups.
Minority groups tend to be diagnosed later and less often.
Early intervention affords the best opportunity to support healthy development
and deliver benefits across the lifespan.
There is no medical detection for autism.

16. Causes
Research indicates that genetics are
involved in the vast majority of cases.
Children born to older parents are at
a higher risk for having autism.
Parents who have a child with ASD have
a 2 to 18 percent chance of having a
second child who is also affected.
Studies have shown that among identical
twins, if one child has autism, the other
will be affected about 36 to 95 percent of
the time. In non-identical twins, if one
child has autism, then the other is
affected about 31 percent of the time.
Over the last two decades, extensive
research has asked whether there is any
link between childhood vaccinations and
autism. The results of this research are
clear: Vaccines do not cause autism.

18. Intervention and Supports
Early intervention can improve
learning, communication and social
skills, as well as underlying brain
development.
Applied behavior analysis (ABA) and
therapies based on its principles are
the most researched and commonly
used behavioral interventions for
autism.
Many children affected by autism also
benefit from other interventions such
as speech and occupational therapy.
Developmental regression, or loss of
skills, such as language and social
interests, affects around 1 in 5 children
who will go on to be diagnosed with
autism and typically occurs between
ages 1 and 3.

20. Associated Challenges
An estimated one-third of people with autism are nonverbal.
31% of children with ASD have an intellectual disability (intelligence quotient [IQ]
<70) with significant challenges in daily function, 25% are in the borderline range (IQ
71–85).
Nearly half of those with autism wander or bolt from safety.
Nearly two-thirds of children with autism between the ages of 6 and 15 have been
bullied.
Nearly 28 percent of 8-year-olds with ASD have self-injurious behaviors. Head banging,
arm biting and skin scratching are among the most common.
Drowning remains a leading cause of death for children with autism and accounts for
approximately 90 percent of deaths associated with wandering or bolting by those age
14 and younger.

22. Associated Medical & Mental Health Conditions
Autism can affect the whole body.
Attention Deficient Hyperactivity Disorder (ADHD) affects an estimated 30 to 61
percent of children with autism.
More than half of children with autism have one or more chronic sleep problems.
Anxiety disorders affect an estimated 11 to 40 percent of children and teens on the
autism spectrum.
Depression affects an estimated 7% of children and 26% of adults with autism.
Children with autism are nearly eight times more likely to suffer from one or more
chronic gastrointestinal disorders than are other children.
As many as one-third of people with autism have epilepsy (seizure disorder).
Studies suggest that schizophrenia affects between 4 and 35 percent of adults with
autism. By contrast, schizophrenia affects an estimated 1.1 percent of the general
population.
Autism-associated health problems extend across the life span – from young children to
senior citizens. Nearly a third (32 percent) of 2 to 5 year olds with autism are overweight
and 16 percent are obese. By contrast, less than a quarter (23 percent) of 2 to 5
year olds in the general population are overweight and only 10 percent are medically
obese.
Risperidone and aripiprazole, the only FDA-approved medications for autism-associated
agitation and irritability.

24. Caregivers & Families
On average, autism costs an estimated
$60,000 a year through childhood,
with the bulk of the costs in special
services and lost wages related to
increased demands on one or both
parents. Costs increase with the
occurrence of intellectual disability.
Mothers of children with ASD, who
tend to serve as the child’s case
manager and advocate, are less likely
to work outside the home. On
average, they work fewer hours per
week and earn 56 percent less than
mothers of children with no health
limitations and 35 percent less than
mothers of children with other
disabilities or disorders.

26. Autism In Adulthood
Over the next decade, an estimated 500,000 teens (50,000 each year) will enter
adulthood and age out of school based autism services.
Teens with autism receive healthcare transition services half as often as those with other
special healthcare needs. Young people whose autism is coupled with associated medical
problems are even less likely to receive transition support.
Many young adults with autism do not receive any healthcare for years after they stop
seeing a pediatrician.
More than half of young adults with autism remain unemployed and unenrolled in higher
education in the two years after high school. This is a lower rate than that of young adults
in other disability categories, including learning disabilities, intellectual disability
or speech-language impairment.
Of the nearly 18,000 people with autism who used state-funded vocational rehabilitation
programs in 2014, only 60 percent left the program with a job. Of these, 80 percent
worked part-time at a median weekly rate of $160, putting them well below the poverty
level.
Nearly half of 25-year-olds with autism have never held a paying job.
Research demonstrates that job activities that encourage independence reduce autism
symptoms and increase daily living skills.

28. Economic Costs
The cost of caring for Americans with autism
had reached $268 billion in 2015 and would
rise to $461 billion by 2025 in the absence of
more-effective interventions and support
across the life span.
The majority of autism’s costs in the U.S. are
for adult services – an estimated $175 to $196
billion a year, compared to $61 to $66 billion a
year for children.
On average, medical expenditures for children
and adolescents with ASD were 4.1 to 6.2
times greater than for those without autism.
Passage of the 2014 Achieving a Better Life
Experience (ABLE) Act allows tax-preferred
savings accounts for people with disabilities,
including autism, to be established by states.
Passage of autism insurance legislation in
48 states is providing access to medical
treatment and therapies.