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Autism Spectrum Disorders (Pervasive Developmental Disorders)
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 Autism is one of five conditions referred to as autism spectrum disorders or pervasive developmental disorders (PDD). These five conditions have different signs:

  • Autism. Children with autism exhibit a wide range of problems with varying degrees of severity. In general, they have problems in three crucial areas of development — social skills, language and behavior. The most severe cases of autism are marked by repetitive and unusual behaviors, sometimes including self-injurious and aggressive behaviors. Children with autism may require lifelong care and supervision, depending on the severity of their condition.

  • Asperger's syndrome. People with Asperger's syndrome usually have average intelligence and normal language development, but impaired social skills and awkward movements. Others often see them as odd or eccentric.

  • Childhood disintegrative disorder (CDD). Children with this rare condition develop normally during their early years before losing many of their language and social skills after age 3. Children with CDD may also show other signs of autistic behavior.

  • Rett syndrome. This very rare genetic disorder affects only girls. It causes them to develop autism-like behaviors after seemingly normal early development.

  • Pervasive developmental disorder not otherwise specified (PDD-NOS). This term applies to children with some signs of autism, but not enough to be diagnosed with the classic form of the disorder.

Two children with the same diagnosis may act quite differently and have strikingly different skills. If your child has any of these autism spectrum disorders, he or she may develop normally for the first few months — or years — of life, then become less responsive to other people, including you. You may recognize the following signs in the areas of social skills, language and behavior:

Social skills

  • Fails to respond to his or her name

  • Has poor eye contact

  • Appears not to hear you at times

  • Resists cuddling and holding — screams to be let down

  • Appears unaware of others' feelings

  • Seems to prefer playing alone — retreats into his or her "own world"


  • Starts speaking later than other children

  • Loses previous ability to say words or sentences

  • Speaks with an abnormal tone or rhythm — may use a singsong voice or robot-like speech

  • Can't start a conversation or keep one going

  • May repeat words or phrases verbatim, but doesn't understand how to use them


  • Performs repetitive movements, such as rocking or hand-twisting

  • Develops specific routines or rituals

  • Becomes disturbed at the slightest change in routines or rituals, such as if you move objects that your child has lined up

  • Hyperactive

  • May be fascinated by parts of an object, such as the spinning wheels of a toy car

  • May be sensitive to sensory stimulation, such as light, sound and touch

Children with autism also show signs of poor joint attention — or shared attention — at a young age. Joint attention is an early-developing social skill in which two people — usually a young child and an adult — share the experience of looking at an object or observing an event. It includes the ability to point at objects and follow another person's gaze. This skill is crucial to later language and social development.

In some children with autism, problems improve as they mature. Some people, usually those with the least severe impairments, eventually may lead normal or near-normal lives. For other people, however, there's little improvement in language or social skills, and the adolescent years can mean a worsening of behavior problems.

The majority of children with autism also have mental retardation, which means they're slow to acquire new knowledge or skills. However, some children with autism have normal to high intelligence. These children learn quickly yet have trouble communicating, applying what they know in everyday life, and adjusting in social situations. An extremely small number of children with autism are "autistic savants," which means they have exceptional skills in a specific area, such as art or math.


Autism has no single, identifiable cause. The disorder seems to be caused by abnormalities in several regions of the brain. Neurons in these regions appear to be smaller than normal and have stunted connections to other areas of the brain, but researchers don't know why.

A number of genetic factors may be behind these abnormalities. Autism also seems to occur more frequently in children who have other medical conditions, including fragile X syndrome, tuberous sclerosis, untreated phenylketonuria and congenital rubella syndrome. Researchers are investigating a number of theories about the cause of autism.

In recent years, some news reports have raised concerns about a connection between autism and vaccines. These reports have targeted the measles-mumps-rubella vaccine (MMR), as well as vaccines containing thimerosal, a preservative that contains a very small amount of mercury. However, extensive reports from the American Academy of Pediatrics, the Institute of Medicine, and the Centers for Disease Control and Prevention conclude that there's no scientifically proven link between these vaccines and autism.

When to seek medical advice

Babies develop at their own pace, and many don't stick to the exact timelines found in parenting books. But children with autism usually show some signs of delayed development by 18 months. If you suspect that your child may have autism, talk to your doctor.

Your doctor may recommend further evaluation if your child:

  • Doesn't babble or coo by 12 months

  • Doesn't gesture — such as point or wave — by 12 months

  • Doesn't say single words by 16 months

  • Doesn't say two-word phrases by 24 months

  • Has any loss of language or social skills at any age



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