People with ASD struggle with social skills and restricted or repetitive behaviors. You or your child may have ASD if you identify with the issues in both of these categories.

Social issues include problems with:

• Making friends, getting along with classmates and coworkers, or engaging in romantic relationships
• Talking back and forth with neurotypical people
• Sharing interests, activities, emotions, and affection with others
• Understanding how someone else thinks or feels
• Navigating body language, gestures, and facial expressions
• Making eye contact

Restricted or repetitive behaviors include:

• An intense interest in specific things or topics.
• Strong attachment to certain objects, such as a special toy.
• Always doing things in a certain way or order. For example, lining up toys or books in a certain order.
• Physical repetition, such as rocking, spinning, flapping their arms, or running back and forth. This stimming helps people with ASD regulate their emotions.
• Avoidance of certain places and things due to a sensitivity to sounds, touch, smells, foods, and textures.

The American Psychiatric Association breaks down ASD into 3 levels based on the severity of symptoms and the need for support.

• Level 1 autism (requires support): If you have level 1 autism, you may do well at school or work but struggle socially. Others do well at home but struggle with school and work. Getting support can help improve your social skills. It was once Asperger's syndrome or high-functioning autism.
• Level 2 autism (substantial support): Kids with level 2 autism may have trouble with social communication and rigid behaviors, even with support. It used to be "classic autism."
• Level 3 autism (very substantial support): When your child has level 3 autism, their symptoms are severe, and they need substantial, often lifelong, support. It used to be autistic disorder.

ASD symptoms often start before the age of 3. You may even notice symptoms of ASD when your child is a baby.

Early signs of autism in babies include:

• No or little eye contact
• No or few smiles or other joyful expressions
• No or little back-and-forth sharing of smiles, sounds, or facial expressions

Early signs of autism in toddlers include:

• Delayed speech, including no or little babbling before 16 months old. By 16 months, your child may speak no or few words. By 24 months, they may only say a few words and no meaningful two-word phrases.
• No or little back-and-forth gestures such as pointing, waving, reaching, or showing.
• No or little response to their name.

ASD is a common disorder in children. While anyone can have ASD, boys are more likely to get an ASD diagnosis than girls. In some cases, girls with ASD are misdiagnosed with another mental health disorder, often ADHD, first.

Girls with ASD often hide their symptoms—called "masking." They may smile and make eye contact, even if it's difficult. They may push through discomfort to fit in and make friends. Masking can lead to other mental and behavioral disorders, like anxiety and depression.

At Carilion, we know the signs and symptoms of ASD vary from kid to kid. We use tools like psychiatric assessments to get to the right diagnosis.

ASD diagnosis in children

If your child's doctor suspects they have ASD, they will refer you to Carilion Children's Child Development Clinic. Our child development care team will do testing to figure out the cause of your child's symptoms.

We can often diagnose ASD in children as young as age 2. If we diagnose your child with ASD, we'll let you know your child's level of autism and create a treatment plan to help.

ASD treatment in children

The earlier we can diagnose ASD, the sooner we can start treatment. Early intervention makes a difference in long-term outcomes and skills. It gives your child the best chance to thrive and develop to their full potential.

With successful treatment, some children may improve their autism level and need less support. Some children can improve so much that when they become adults, they're no longer on the autism spectrum.

Every child has strengths, challenges, and support needs. Our Child Development Clinic will work with your family to design a treatment plan that meets your child's needs.

This may include:

• Behavioral care: Tools to improve their physical, thinking, emotional, social, and communication skills. We also provide family training to help parents, siblings, and caregivers interact with children with ASD.
• Outpatient therapy: This may include physical and occupational therapy for fine and gross motor skills and speech therapy for language delays and speech problems.
• Mental health counseling: We offer talk therapy to help people work through emotions and feelings and learn coping skills. We also provide talk therapy for parents, siblings, and other family members.
• Clinical social work: To help you access community resources and services that help your child thrive and help you care for them. 
• Medicines: We may use mental health medicine to manage some of the symptoms of ASD.

We treat ASD in adults—whether you've had an ASD diagnosis since childhood or are newly diagnosed with ASD.

It's possible to reach adulthood without knowing you have ASD. When you were a child or teen, you may have received an incorrect diagnosis of ADHD or another mental disorder. 

Some signs that you may have ASD include:

• Problems making friends or forming romantic relationships
• Problems getting or keeping a job
• Sensitivities to certain sounds, smells, foods, or textures
• Obsessive tendencies, such as needing to follow the same routine every day

ASD diagnosis in adults

If you think you may have ASD, talk to your doctor. They can refer you to one of our mental health professionals for a psychological assessment. We may ask you to complete a questionnaire to understand your symptoms better.

ASD treatment in adults

ASD treatment plans include care into adulthood. As your teen becomes a young adult, our child development experts transition care to our adult mental and behavioral care experts. 

ASD care in adults includes many of the same treatments as children:

• Skill-building therapies
• Mental health counseling
• Medicines