Autism spectrum disorder is a developmental disability characterized by difficulties in social interaction, communication, and behavior. There are several medical conditions that have signs or symptoms similar to ASD: ADHD, PTSD, OCD, anxiety, depression, hearing impairment, and language disorders are the more common ones. It’s best to bring your child to a developmental-behavioral pediatrician so they can be assessed properly.
Introduction: What is ASD?
Autism spectrum disorder (ASD) is one of the most common developmental disabilities diagnosed in kids.
According to the Centers for Disease Control and Prevention, children with ASD have problems in social interaction and communication, and tend to stick with repetitive behavior.
ASD can start in early childhood and should be treated once diagnosed.
The American Psychiatric Association has laid out specific criteria to diagnose ASD.
There are two main categories that should be present in order to consider ASD in a child:
- Deficits in social communication or interaction
- Repetitive or restrictive behaviors
Note that a qualified healthcare professional will ultimately determine if a child does have ASD or not.
Children with ASD have problems with social interaction and communication.
- Being unable to interact properly or sustain everyday conversations with people (as appropriate for the child’s age)
- Unusual use or understanding of eye contact, facial expressions, and body language to communicate with others
- Low or complete lack of use of words to communicate
- Difficulty interacting with and forming relationships with others, even through simple activities such as playtime
The second category is repetitive or restrictive patterns of behavior.
Some examples are:
- Repetitive manner of speaking or interacting with objects, such as repeating the same words over and over again or always arranging toys in the same way
- Difficulty adjusting to changes in their routine, such as walking a different path back home, trying new foods, or playing with new toys
- Intense interest or attachment to toys or other similar objects
- Very low or very high sensitivity with their senses, like lights, smells, temperature, pain, or textures of objects
Other conditions that get confused with ASD
It can be quite difficult to diagnose ASD because other disorders can occur along with it. The most common ones are psychiatric disorders.
Anxiety, depression, attention-deficit/hyperactivity disorder (ADHD), and post-traumatic stress disorder (PTSD) are some examples.
This is why it can be hard at times to determine which condition your child has and whether they have more than one.
Attention deficit-hyperactivity disorder (ADHD)
Attention deficit hyperactivity disorder (ADHD) is a combination of inattention and impulsive behavior that develops before a child turns 12 years old.
It often negatively affects a child’s holistic development. Sometimes, ADHD can be diagnosed in kids as young as 3 years old.
In ADHD, children hardly stay attentive or stay put in one place, making it hard to communicate properly and bond with kids their age. This kind of behavior is also commonly seen in autism.
Post-traumatic stress disorder (PTSD)
In post-traumatic stress disorder, or PTSD, a person who experiences a very dangerous or emotionally stressful situation may have difficulty recovering from the event.
PTSD can develop within 3 months from the event or as late as several years after. They can become withdrawn and avoidant of anything that can remind them of the traumatic event.
Children with PTSD may become avoidant and prefer repetitive activities, traits that can be seen in ASD. In this case, it may be difficult for the healthcare team to determine whether the diagnosis is ASD, PTSD, or both.
It’s important to note that kids with PTSD usually have their communication and socialization skills intact or possibly slightly reduced, as compared to those with ASD.
Currently, there aren’t enough studies about PTSD and ASD together, but several experts are considering that ASD can be a risk factor for PTSD.
Related to PTSD is a history of abuse or neglect, which may cause children to lose their language skills and feel withdrawn from others, even kids their age.
These symptoms may also be confused with autism.
Obsessive-compulsive disorder (OCD)
Obsessive-compulsive disorder, also known as OCD, is a condition wherein a person is plagued by a lot of unwanted thoughts that raise their fears and anxieties.
These thoughts force them to perform a certain action again and again to counteract these feelings.
As an example, a child may worry about getting sick from touching objects in public. They may end up refusing to shake hands with friends or touch any door handle outside their house.
A college student may be fearful of leaving her dorm room open, so she may feel the need to return back to her dorm several times throughout the day to check if she did lock her door.
The presence of repetitive behaviors can be confusing, as this could be due to OCD, autism, or even both at the same time.
Anxiety disorders are similar to OCD in that they often have repetitive and bothersome thoughts that increase their worries.
There are different types of anxiety disorders – examples are generalized anxiety disorder and social anxiety disorder.
These thoughts can be so intrusive that they can manifest as physical symptoms, like dizziness and palpitations.
Children with anxiety can have trouble adjusting to sudden changes in their everyday activities, including interactions with new people. However, like PTSD, their sense of social connection with other people is still intact.
Depression is intense sadness that lasts for more than a few weeks, affecting a person’s physical health and productivity. They have difficulty concentrating, feel worthless, or may think of death or suicide.
Depression can also cause symptoms such as weight loss or gain, decreased energy, and sleeping too much or too little.
In depression and other related disorders, kids may withdraw from other people, avoid social interactions (like eye contact), and have decreased emotional responses when talking to others. These are also present in ASD.
Language disorders and hearing impairment
Some parents worry that their child may have autism when they show signs of language development delay.
Language disorders may be expressive (speaking words and sentences) or receptive (understanding others).
These disorders may appear even before a child turns 1 but is commonly diagnosed between 3 to 5 years old.
Children with ASD may barely use words to communicate, similar to language delay. However, only those with ASD will show restrictive or repetitive behavioral patterns.
Deaf children prefer to communicate with parents through gestures, do not verbalize frequently, and do not naturally make eye contact with other people.
These may initially be seen as signs of autism. But these children, as compared to those with ASD, have no problems in social interactions with family and peers.
Can a child have autistic traits but not be autistic?
Yes. Autism spectrum disorder is diagnosed through a set of signs and symptoms. Having only one of these does not automatically mean a child has autism.
There are certain criteria that have to be met, including being seen by a qualified healthcare professional before being diagnosed with autism.
How do you rule out autism?
It isn’t easy to diagnose autism. This requires years of specialized medical training.
To completely rule out autism, your child should be screened by a developmental-behavioral pediatrician or a similarly qualified healthcare professional.
Autism spectrum disorder can have varying signs and symptoms, which may be confused with other medical conditions.
If you are concerned that your child may have ASD, take them to a developmental-behavioral pediatrician for an evaluation.
After all, each disorder is treated differently, and it’s best that your child is diagnosed and treated early.