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  • Psychology Assessment Center

    The pediatric neuropsychology specialists at Massachusetts General Hospital’s Psychology Assessment Center provide neuropsychological assessments to aid in the diagnosis and treatment of neurological, medical, genetic and developmental disorders.

    For more information, please call: 617-643-3997

About This Condition

Autism Spectrum Disorder

What is autism spectrum disorder?

Autism spectrum disorder is a neurological and developmental disorder that usually appears during the first 3 years of life. A child with autism appears to live in his or her own world, showing little interest in others, and a lack of social awareness. The focus of an autistic child is a consistent routine and includes an interest in repeating odd and peculiar behaviors. Autistic children often have problems in communication, avoid eye contact, and show limited attachment to others.

Autism can prevent a child from forming relationships with others. This is in part because of an inability to interpret facial expressions or emotions. A child with autism may resist cuddling, play alone, be resistant to change, and have delayed speech development. People with autism tend to exhibit repeated body movements. This includes flapping hands or rocking. They also have unusual attachments to objects. However, many people with autism excel consistently on certain mental tasks, such as counting, measuring, art, music, or memory.

What causes autism?

Scientists do not know the cause of autism. Research suggests that autism is a genetic condition. It is believed that several genes are involved in the development of autism. Research studies in autism have found a variety of abnormalities in the brain structure and chemicals in the brain, but the findings have not been consistent. One theory is the possibility that autistic disorder is a behavioral syndrome that includes several distinct conditions. However, parenting behaviors do not cause or contribute to autism.

Who is affected by autism?

About 1 in 88 children in the U.S. have an autism spectrum disorder, according to the CDC. Autism is more prevalent in boys than girls, with 4 to 5 times as many boys affected than girls.

What are the symptoms of autism?

The following are the most common symptoms of autism. However, each child may experience symptoms differently. Symptoms may include:

  • Does not socially interact well with others, including parents:

    • Shows a lack of interest in, or rejection of physical contact. Parents describe autistic infants as "unaffectionate." Autistic infants and children are not comforted by physical contact.

    • Avoids making eye contact with others, including parents

    • Fails to develop friends or interact with other children

  • Does not communicate well with others:

    • Is delayed or does not develop language

    • Once language is developed, does not use language to communicate with others

    • Has echolalia (repeats words or phrases repeatedly, like an echo)

  • Demonstrates repetitive behaviors:

    • Has repetitive motor movements (such as rocking and hand or finger flapping)

  • Is preoccupied, usually with lights, moving objects, or parts of objects

  • Does not like noise

  • Has rituals

  • Requires routines

The symptoms of autism may resemble other conditions or medical problems. Always talk with your child's healthcare provider for a diagnosis.

How is autism diagnosed?

Standard guidelines have been developed to help identify autism in children before the age of 24 months. In the past, diagnosis of autism was often not made until late preschool-age or later. The guidelines can help identify children with autism early. This means earlier, more effective treatment for the disorder.

According to the guidelines, all children before the age of 24 months should routinely be screened for autism and other developmental delays at their well-child check-ups. Children who show developmental delays and other behavior disorders should be further tested for autism.

The American Academy of Pediatrics recommends that all children should be screened for autism spectrum disorders at 18 and 24 months, regardless of whether any signs are apparent or any concerns have surfaced about a child’s developmental progress.

By screening children early for autism, those diagnosed with the disorder can be treated immediately and aggressively.

What are the guidelines?

The standardized guidelines developed for the diagnosis of autism actually involve 2 levels of screening for autism. Level 1 screening, which should be performed for all children seeing a healthcare provider for well-child checkups during their first 2 years of life, should check for the following developmental deficits:

  • No babbling, pointing, or gesturing by age 12 months

  • No single words spoken by age 16 months

  • No 2-word spontaneous (nonecholalic, or not merely repeating the sounds of others) expressions by age 24 months

  • Loss of any language or social skills at any age

  • No eye contact at 3 to 4 months

The second level of screening should be performed if a child is identified in the first level of screening as developmentally delayed. The second level of screening is a more in-depth diagnosis and evaluation that can differentiate autism from other developmental disorders. The second level of screening may include more formal diagnostic procedures by clinicians skilled in diagnosing autism. These include medical history; neurological evaluation; genetic testing; metabolic testing; electrophysiologic testing, such as CT scan, MRI, or PET scan; and psychological testing.

Genetic testing involves an evaluation by a medical geneticist, a healthcare provider who has specialized training and certification in clinical genetics. This is because symptoms of autism may be caused by several genetic syndromes. These include Fragile-X, untreated phenylketonuria (PKU), neurofibromatosis, tuberous sclerosis, and a variety of chromosome abnormalities. A geneticist can determine whether the symptoms of autism are caused by a genetic disorder, or whether the symptoms have no known genetic cause. If a genetic disorder is diagnosed, other health problems may be involved. The chance for recurrence in a future pregnancy would depend on the syndrome found. For example, PKU is an autosomal recessive disorder with a reoccurrence risk of 1 in 4, or 25%, chance. Tuberous sclerosis is an autosomal dominant disorder, with a reoccurrence risk of 50%.

In cases where no genetic cause for the autism is identified, the couple has a slightly increased chance for having another child with autism. The reason for this increase over the general population is thought to be because autism may result from several genes inherited from both parents acting in combination, in addition to unknown environmental factors. There is no action or inaction known that parents could have done, or did not do, to cause autism to happen in a child.

Always talk with your child's healthcare provider for a diagnosis and for more information.

Treatment for autism

Specialized behavioral and educational programs are designed to treat autism. Behavioral therapy is used to teach social skills, motor skills, and cognitive (thinking) skills. Behavior modification is also useful in reducing or eliminating maladaptive behaviors. Individualized treatment planning for behavioral therapy is important as autistic children vary greatly in their behavioral needs. Intensive behavior therapy during early childhood and home-based approaches training and involving parents are considered to produce the best results.

Special education programs that are highly structured focus on developing social skills, speech, language, self-care, and job skills. Medicine is also helpful in treating some symptoms of autism in some children. Mental health professionals provide parent counseling, social skills training, and individual therapy. They also help families identify and participate in treatment programs based on an individual child's treatment needs. Your child's healthcare provider will figure out the best treatment for your child based on: 

  • How old your child is

  • His or her overall health and past health

  • How sick he or she is

  • How well your child can handle specific medicines, procedures, or therapies

  • How long the condition is expected to last

  • Your opinion or preference

Prevention of autism

Preventive measures to reduce the incidence or severity of autistic disorders are not known at this time.


  • At Seat at the Table raises funds for autism - 2/21/2015, Mass General

    A Seat at the Table took place on November 4 with cooking sensation Ina Garten, known to her legions of fans as the Barefoot Contessa. The event offered an intimate dining experience at Boston's Mandarin Oriental, and benefited Massachusetts General Hospital and MassGeneral Hospital for Children's Lurie Center for Autism.

  • Help us discover new ways to treat the symptoms of autism - 2/21/2015, Research

    The Lurie Center's Research Program offers children, adolescents and adults a unique opportunity to participate in groundbreaking research studies. Learn how you can participate in an exciting study that is exploring a new autism treatment. This new treatment could potentially treat autism's core symptoms, including impaired communication and social skills.

  • Buie Featured in Video Series for Autism Speaks - 1/26/2015, Mass General

    Timothy Buie, MD, director of Pediatric Gastroenterology and Nutrition at the Lurie Center for Autism, discusses various topics surrounding gastroenterology issues and autism in a video series for Autism Speaks.

  • Decompressing After School: Students with an Autism Spectrum Disorder - 9/8/2014, Mass General

    Many children and teens on the autism spectrum expend a lot of energy to “hold it together” just to make it through the school day. When they get home from school they could benefit from a little time to decompress. Here are strategies parents can use to help facilitate this process.

  • Determined to succeed - 8/29/2014, Mass General

    The Aspire Adult Internship Program at the Lurie Center for Autism helps adults gain valuable experience in the work world.

  • No Connection Between School Shooting and Asperger's Syndrome - 12/17/2012, Mass General

    In a blog post shared here, D. Scott McLeod, PhD, a MassGeneral Hospital for Children psychologist and executive director of Aspire Program, says persons with ASD are no more likely to commit a violent act than persons not on the autism spectrum.

  • McDougle named inaugural Nancy Lurie Marks Professor - 5/11/2012, Mass General

    To advance understanding and treatment of autism, Nancy Lurie Marks and the Nancy Lurie Marks Family Foundation have established the Nancy Lurie Marks Professorship in the Field of Autism at Harvard Medical School (HMS). The chair’s first incumbent is Christopher McDougle, MD, who joined the MGH in October as the inaugural director of the Lurie Center for Autism.

  • Improving care for patients with autism - 4/1/2011, Mass General

    MGH Hotline 4.1.11 April is Autism Awareness Month, and at MassGeneral Hospital for Children (MGHfC), a team led by Sarabeth Broder-Fingert, MD, a second-year resident in Pediatrics, is working to improve the inpatient experience for patients with autism and their families.

  • Is There a Link between Autism and the Gut? - 1/19/2010, Mass General

    Autism spectrum disorders and gastrointestinal woes: A discussion with Dr. Timothy Buie, pediatric gastroenterologist at MassGeneral Hospital for Children.

  • A generous gift - 8/28/2009, Mass General

    MGH Hotline 08.28.09 Many associate autism with children, but the complex disorder is a lifelong condition affecting a growing population of adults.

  • Tuberous Sclerosis Complex - 7/21/2009, Mass General

    The Carol and James Herscot Center for Tuberous Sclerosis Complex (TSC) at Massachusetts General Hospital and MassGeneral Hospital for Children is using genetic research to better understand TSC and other diseases like cancer, autism and obesity.


  • Photo of Dr. Lisa Nowinski

    Lisa Nowinski, PhD

    Dr. Lisa Nowinski talks about her work as a neuropsychologist at the Lurie Center for Autism.

  • Photo of Ann Neumeyer, MD

    Ann Neumeyer, MD

    Dr. Ann Neumeyer, the medical director at the Lurie Center for Autism, talks about her work as a neurologist.

  • Photo of Gretchen Timmel, MEd

    Gretchen Timmel, MEd

    Gretchen Timmel works with adults and children at the Lurie Center for Autism.

  • Photo of Christopher McDougle, MD

    Christopher McDougle, MD

    Dr. Christopher McDougle, the director of the Lurie Center for Autism, talks about his work as a psychiatrist.

  • ASPIRE Program 2012

    ASPIRE Program 2012

    Hear from program administrators and participants about the ASPIRE program which benefits children and young adults with autism and other related disorders.