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Autism Spectrum Disorder

Atlantic General Hospital and the neurodevelopmental specialists at Baltimore’s renowned Kennedy Krieger Institute have developed a collaborative partnership to deliver the most advanced diagnostics and treatment to children with autism spectrum disorder (ASD).

Atlantic Health Center
9714 Healthway Drive
Berlin, Maryland 21811
Get directions
Phone: (410) 641-3340
By appointment: 8:00am – 5:00 pm, Monday through Friday

What Is Autism Spectrum Disorder?

Autism Spectrum Disorder (ASD) is a general term used to describe a group of complex developmental brain disorders – autism spectrum disorders – caused by a combination of genes and environmental influences. These disorders are characterized, in varying degrees, by communication difficulties, social and behavioral challenges, and repetitive behaviors.

Autism Spectrum Disorder by the Numbers:

The National Centers for Disease Control and Prevention (CDC) report released March 31, 2016 found the overall prevalence of Autism Spectrum Disorder (ASD) as

  • 1 in every 68 children
  • The prevalence among boys is 78% higher than among girls
  • 1 in every 42 boys
  • 1 in every 189 girls

The overall prevalence in Maryland is even higher, finding;

  • 1 in every 55 children
  • 1 in every 34 boys
  • 1 in every 161 girls

Caucasian children are more likely to be identified with ASD:

  • 1 in every 60 Caucasian children
  • 1 in every 65 African American children
  • 1 in every 84 Asian or Pacific Islander children
  • 1 in every 102 Hispanic children

When should children first be evaluated for developmental concerns?

The Centers for Disease Control and Prevention (CDC) released (March 31, 2016) its newest estimate of autism prevalence among the nation’s children.

  • The report shows that, overall, less than half the children identified with autism (43 percent) had received comprehensive developmental evaluations by age 3. Despite the fact that the vast majority (87 percent) had developmental concerns noted in their medical or educational records before age 3.

Currently, Autism can be reliably diagnosed by age 2, with earlier diagnosis affording greater opportunities for intervention that supports healthy development and improves function and quality of life.

What are the signs and symptoms of Autism Spectrum Disorder?

What to look for…

Early signs of autism in babies and toddlers

  • Doesn’t make eye contact (e.g. look at you when being fed)
  • Doesn't smile when smiled at
  • Doesn't respond to his or her name, or to the sound of a familiar voice
  • Doesn’t follow objects visually
  • Doesn't point or wave goodbye, or use other gestures to communicate
  • Doesn’t follow the gesture when you point things out
  • Doesn’t make noises to get your attention
  • Doesn’t initiate or respond to cuddling
  • Doesn’t imitate your movements and facial expressions
  • Doesn’t reach out to be picked up
  • Doesn’t play with other people or share interest and enjoyment
  • Doesn’t ask for help or make other basic requests

The following delays warrant an immediate evaluation by your child’s pediatrician.

  • By 6 months: No big smiles or other warm, joyful expressions
  • By 9 months: No back-and-forth sharing of sounds, smiles, or other facial expressions
  • By 12 months: Lack of response to name
  • By 12 months: No babbling or “baby talk”
  • By 12 months: No back-and-forth gestures, such as pointing, showing, reaching, or waving
  • By 16 months: No spoken words
  • By 24 months: No meaningful two-word phrases that don’t involve imitating or repeating

Signs and symptoms of autism in older children

As children get older, the red flags for autism become more diverse. There are many warning signs and symptoms, but they typically revolve around impaired social skills, speech and language difficulties, non-verbal communication difficulties, and inflexible behavior.

Signs and symptoms of social difficulties in autism

  • Appears disinterested or unaware of other people or what’s going on around them
  • Doesn’t know how to connect with others, play, or make friends
  • Prefers not to be touched, held, or cuddled
  • Doesn’t play "pretend" games, engage in group games, imitate others, or use toys in creative ways
  • Has trouble understanding or talking about feelings
  • Doesn’t seem to hear when others talk to him or her
  • Doesn't share interests or achievements with others (drawings, toys)

Basic social interaction can be difficult for children with autism spectrum disorders. Many kids on the autism spectrum seem to prefer to live in their own world, aloof and detached from others.

Signs and symptoms of speech and language difficulties in autism

  • Speaks in an abnormal tone of voice, or with an odd rhythm or pitch (e.g. ends every sentence as if asking a question)
  • Repeats the same words or phrases over and over
  • Responds to a question by repeating it, rather than answering it
  • Refers to themselves in the third person
  • Uses language incorrectly (grammatical errors, wrong words)
  • Has difficulty communicating needs or desires
  • Doesn’t understand simple directions, statements, or questions
  • Takes what is said too literally (misses undertones of humor, irony, and sarcasm)

Children with autism spectrum disorders have difficulty with speech and language. Often, they start talking late.

Signs and symptoms of nonverbal communication difficulties in autism

  • Avoids eye contact
  • Uses facial expressions that don't match what he or she is saying
  • Doesn’t pick up on other people’s facial expressions, tone of voice, and gestures
  • Makes very few gestures (such as pointing). May come across as cold or “robot-like.”
  • Reacts unusually to sights, smells, textures, and sounds. May be especially sensitive to loud noises.
  • Abnormal posture, clumsiness, or eccentric ways of moving (e.g. walking exclusively on tiptoe)

Children with autism spectrum disorders have trouble picking up on subtle nonverbal cues and using body language. This makes the "give-and-take" of social interaction very difficult.

Signs and symptoms of inflexibility in autism

  • Follows a rigid routine (e.g. insists on taking a specific route to school)
  • Has difficulty adapting to any changes in schedule or environment (e.g. throws a tantrum if the furniture is rearranged or bedtime is at a different time than usual)
  • Unusual attachments to toys or strange objects such as keys, light switches, or rubber bands
  • Obsessively lines things up or arranges them in a certain order
  • Preoccupation with a narrow topic of interest, often involving numbers or symbols (e.g. memorizing and reciting facts about maps, train schedules, or sports statistics)
  • Spends long periods of time arranging toys in specific ways, watching moving objects such as a ceiling fan, or focusing on one specific part of an object such as the wheels of a toy car
  • Repeats the same actions or movements over and over again, such as flapping hands, rocking, or twirling (known as self-stimulatory behavior, or “stimming”). Some researchers and clinicians believe that these behaviors may soothe children with autism more than stimulate them.​

Children with autism spectrum disorders are often restricted, inflexible, and even obsessive in their behaviors, activities, and interests.

Common self-stimulatory behaviors:

  • Hand flapping
  • Rocking back and forth
  • Spinning in a circle
  • Finger flicking
  • Head banging
  • Staring at lights
  • Moving fingers in front of the eyes
  • Snapping fingers
  • Tapping ears
  • Scratching
  • Lining up toys
  • Spinning objects
  • Wheel spinning
  • Watching moving objects
  • Flicking light switches on and off
  • Repeating words or noises

Authors: Melinda Smith, M.A., Jeanne Segal, Ph.D., and Ted Hutman, Ph.D (UCLA Center for Autism Research & Treatment). Last updated: April 2016.

Help is Right Here

Children with Autism Spectrum Disorder can receive the top quality care they deserve without the inconvenience and disruption of having to travel outside our region.

As part of a unique collaborative partnership between Atlantic General Hospital and the neurodevelopmental specialists at Baltimore’s renowned Kennedy Krieger Institute we are able to deliver the most advanced diagnostics and treatment via innovative telemedicine delivery capabilities. This is the first program of its kind in the United States.

Learn More

Kennedy Krieger InstituteFor more information or to schedule a developmental health consultation, please call (410) 641-3340.