Autism Spectrum Disorders (ASD) represent a group of atypical neurodevelopmental conditions.

They have an early onset, meaning they manifest at a young age, with effects that influence the person's development throughout their life.

These disorders can alter the behavior of those affected in varying degrees of severity.

They impact social communication, reciprocal social interaction, and functional and symbolic play:

• Language is compromised, sometimes very severely, up to a total absence of it;

• behaviors, attitudes, and communication methods, including non-verbal ones, that are inappropriate for age, context, or achieved mental development. This is due to the difficulty or inability to develop emotional reciprocity, both with adults and peers:

• restricted interests and stereotypical and repetitive behaviors.

Intellectual development can also be compromised, in mild, moderate, or severe forms.

Some cases present characteristically involved areas or less severe or variable behavioral manifestations, sometimes accompanied by normal intellectual development.

The care intervention for Autism Spectrum Disorders is a dedicated pathway for the assisted person, mobilizing multiprofessional and multidisciplinary resources. It involves parents and family members, healthcare, social, and educational professionals.

Families residing in Lazio can count on a financial support, aimed at minors with autism spectrum disorders up to the twelfth year of age. (link to page 2 – financial support)

If you suspect that the minor you are caring for may be affected by a Autism Spectrum Disorder, it is important to always consult your doctor or family pediatrician.

Already in the first year of life, parents can notice a first warning bell: the lack of language or atypical language development.

Another aspect to consider is the loss of skills that the child was acquiring.

In the stories of these children, it is common for parents to report news about the loss of competencies: they start to say a few words and then, after a while, they no longer say them, they have good eye contact and then gradually lose it, they tend to isolate themselves, engage in repetitive play, or develop stereotyped movements.

In other cases, some characteristics of autism emerge precisely when the child is placed in a social context, such as daycare or preschool.

Turning to the pediatrician is the first step to understanding what is happening. The pediatrician plays an important role in the early recognition of autism spectrum disorders, as they are usually the first point of contact for parents.

The pediatrician can proceed with initial screening tests or decide to refer the child to the developmental services TSMREE of the local health authority. Here, a more accurate neuropsychiatric clinical diagnosis will be made and any necessary support will be provided.

The service TSMREE (Unit for the Protection of Mental Health and Rehabilitation in Childhood) is a public territorial structure open for direct access that performs functions of prevention, protection, diagnosis, care, rehabilitation, and social and educational integration for individuals in developmental age (0-17 years).

The overall clinical assessment is carried out by a multidisciplinary team that includes a child neuropsychiatrist, a developmental neuropsychomotor therapist, a psychologist, and a speech therapist.

To perform it, a series of standardized tests and a defined process are used, in which observations are made and specific structured tests for autism, developmental tests, and functional assessments are administered.

It is essential to evaluate the child globally, to describe cognitive development (understanding ability), communicative (language), social (relationship ability), and emotional development, in order to define the therapeutic plan.

In younger children, aged 15 or 18 months, the diagnosis is more complex, especially when autism presents in a mild form and is not associated with intellectual disability.

For those children who have normal cognitive abilities and have not developed language, or have not yet developed the typical characteristics of autism such as stereotypies, it is necessary to proceed with specialized assessments that allow for an accurate differential diagnosis.

Diagnostic difficulties can be encountered in milder cases, such as in older children without intellectual disability and perhaps with an attention disorder that is often associated with autism.

Another cause of diagnostic complexity is the alterations in neurodevelopment, which somehow contribute to the impairment of the child's behavior.