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Part One: Understanding Autism Spectrum Disorder

The Open Sky Clinical Team

This is the first installment of a two-part series on autism spectrum disorder. Stay tuned for part two, which focuses specifically on how Open Sky supports students on the spectrum. 

At Open Sky, we frequently support students who have autism. Sometimes these students have been diagnosed with autism spectrum disorder (ASD) before they come to us, but many have not been or have been misdiagnosed. Through careful assessment, Open Sky staff can identify students on the spectrum and provide support through therapeutic interventions to help them develop skills to manage some of their challenges. 

What is autism?

Autism, or autism spectrum disorder, refers to a broad range of conditions characterized by challenges with social skills, repetitive behaviors, speech, and communication. In 2013, the American Psychiatric Association merged four distinct autism diagnoses (including the term Asperger’s) into one umbrella diagnosis of autism spectrum disorder (ASD). According to the Centers for Disease Control, ASD affects an estimated 1 in 44 children in the United States today. 

 The word “spectrum” indicates that autism appears in different forms with varying levels of severity. That means that each individual with autism experiences unique strengths, symptoms, and challenges, and each person’s experience can vary widely. 

What causes autism?

Until recently, the cause of autism wasn’t clear, but more current research is starting to provide answers. What is clear is that there is no one cause of autism and no one type of autism. A number of rare gene changes or mutations are associated with autism, and in most cases, a complex combination of genetic risk and environmental factors influence early brain development, which can lead to autism. 

What are the characteristics of autism?

There are wide-ranging and numerous symptoms and behaviors of autism. While not a comprehensive list, here are some characteristics that we typically see in students at Open Sky: 

  • Rigid thinking 
  • Difficulty with transitions 
  • Emotional dysregulation 
  • Difficulty reading others’ emotions or social cues 
  • Closely focused interests 
  • Reduced eye contact 
  • Differences in body language 

Social Symptoms 

People with autism may have difficulty interpreting what others think and feel and may miss social cues. Individuals on the spectrum may also struggle with seeing things from another person’s perspective. People with autism may also have difficulty with emotional regulation. 

Communication Challenges 

Sometimes, young children with autism may experience significant language delays. Interestingly, others may only experience slight delays or even display extensive vocabularies yet have difficulty sustaining conversations. People on the spectrum may struggle with the “give-and-take” of conversations and may carry on monologues on topics of interest to them.  

Repetitive Behaviors 

Some people with ASD engage in repetitive behaviors or intense preoccupations or obsessions. This may look like arranging or rearranging objects or insisting that objects must be in a fixed order or place. Extreme interests held by people on the spectrum may include a fixation on something like machines, science topics, certain collectibles, social media, popular culture, etc. and may result in an unusual depth of knowledge on the interest. 

Executive Functioning and Theory of Mind 

People on the autism spectrum may struggle with executive functioning, including organizing, planning, sustaining attention, flexible thinking, and self-control. People on the spectrum may also have difficulty with theory of mind, which is a person’s ability to understand the thoughts, feelings, and intentions of others. This may present as others falsely believing that the individual does not show empathy or emotional understanding, which can lead to challenges in social settings. 

What are mental health conditions that co-occur with ASD? 

At Open Sky, we frequently see co-occurring conditions with ASD that may include: 

  • ADHD
  • Anxiety
  • Depression
  • Sleeping disorders
  • Eating disorders

How is autism diagnosed?

Signs of autism can appear by age two or three, but people with milder forms of autism may not be diagnosed until their teenage years or even as adults. There is no known biological marker for autism, meaning no test can diagnose the disorder. Instead, we as clinicians rely on close observation, medical histories, and questionnaires to determine whether an individual has autism.  


  • Autism, or autism spectrum disorder, refers to a broad range of conditions characterized by challenges with social skills, repetitive behaviors, speech, and nonverbal communication.  
  • Because of mental health conditions that frequently co-occur with ASD, a diagnosis may be missed. Through close observation, Open Sky staff are experienced in assessing students and correctly diagnosing ASD. 

Interested in learning more? Stay tuned for our second part of this series, focused on how Open Sky supports students on the autism spectrum.  

March 13th, 2023

The Open Sky Clinical Team