What is Autism?
What Is Autism?
Autism is a complex neurobehavioral disorder that includes impairments in social interaction and developmental language and communication skills combined with rigid, repetitive behaviors. The disorder covers a large spectrum of symptoms, skills, and levels of impairment. It ranges in severity from a handicap that somewhat limits an otherwise normal life to a devastating disability that may require institutional care.
Children with autism have trouble communicating. They have trouble understanding what other people think and feel. This makes it very hard for them to express themselves either with words or through gestures, facial expressions, and touch.
What Are the Symptoms of Autism?
A child with autism spectrum disorder may have problems in three different areas — socializing, communicating, and behavior.
Each child with an autism spectrum disorder will have his or her own individual pattern of behavior: Sometimes, a child’s development is delayed from birth; other children develop normally before suddenly losing social or language skills. In some children, a loss of language is the impairment; in others, unusual behaviors (like spending hours lining up toys) predominate.
No babbling by 9 months
No pointing or gestures by 12 months
Not responding to their name by 12 months of age
No single words by 16 months
Lack of pretend play by 18 months
No two-word phrases by 24 months
Any loss of language or social skills at any age
Other signs of autism to look for include:
Extreme difficulty in learning language.
Inappropriate response to people: A child with autism may avoid eye contact, resist being picked up or cuddled, and seem to tune out the world.
Inability or reduced ability to play cooperatively with other children or to make friends.
Inability to understand other people’s feelings.
Need for a rigid, highly structured routine — and being very distressed by changes in routines
Extreme hyperactivity or unusual passivity, and extreme resistance to change.
Aggressive, self-injurious behavior.
Repetitive body movements, including pacing, hand flicking, twisting, spinning, rocking, or hitting oneself.
Insensitivity to pain or lack of response to cold or heat.
Impulsive behavior and no real fear of dangers.
An unusual attachment to inanimate objects such as toys, strings, or spinning objects.
Frequent crying and tantrums for no apparent reason.
Peculiar speech patterns: A child with autism may use words without understanding their meanings.
Abnormal responses to sensations such as light, sound, and touch: At times, a child with autism may appear deaf or may be extremely distressed by everyday noises or repeat words or phrases over and over.
Some of these symptoms occur in children with other disabilities. Symptoms can change as the child grows older.
How Is Autism Diagnosed?
Because there aren’t specific medical tests for autism, it’s best to get a diagnosis from a physician or psychologist who specializes in developmental disabilities and has experience diagnosing Autism Spectrum Disorders (ASDs).
The diagnosis of autism is made by taking into account the child’s complete medical and behavioral history, lengthy observation of the child’s behavior, and ruling out other problems that may cause some of the same symptoms. It is important to distinguish autism from other disorders, because a misdiagnosis may result in delayed, inappropriate, or ineffective treatment.
Find out more about autism:
Diagnosis and Treatment
What Are the Treatments for Autism?
There is no known cure for autism, but it is treatable. Many people with autism become more responsive as they come to better understand the world. Some children’s symptoms may improve significantly or resolve altogether. The goals of treatment include:
Stopping inappropriate behaviors so the child can relate better to others.
Teaching the child to attend to purposeful activity. This can help the child succeed in educational settings.
Helping the child learn self-care skills.
Providing opportunities for the child to socialize with others.
Improving the child’s communication skills.
Teaching parents how to provide helpful educational and social experiences for their child.
In most cases, treatment is provided in an individualized program that focuses on behavior modification and skills development. Treatment also may include medication to help control specific symptoms such as hyperactivity. Usually, a team of specialists — a psychologist, a special education teacher, a speech therapist, an occupational therapist, a child development specialist, and trained aides — is involved in treatment for an individual child.
In general, treatment programs tend to be more effective if they build on the child’s unique interests, if they engage the child in highly structured activities according to a predictable schedule, and if they provide regular rewards for desired behavior. Also, the parents’ involvement is very important to the educational and social development of autistic children.
The earlier treatment for autism begins, the better the child’s chance of developing important skills. Early treatment can greatly help most children with autism. Treatment usually reduces symptoms of autism, regardless of the child’s age or the severity of the condition.
There are many complementary and alternative therapies touted to help an autistic child. Because there is no cure for autism, many families turn away from traditional medicine. It is important that these therapies cause no harm. Discussing them with the child’s autism specialist is recommended.
In the U.S., the Individuals with Disabilities Education Act (IDEA) guarantees a free and appropriate public education for every child with a disability, including those with autism. Children under the age of 3 years who are at risk of having developmental delays may be eligible for services under IDEA. These services are provided through an early intervention system in your state. Through this system, you can also ask for an evaluation.
A child with autism who is very sensitive may be greatly troubled — sometimes even pained — by sounds, touches, smells, or sights that seem normal to others.
Children who are autistic may have repetitive, stereotyped body movements such as rocking, pacing, or hand flapping. They may have unusual responses to people, attachments to objects, resistance to change in their routines, or aggressive or self-injurious behavior. At times they may seem not to notice people, objects, or activities in their surroundings. Some children with autism may also develop seizures. And in some cases, those seizures may not occur until adolescence.
Many people with autism are cognitively impairted to some degree. In contrast to more typical cognitive impairment, which is characterized by relatively even delays in all areas of development, people with autism show uneven skill development. They may have problems in certain areas, especially the ability to communicate and relate to others. But they may have unusually developed skills in other areas, such as drawing, creating music, solving math problems, or memorizing facts. For this reason, they may test higher — perhaps even in the average or above-average range — on nonverbal intelligence tests.
Autism typically appears during the first three years of life. Some children show signs from birth. Others seem to develop normally at first, only to slip suddenly into symptoms when they are 18 to 36 months old. However, it is now recognized that some individuals may not show symptoms of a communication disorder until demands of the environment exceed their capabilities. Autism is four times more common in boys than in girls. It knows no racial, ethnic, or social boundaries. Family income, lifestyle, or educational levels do not affect a child’s chance of being autistic.
Autism is said to be increasing; however, it is not entirely clear whether the increase is related to changes in how it is diagnosed or whether it is a true increase in the incidence of the disease.
The most recent version of the Diagnostic and Statistical Manual of Mental Disorders version 5 (DSM-5) has just a single category for the diagnosis of an autistic disorder– autism spectrum disorders, which includes the following disorders that were previously diagnosed as individual disorders:
Autistic disorder. This is what most people think of when they hear the word “autism.” It refers to problems with social interactions, communication, and imaginative play in children younger than 3 years.
Asperger’s syndrome. These children don’t have a problem with language — in fact, they tend to score in the average or above-average range on intelligence tests. But they have the same social problems and limited scope of interests as children with autistic disorder.
Pervasive developmental disorder or PDD — also known as atypical autism. This is a kind of catch-all category for children who have some autistic behaviors but who don’t fit into other categories.
Rett syndrome. Children with Rett syndrome, primarily girls, start developing normally but then begin losing their communication and social skills. Beginning at the age of 1 to 4 years, repetitive hand movements replace purposeful use of the hands. Children with Rett syndrome are usually severely cognitively impaired.
Childhood disintegrative disorder. These children develop normally for at least two years and then lose some or most of their communication and social skills. This is an extremely rare disorder and its existence as a separate condition is a matter of debate among many mental health professionals.
These disorders may now be diagnosed as either a social communication disorder or autism spectrum disorder based on the primary impairments.