The following is
information is derived from the Autism Society of
America's introductory information about autism. We have added
additional information and/or commentary in italics.
Definition of Autism
Autism is a complex developmental disability that
typically appears during the first three years of life. The result of a
neurological disorder that affects the functioning of the brain, autism
impacts the normal development of the brain in the areas of social
interaction and communication skills. Children and adults with autism
typically have difficulties in verbal and non-verbal communication,
social interactions, and leisure or play activities. (Autism
Coach - Children with severe symptoms may not be able to speak or have a limited
range of speech. They may also have difficulty understanding
others through spoken and/or written communication. Children and adults with milder
symptoms can speak but often have difficulty understanding the give and
take of social interactions, reading other people's emotions and
motivations accurately, and have difficulty carrying out day to
day activities independently and in a timely fashion. Even an
adult diagnosed with Asperger's Syndrome or High Functioning Autism and
an IQ of over 130 may not be able to live independently unless he or she
is able to get along with co-workers, cope with sensory distractions in
the workplace, appropriately allocate money to pay for food, rent,
health care and other essentials, and meet other challenges that may
arise.)
Autism is one of five disorders coming under the umbrella of
Pervasive Developmental Disorders (PDD), a category of neurological
disorders characterized by "severe and pervasive impairment in
several areas of development," including social interaction and
communications skills (DSM-IV-TR). The five disorders under PDD are
Autistic Disorder, Asperger's Disorder, Childhood Disintegrative
Disorder (CDD), Rett's Disorder, and PDD-Not Otherwise Specified (PDD-NOS).
Each of these disorders has specific diagnostic criteria as outlined by
the American Psychiatric Association (APA) in its Diagnostic &
Statistical Manual of Mental Disorders (DSM-IV-TR).
(Autism Coach - Labels given to
individuals with milder symptoms of autism include High Functioning
Autism, Asperger's Syndrome, and Pervasive Developmental Disorder Not
Otherwise Specified (PDD NOS). Sometimes an individual may have have additional
issues and may also be labeled with Hyperlexia, ADD, or ADHD,
Tourette's Syndrome or Learning Disabled (LD) although children with
these labels are frequently not within the autism spectrum. Frequently,
high-functioning children are unlabeled or mislabeled for many years until
someone knowledgeable about high functioning autism comes into contact with
them.)
Prevalence of Autism
Autism is the most common of the Pervasive Developmental Disorders,
affecting an estimated 2 to 6 per 1,000 individuals (Centers for Disease
Control and Prevention, 2001). This means that as many as 1.5 million
Americans today are believed to have some form of autism.
And that number is on the rise. Based on statistics from the U.S.
Department of Education and other governmental agencies, autism is
growing at a rate of 10-17 percent per year. At these rates, it is
estimated that the prevalence of autism could reach 4 million Americans
in the next decade.
The overall incidence of autism is consistent around the globe, but
is four times more prevalent in boys than girls. Autism knows no racial,
ethnic, or social boundaries, and family income, lifestyle, and
educational levels do not affect the chance of autism's occurrence. (Autism
Coach - Clusters of higher incidence of autism have been found in
certain areas of the U.S. - Brick County, New Jersey is one such
example. Also, according to an article in Wired Magazine, there
appears to
be a higher incidence of autism amongst the children of scientists,
musicians, programmers, and engineers - with a cluster of autism occurring in Silicon Valley,
California.)
Common Characteristics of Autism
While understanding of autism has grown tremendously since it was
first described by Dr. Leo Kanner in 1943, most of the public, including
many professionals in the medical, educational, and vocational fields,
are still unaware of how autism affects people and how they can
effectively work with individuals with autism. Contrary to popular
understanding, many children and adults with autism may make eye
contact, show affection, smile and laugh, and demonstrate a variety of
other emotions, although in varying degrees.
Autism is a spectrum disorder. The symptoms and characteristics of
autism can present themselves in a wide variety of combinations, from
mild to severe. Two children, both with the same diagnosis, can act very
differently from one another and have varying skills. All children
with autism can learn, function productively and improve with
appropriate education and treatment. (Autism Coach -
substantial, and not infrequently, huge improvements are being made by
children within the autism spectrum when the children are under the
age of five and the behavioral and bio-medical issues are addressed
through a comprehensive intervention program.)
Every person with autism is an individual, and like all individuals,
has a unique personality and combination of characteristics. Some
individuals mildly affected may exhibit only slight delays in language
and greater challenges with social interactions. The person may
have difficulty initiating and/or maintaining a conversation.
Communication is often described as talking at others (for example,
monologue on a favorite subject that continues despite attempts by
others to interject comments).
People with autism process and respond to information in ways that
differ from neurotypical (non-autistic) people. (Autism Coach -
how individuals within the autism spectrum perceive incoming information through sight,
hearing, touch, taste and balance, store and organize this information
and retrieve information from memory may be the underlying issues
contributing to autistic behavior, according to recent research).
Persons with autism may also exhibit some of the following
traits.
For most of us, the integration of our senses helps us to understand
what we are experiencing. For example, our senses of touch, smell and
taste work together in the experience of eating a ripe peach: the feel
of the peach fuzz as we pick it up, its sweet smell as we bring it to
our mouth, and the juices running down our face as we take a bite. For
children with autism, sensory integration problems are common. Their
senses may be over-or under-active. The fuzz on the peach may actually
be experienced as painful; the smell may make the child gag. Some
children with autism are particularly sensitive to sound, finding even
the most ordinary daily noises painful. Many professionals feel that
some of the typical autism behaviors are actually a result of sensory
integration difficulties. (Autism Coach - some children who
appear to be undersensitive to sensory input, such as hearing, may
actually be overly sensitive and have tuned out sound completely because
it is so unpleasant for them.)
There are many myths and misconceptions about autism. Contrary to
popular belief, many autistic children do make eye contact; it just may
be less or different from a non-autistic child. Many children with
autism can develop good functional language and others can develop some
type of communication skills, such as sign language or use of
pictures. (Autism Coach - According to
some autistic children
who are able to communicate through speech, typing or letter boards,
they only process one form of sensory input at a time. If they are
looking, they can't hear - so frequently they look away from someone who
is talking to them so they can concentrate on understanding what the
speaker is saying.)
Diagnosing Autism
An diagnosis of autism is based on observation of the individual's
communication, behavior, and developmental levels. However,
because many of the behaviors associated with autism are shared by other
disorders, various medical tests may be ordered to rule out or identify
other possible causes of the symptoms being exhibited. Autism may
also co-occur with other conditions such as Tourette's Syndrome, seizure
disorders, ADD, ADHD, and depression.
It is important to distinguish autism from other conditions,
since an accurate diagnosis and early identification can provide the
basis for building an appropriate and effective educational and
treatment program. (Autism Coach - In our
opinion, it is important to identify and address underlying and related
medical conditions. However, as a wise
parent once said, "Labels are for cans, not for kids!" Our
children are not a collection of labels. We must look beyond
labels to the whole child we love, determine our child's strengths and
areas of deficit, and then create an intervention program that allows
that child to use his or her strengths to lay the groundwork for new
learning and the acquisition of new skills and abilities.)
Early Diagnosis
Research indicates that early diagnosis is associated with
dramatically better outcomes for individuals with autism. The earlier a
child is diagnosed, the earlier the child can begin benefiting from one
of the many specialized intervention approaches. (Autism Coach
- We can't emphasize enough how important it is to begin treatment as
early as possible!)
Diagnostic Tools
The characteristic behaviors of autism spectrum disorders may or may
not be apparent in infancy (18 to 24 months), but usually become obvious
during early childhood (24 months to 6 years). The National
Institute of Child Health and Human Development (NICHD) lists these five
behaviors that signal further evaluation is warranted:
Having any of these five "red flags" does not mean a child
has autism, but because the characteristics of the disorder vary so
much, a child should have further evaluations by a multidisciplinary
team that may include a neurologist, psychologist, developmental
pediatrician, speech/language therapist, learning consultant, or other
professionals knowledgeable about autism.
While there is no one behavioral or communications test that can
detect autism, several screening instruments have been developed that
are now used in diagnosing autism.
CARS rating system (Childhood Autism Rating Scale),
developed by Eric Schopler in the early 1970s, is based on observed
behavior. Using a 15-point scale, professionals evaluate a child's
relationship to people, body use, adaptation to change, listening
response, and verbal communication.
The Checklist for Autism in Toddlers (CHAT) is
used to screen for autism at 18 months of age. It was developed by
Simon Baron-Cohen in the early 1990s to see if autism could be
detected in children as young as 18 months. The screening tool uses
a short questionnaire with two sections, one prepared by the
parents, the other by the child's family doctor or pediatrician.
The Autism Screening Questionnaire is a 40 item
screening scale that has been used with children four and older to
help evaluate communication skills and social functioning.
The Screening Test for Autism in Two-Year Olds,
being developed by Wendy Stone at Vanderbilt, uses direct
observations to study behavioral features in children under two. She
has identified three skills areas - play, motor imitation, and joint
attention - that seem to indicate autism.
Autism Organizations
The following is a list of links to major autism organizations
world-wide. These links do not constitute an endorsement - they are provided for informational purposes. For
a list of recommended links, please click here.