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Autism Spectrum Disorders

Autism is an umbrella term for a wide spectrum of disorders, sometimes referred to as “Pervasive Developmental Disorders” or “Autism Spectrum Disorders.” This essay is intended as a basic introduction -- a who, what, when, where, why, and how of autism.

WHO does autism affect?

Autism spectrum disorders cut across all lines of race, class, and ethnicity. Autism impacts millions of children, adults, and their families around the world. Boys have a significantly higher incidence of autism than girls: four out of every five people with autism are male. Because of the genetic link, siblings of a child with autism have a greater chance of being diagnosed with an autism spectrum disorder. Autism spectrum disorders affect not only the person diagnosed with the disorder, but also make a significant impact on the entire family with a variety of social, financial, and other practical demands.

WHAT is autism?

The word “autism” often evokes an image of a person with the most severe symptoms of the disorder; however, autism is an umbrella term for a wide range of disorders. Clinically, they may be referred to as “Pervasive Developmental Disorders” (PDDs) or “Autism Spectrum Disorders.”

The term “spectrum” is crucial to understanding autism, because of the wide range of intensity, symptoms and behaviors, types of disorders, and as always, considerable individual variation. Children with autism spectrum disorders may be non-verbal and asocial, as in the case of many with “classic” autism, or Autistic Disorder. On the other end of the spectrum are children with a high-functioning form of autism characterized by idiosyncratic social skills and play, such as Asperger Syndrome. In the Diagnostic and Statistical Manual (DSM-IV), these diagnostic categories are outlined under the heading of “Pervasive Developmental Disorders (PDDs).” In the DSM-IV, these disorders are defined by deficits in three core areas: social skills, communication, and behaviors and/or interests. Types of autism spectrum disorders, or PDDs, include:

  • Autistic Disorder
  • Asperger Syndrome
  • Childhood Disintegrative Disorder
  • Rett Syndrome
  • Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS)

More information about the diagnostic categories of autism may be found at the Autism Society of America’s Web site.

WHEN is autism diagnosed?

The First Signs of autism most often present themselves before the age of three; with education and practice, some clinicians have even been able to identify the warning signs in children under the age of one. Often, however, 15 to 18 months is the time parents first notice loss of skills or delays in development. Please see Hallmark Developmental Milestones and Red Flags for some of the warning signs.

Autism is characterized by what is clinically described as “deficits in social reciprocity.” Social reciprocity may include a range of back-and-forth actions, such as gestures, sounds, play, attention, and conversation. Further, ritualistic and obsessive behaviors are often present: for example, a child may insist on lining up toys rather than playing with them. In addition, a child with an autism spectrum disorder may have uncontrollable temper tantrums, an extreme resistance to change, and over- or under-sensitivity to sights and sounds. The signs may be obvious, or subtle: for example, a three year old child can read, but can’t play peek-a-boo. Another child may never utter a spoken word, but rather uses pictures or signing to be understood. The symptoms are varied, but one thing is clear: the earlier a child is diagnosed and begins receiving services, the better the prognosis for the child.

WHERE can a parent of a child with autism go for help?

Help for a child with autism begins at the physician’s office, with a referral to Early Intervention, specialists, and other services that might be covered by the insurance plan. Six months before a child’s third birthday, parents should contact their local school district for special educational services. At all stages of the process, from screening and diagnosis to making decisions about educational and treatment options, parents may benefit from an array of support groups, advocacy groups, and other organizations. These groups can provide a firm base for parent education and action. For more information, please see Resources.

WHY does a child have autism?

At this juncture, autism has no known cause or cure. Today, many parents and physicians are working together to advocate for increased funding of autism research.

HOW can I ensure the best developmental outcome for a child with autism?

Children with autism will have the best developmental outcome through early identification as well as early, intensive, and appropriate intervention. Please see the Treatments section for more information. Parents can help promote a healthy developmental pathway for a child with autism in much the same way as for a typically-developing child: by being a loving, active, and involved caregiver, and by working creatively with each child’s unique challenges and opportunities.

WHAT other disorders are often associated with this profile and should be ruled out or in by a specialist?

Often, you will see one or more overlapping disorders, including seizures, allergies, gastrointestinal disorders, immune dysfunction, hyperactivity, obsessive behaviors, anxiety, mood regulation, and depression. None of these on their own would indicate a presence of an autism spectrum disorder, however, many children with ASD will have one or more of these co-morbid symptoms. About 25% of children with autism will experience seizures during their lifetime. Before the diagnosis of ASD is given, the following disorders should be ruled out or in:

Fragile X Syndrome
Tuberous Sclerosis
Landau-Kleffner Syndrome
Developmental Language Disorder
Mental Retardation
Selective Mutism
Obsessive-Compulsive Disorder
Schizoid Personality Disorder
Reactive Attachment Disorder
Hearing Impairment
Chromosomal and Metabolic Disorders

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