www.AutismSpectrumDisorder.infoAutism
Autism is classified as a neurodevelopmental disorder that manifests itself in markedly abnormal social interaction, communication ability, patterns of interests, and patterns of behavior.
Although the specific etiology of autism is unknown, many researchers suspect that autism results from genetically mediated vulnerabilities to environmental triggers. While there is disagreement about the magnitude, nature, and mechanisms for such environmental factors, researchers have found seven genes prevalent among individuals diagnosed as autistic. Some estimate that autism occurs in as many as one child in 166 in the United States. However, the National Institute of Mental Health gives a more conservative estimate of one in 1000.[1] A study published in 2006 indicates that men over 40 are almost six times more likely to father a child with autism than younger men.[2] Overall autism is three to four times more common in boys than girls though this average obscures the spread of severity - at the more severe end of diagnosis, the ratio of boys to girls is closer to 1:1.[3] Diagnosis is based on a list of psychiatric criteria, and a series of standardized clinical tests may also be used.
Autism may not be physiologically obvious. A complete physical and neurological evaluation will typically be part of diagnosing autism. Some now speculate that autism is not a single condition but a group of several distinct conditions that manifest in similar ways. Recently, researchers at the University of Pennsylvania School of Medicine have found a link between autism, abnormal blood vessel function and oxidative stress (the result of higher levels of free radicals). The study suggests that, if researchers can find more evidence linking decreased blood flow to the brain and oxidative stress with the pathology of autism, improvements in therapy could be found.[4] One factor noted about autistic children is they have on average a larger head circumference.[5] By definition, autism must manifest delays in "social interaction, language as used in social communication, or symbolic or imaginative play", with "onset prior to age 3 years", according to the Diagnostic and Statistical Manual of Mental Disorders. The ICD-10 also requires symptoms to be "manifest before the age of three years." There have been large increases in the reported incidence of autism, for reasons that are heavily debated by researchers in psychology and related fields within the scientific community. With intense therapy (most notably Applied Behavioral Analysis) and practice and schooling, some children diagnosed with autism can improve their social and other skills to the point where they can fully participate in mainstream education and social events, but there are no indications that a cure from autism is possible with current technology or advances in medicine. Some autistic children and adults who are able to communicate (at least in writing) are opposed to attempts to cure their autism, because they (and/or the guardians) see autism as part of who they are.
History
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The word autism was first used in the English language by Swiss psychiatrist Eugene Bleuler in a 1912 issue of the American Journal of Insanity. It comes from the Greek word for "self". Bleuler used it to describe the schizophrenic's seeming difficulty in connecting with other people.
However, the classification of autism did not occur until the middle of the twentieth century, when in 1943 psychiatrist Dr. Leo Kanner of the Johns Hopkins Hospital in Baltimore reported on 11 child patients with striking behavioral similarities, and introduced the label early infantile autism. He suggested "autism" from the Greek a?t?? (autos), meaning "self", to describe the fact that the children seemed to lack interest in other people. Although Kanner's first paper on the subject was published in a now defunct journal, The Nervous Child, almost every characteristic he originally described is still regarded as typical of the autistic spectrum of disorders. At the same time an Austrian scientist, Dr. Hans Asperger, made similar observations, although his name has since become attached to a different, "higher-functioning", form of autism known as Asperger's syndrome. However, widespread recognition of Asperger's work was delayed by World War II in Germany, and by the fact that his seminal paper wasn't translated into English for almost 50 years. The majority of his work wasn't widely read until 1997. These two conditions are today listed in the Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR (fourth edition, text revision 1) as two of the five pervasive developmental disorders (PDD), more often referred to today as autism spectrum disorders (ASD). All of these conditions are characterized by varying degrees of difference in communication skills, social interactions, and restricted, repetitive and stereotyped patterns of behavior. Few clinicians today use only the DSM-IV criteria, which are based on the absence or delay of certain developmental milestones, to diagnose autism. |  Dr. Hans Asperger described a form of autism in the 1940s that later became known as Asperger's syndrome. |
Terminology
Look up autism, autistic in Wiktionary, the free dictionary.When referring to someone diagnosed with autism, the term autistic is often used. However, the terms person with autism or person who experiences autism can be used instead. These are referred to as person-first terminology. The autistic community generally prefers the term autistic for reasons that are fairly controversial.[6] This article uses the term autistic.
Characteristics
There is a great diversity in the skills and behaviors of individuals diagnosed as autistic, and physicians will often arrive at different conclusions about the appropriate diagnosis. Much of this is due to the sensory system of autistics, which is quite different from the sensory system of other people, since certain stimulations can affect an autistic differently than a non-autistic, and the degree to which the sensory system is affected varies wildly from one autistic person to another.
Nevertheless, professionals within pediatrics, child psychology, behavior analysis, and child development often look for early indicators of autism in order to initiate treatment as early as possible for the greatest benefit. However, some people do not believe in treatment for autism, either because they do not believe autism is a disorder or because they believe treatment can do more harm than good.
The majority of autistics have slightly enlarged brain size, compared to normal people. Neurology Today (Volume 2,8: August 2002) stated that "Although it is accepted that autistic individuals have, on average, an enlarged brain size, the nature of this abnormality remains unknown.". (See also the paper "Brain Volume in Autism" PDF link).
Social development
Typically, developing infants are social beings—early in life they do such things as gaze at people, turn toward voices, grasp a finger, and even smile. In contrast, most autistic children prefer objects to faces and seem to have tremendous difficulty learning to engage in the give-and-take of everyday human interaction. Even in the first few months of life, many seem indifferent to other people because they avoid eye contact and do not interact with them as often as non-autistic children. Some infants with autism may present as very "good" babies--they may tend not to cry since they are not wont to seek the attention and ministration of parents.
Autistic children often appear to prefer being alone to the company of others and may passively accept such things as hugs and cuddling without reciprocating, or resist attention altogether. Later, they seldom seek comfort from others or respond to parents' displays of anger or affection in a typical way. Research has suggested that although autistic children are attached to their parents, their expression of this attachment may be unusual and difficult to interpret. Parents who looked forward to the joys of cuddling, teaching, and playing with their child may feel crushed by this lack of expected attachment behavior.
According to Simon Baron-Cohen, autistic children often also appear to lack a "theory of mind", the ability to see things from another person's perspective, a behavior cited as exclusive to human beings above the age of five and, possibly, other higher primates such as adult gorillas, chimpanzees and bonobos. Typical 5-year-olds can develop insights into other people's different knowledge, feelings, and intentions, interpretations based upon social cues (e.g., gestures, facial expressions). An autistic individual may lack these interpretation skills, an inability that leaves them unable to predict or understand other people's actions.
The social alienation of autistics and people with Asperger's can be so intense from childhood that many of them report having imaginary friends or inventing imaginary worlds or scenarios. Making friends in real life, and maintaining those friendships, can be difficult.
Although not universal, it is common for autistics to be unable to regulate their behavior. This can take the form of crying or verbal outbursts or self-injurious behaviours that may seem out of proportion to the situation. Autistic individuals generally prefer consistent routines and environments; they may react negatively to changes in them. It is not uncommon for these individuals to exhibit aggression, increased levels of self-stimulatory behavior, self-injury or extensive withdrawal in overwhelming situations.
Sensory system
A key indicator to clinicians making a proper assessment for autism would include looking for symptoms much like those found in sensory integration dysfunction. Children will exhibit problems coping with the normal sensory input. Indicators of this disorder include oversensitivity or underreactivity to touch, movement, sights, or sounds; physical clumsiness or carelessness; poor body awareness; a tendency to be easily distracted; impulsive physical or verbal behavior; an activity level that is unusually high or low; not unwinding or calming oneself; difficulty learning new movements; difficulty in making transitions from one situation to another; social and/or emotional problems; delays in speech, language or motor skills; specific learning difficulties/delays in academic achievement.However, it is essential to keep in mind that while most people with autism have some degree of sensory integration difficulty, not every person who has sensory problems is autistic.
One common example is autistic hearing. An autistic person may have trouble hearing certain people while other people are louder than usual. Or the autistic may be unable to filter out sounds in certain situations, such as in a large crowd of people (see cocktail party effect). However, this is perhaps a part of autism that tends to vary widely from person to person, so these examples may not apply to every autistic person. Note that such auditory difficulties fall under auditory processing disorders, and like sensory integration dysfunction, are not necessarily experienced by all people with autism or indicative of a diagnosis of autism.
Communication difficulties
By age 3, typical children have passed predictable language learning milestones; one of the earliest is babbling. By the first birthday, a typical toddler says words, turns when he or she hears his or her name, points when he or she wants a toy, and when offered something distasteful, makes it clear that the answer is "no." It should be noted, however, that late language development does occur in a minority of neurotypical children.
Speech development in people with autism takes different paths to the majority of neurotypical children. Some remain mute throughout their lives with varying degrees of literacy; communication in other ways—images, visual clues, sign language, and typing may be far more natural to them. Contrary to the prevailing traditional stereotype of mute people with Kanner-type autism, around one third of people diagnosed with this type of autism will develop what is often viewed as dysfunctional verbal language, relying on rote learned stored phrases, songs, jingles and advertisements. Those with the autism spectrum condition of Semantic Pragmatic Disorder fall into this group.
Those who do speak sometimes use language in unusual ways, retaining features of earlier stages of language development for long periods or throughout their lives. Some speak only single words, while others repeat a mimicked phrase over and over. Some repeat what they hear, a condition called echolalia. Sing-song repetitions in particular are a calming, joyous activity that many autistic adults engage in. Many people with autism have a strong tonal sense, and can often understand at least some spoken language whilst others can understand language fluently.
Some children may exhibit only slight delays in language, or even seem to have precocious language and unusually large vocabularies, but have great difficulty in sustaining typical conversations. The "give and take" of non-autistic conversation is hard for them, although they often carry on a monologue on a favorite subject, giving no one else an opportunity to comment. When given the chance to converse with other autistics, they comfortably do so in "parallel monologue"—taking turns expressing views and information. Just as "neurotypicals" (people without autism) have trouble understanding autistic body languages, vocal tones, or phraseology, people with autism similarly have trouble with such things in people without autism. In particular, autistic language abilities tend to be highly literal; people without autism often inappropriately attribute hidden meaning to what people with autism say or expect the person with autism to sense such unstated meaning in their own words.
Some people with high-functioning Autism can be extremely brilliant and have great vocabulary, but their social skills can be very low, even nonexistent at times. An example of the this is the noted autistic Temple Grandin, who holds a PhD and is a successful developer of livestock handling technologies, but memorably describes her inability to understand the social communication of neurotypicals as leaving her feeling "like an anthropologist on Mars." Temple's case was described by neurologist Oliver Sacks in his 1995 book titled "An Anthropologist on Mars: Seven Paradoxical Tales."
Some infants who later show signs of autism coo and babble during the first few months of life, but stop soon afterwards. Others may be delayed, developing language as late as the teenage years. Still, inability to speak does not mean that people with autism are unintelligent or unaware. Once given appropriate accommodations, some will happily converse for hours, and can often be found in online chat rooms, discussion boards or websites and even using communication devices at autism-community social events such as Autreat.
Sometimes, the body language of people with autism can be difficult for other people to understand. Facial expressions, movements, and gestures may be easily understood by some other people with autism, but do not match those used by other people. Also, their tone of voice has a much more subtle inflection in reflecting their feelings, and the auditory system of a person without autism often cannot sense the fluctuations. What seems to non-autistic people like odd prosody ; things like a high-pitched, sing-song, or flat, robot-like voice may be common in autistic children and some will have combinations of these prosody issues. Some autistic children with relatively good language skills speak like little adults, rather than communicating at their current age level, which is one of the things that can lead to problems.
Since non-autistic people are often unfamiliar with the autistic body language, and since autistic natural language may not tend towards speech, autistic people often struggle to let other people know what they need. As anybody might do in such a situation, they may scream in frustration or resort to grabbing what they want. While waiting for non-autistic people to learn to communicate with them, people with autism do whatever they can to get through to them. Communication difficulties may contribute to autistic people becoming socially anxious or depressed or prone to self-injurious behaviours. Recently, with the awareness that those with autism can have more than one condition a significant percentage of people with autism are being diagnosed with co-morbid mood, anxiety and compulsive disorders which may also contribute to behavioural and functioning challenges.
Repetitive behaviors
Although people with autism usually appear physically normal and have good muscle control, unusual repetitive motions, known as self-stimulation or "stimming", may set them apart. These behaviors might be extreme and highly apparent or more subtle. Some children and older individuals spend a lot of time repeatedly flapping their arms or wiggling their toes, others suddenly freeze in position. As children, they might spend hours lining up their cars and trains in a certain way, not using them for the type of pretend play expected of a non-autistic child. If someone accidentally moves one of these toys, the child may be tremendously upset. Autistic children often need, and demand, absolute consistency in their environment. A slight change in any routine—in mealtimes, dressing, taking a bath, or going to school at a certain time and by the same route—can be extremely disturbing to them. Autistics sometimes have persistent, intense preoccupations. For example, the child might be obsessed with learning all about computers, movie schedules or lighthouses. Often they show great interest in different languages, numbers, symbols or science topics. Repetitive behaviors can also extend into the spoken word as well. Preseveration of a single word or phrase, even for a specific number of times can also become a part of the child's daily routine.
Effects in education
Children with autism are affected by these symptoms every day. These unusual characteristics set them apart from typical students. Because they have trouble understanding people’s thoughts and feelings, they have trouble understanding what their teacher may be telling them. They do not understand that facial expressions and vocal variations hold meanings and may misinterpret what emotion their instructor is displaying. This inability to fully decipher the world around them makes education stressful. Teachers need to be aware of a student's disorder so that they are able to help the student get the best out of the lessons being taught.
Some students learn better with visual aids as they are better able to understand material presented this way. Because of this, many teachers create “visual schedules” for their autistic students. This allows the student to know what is going on throughout the day, so they know what to prepare for and what activity they will be doing next. Some autistic children have trouble going from one activity to the next, so this visual schedule can help to reduce stress.
Research has shown that working in pairs may be beneficial to autistic children. Autistic students have problems in schools not only with language and communication, but with socialization as well. They feel self-conscious about themselves and many feel that they will always be outcasts. By allowing them to work with peers they can make friends, which in turn can help them cope with the problems that arise. By doing so they can become more integrated into the mainstream environment of the classroom.
A teacher's aide can also be useful to the student. The aide is able to give more elaborate directions that the teacher may not have time to explain to the autistic child. The aide can also facilitate the autistic child in such a way as to allow them to stay at a similar level to the rest of the class. This allows a partially one-on-one lesson structure so that the child is still able to stay in a normal classroom but be given the extra help that they need. Although, many students with one-on-one aide help may become dependent on this adult and have trouble being independent, which should be the goal.
There are many different techniques that teachers can use to assist their students. A teacher needs to become familiar with the child’s disorder to know what will work best with that particular child. Every child is going to be different and teachers have to be able to adjust with every one of them.
Students with Autism Spectrum Disorders sometimes have high levels of anxiety and stress, particularly in social environments like school. If a student exhibits aggressive or explosive behavior, it is important for educational teams to recognize the impact of stress and anxiety. Preparing students for new situations by writing Social Stories can lower anxiety. Teaching social and emotional concepts using systematic teaching approaches such as The Incredible 5-Point Scale or other Cognitive Behavioral strategies can increase a student's ability to control excessive behavioral reactions.
williamshaffer.org
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