Overview  of ASD

The term “Autism Spectrum Disorders” or ASD refers to a category of neurological disorders characterized by “severe and pervasive impairment in several areas of development.” The disorders are

• Autism (sometimes called “classic autism” or “Kanner autism”) - characterized by impaired social interaction, problems with verbal and nonverbal communication, and unusual, repetitive, or severely limited activities and interests.
• Asperger Syndrome - Individuals with Asperger’s have IQ’s within normal ranges.  One of the major differences between Asperger's Syndrome and autism is that, by definition, there is no speech delay in Asperger's. In fact, children with Asperger's frequently have excellent language skills, but do not understand the subtleties of language, such as irony and humor, or they may not recognize the give-and-take nature of a conversation.  They may be socially awkward, not understanding of conventional social rules, or show a lack of empathy.  To the untrained observer, a child with Asperger's may seem just like a normal child behaving a little “odd.”
• Childhood Disintegrative Disorder (CDD) - This rare disorder is characterized by two to four years of normal development, followed by loss of language, social skills, and motor skills before age ten.
• Rett's Disorder – Condition found primarily in girls. Head growth decelerates in the fifth month.  A loss of purposeful hand movements occurs. After 30 months, the child frequently develops repetitive hand-washing or hand-wringing gestures.  Profound mental retardation is typical. For more information contact International Rett Syndrome Association  
• Pervasive Development Disorder -Not Otherwise Specified (PDD-NOS) – This diagnosis is given when some, but not all, features of autism are present. 

For more information visit the Autism Society of America webpage

Overview of Autism

Autism was first identified in 1943 by Dr. Leo Kanner of Johns Hopkins Hospital.  Dr. Kanner thought that autism was caused by poor parenting – that it was a “refrigerator mother” (cold, uncaring, detached) who caused the child to have autism.  Today, we know that autism is a complex, neurological disorder that typically appears during the first three years of life.   It affects the normal functioning of the brain, impacting development in the areas of social interaction, verbal and non-verbal communication and leisure or play skills.  Every person with autism is unique.  Children and adults with autism can exhibit any combination of these behaviors in any degree of severity. Two children, both with the same diagnosis, can act completely different from one another and have varying capabilities.

You may hear different terms used to describe children within this spectrum, such as autistic-like, autistic tendencies, autism spectrum, high-functioning or low-functioning autism, more-abled or less-abled, but more important than the term used to describe autism is understanding that whatever the diagnosis, children with autism can learn and function normally and show improvement with appropriate treatment and education.

Every person with autism is an individual, and like all individuals, has a unique personality and combination of characteristics. Some individuals who are mildly affected may exhibit only slight delays in language and greater challenges with social interactions. They may have difficulty initiating and/or maintaining a conversation. Their communication is often described as talking at others instead of to them (e.g., monologue on a favorite subject that continues despite attempts by others to interject comments).

People with autism also process and respond to information in unique ways. In some cases, aggressive and/or self-injurious behavior may be present. Persons with autism may also exhibit some of the following traits:

• Insistence on sameness; resistance to change
• Difficulty in expressing needs; using gestures or pointing instead of words
• Repeating words or phrases in place of normal, responsive language
• Laughing (and/or crying) for no apparent reason; showing distress for reasons not apparent to others
• Preference to being alone; aloof manner
• Tantrums
• Difficulty in mixing with others
• Not wanting to cuddle or be cuddled
• Little or no eye contact
• Unresponsive to normal teaching methods
• Sustained odd play
• Spinning objects
• Obsessive attachment to objects
• Apparent over-sensitivity or under-sensitivity to pain
• No real fears of danger
• Noticeable physical over-activity or extreme under-activity
• Uneven gross/fine motor skills
• Non-responsive to verbal cues; acts as if deaf, although hearing tests are in normal range

For most of us, the integration of our senses helps us to understand what we are experiencing. For example, our sense of touch, smell and taste work together in the experience of eating a ripe peach: the feel of the peach's skin, its sweet smell, and the juices running down your face. For children with autism, sensory integration problems are common, which may throw their senses off (they may be over- or under-active). The fuzz on the peach may actually be experienced as painful, and 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 behaviors of autism, like the ones listed above, are actually a result of sensory integration difficulties.

There are also many myths and misconceptions about autism. Contrary to popular belief, many children with autism do make eye contact; it just may be less often or different from a neuro-typical 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. Children do not "outgrow" autism, but symptoms may lessen as the child develops and receives treatment.

One of the most devastating myths about children with autism is that they cannot show affection. While sensory stimulation is processed differently in some children, they can and do give affection. However, it may require patience on the parents' part to accept and give love in the child's terms.

Source: The Autism Society of America  (view source page here)

Prevalence

In 2009, the CDC estimated that autism occurs in one of 110 children; that is 1% of the population.  It occurs in all racial, ethnic, and social groups and is four times more likely to strike boys than girls.  One in 70 boys is on the autism spectrum.   It is estimated that approximately 1,500,000 Americans have an autism spectrum disorder. 

Autism is the fastest growing developmental disability. In the U.S. alone, autism increased by 600% in the last 20 years.  The autism spectrum disorders are more common in the pediatric population than are some better known disorders such as diabetes, spinal bifida, or Down syndrome. At the present rate of growth, ASA estimates that the prevalence of autism could reach 4 million Americans in the next decade.

Causes

Autism is a complex disorder which no doubt has many causes.  Although no one is sure what causes autism, we do know is that it tends to run in families, suggesting a genetic link. Scientists suspect a number of genes are responsible, however and are also investigating the interplay between genetics and environmental factors such as exposure to mercury and other neurotoxins.   Because autism manifests in many different ways, one hypothesis points to the possibility that there are more than one  “subtype” of autism. Researchers are also investigating the between the link between autism and vaccinations, problems in the immune system, and allergies to certain foods (the most common are gluten and casein).

Visit these sites for current research news:

• Autism Research Institute
• Autism Research Network
• Autism Society of America
• Autism Speaks Science News 
• UC Davis Mind Institute

“Cure” and “Recovery”

This is a controversial topic in the autism community.  There are adults with autism who resent the fact that they need to be “cured” – they like who they are.  Others will argue that there is a difference between trying to “cure” a child who is non-verbal with severe behaviors while leaving the scientist who has Asperger’s alone. 

There have been reports from parents who have used a variety of different treatment that have seen great improvement in their child.  Dr. Bernard Rimland, father of modern autism research, founder of the Autism Research Institute and the Autism Society of America, made popular the term “recovery.” He borrowed the analogy by Stan Kurtz, director of the Children's Corner Schools in Van Nuys, California "Assume that a person is hit by a car. His legs are broken, and he suffers brain damage. At this point, he is considered disabled. Now let's say after intense rehabilitation he is able to walk again with a slight limp and has some remaining neurological issues but can live a normal life-or maybe he heals so well that you couldn't tell he was in an accident at all. That's recovery.”

With appropriate services and supports, training, and information, children on the autism spectrum will grow, learn and flourish, even if at a different developmental rate than others.  Some behaviors associated with autism may change or diminish over time. The communication and social deficits continue in some form throughout life, but difficulties in other areas may fade or change with age, education, or level of stress. Often, the person begins to use skills in natural situations and to participate in a broader range of interests and activities. Many individuals with autism enjoy their lives and contribute to their community in a meaningful way. People with autism can learn to compensate for and cope with their disability.  For further exploration of “cure” and “recovery” refer to the following websites.

• Autism Research Institute’s Recovery Page

• “Can ABA Cure Autism?” by Lisa Jo Rudy

• “Interview with Temple Grandin” (Dr. Grandin is the most well-known autistic individual in the world) talks about why she would not support a cure.
• Center for Autism and Related Disorders sells a 2 disk DVD, “Recovered:  Journeys Through the Autism Spectrum and Back.”