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What is autism?
Autism is a complex developmental disability that typically appears during the first three years of life and is the result of a neurological disorder that affects the normal functioning of the brain, impacting development in the areas of social interaction, communication skills and behavior. Both children and adults with autism typically show difficulties in verbal and non-verbal communication, social interactions, and leisure or play activities. Autism is a spectrum disorder and it affects each individual differently and at varying degrees. Parents are usually the first to notice unusual behaviors in their child or their child's failure to reach appropriate developmental milestones. Some parents describe a child that seemed different from birth, while others describe a child who was developing normally and then lost skills. If you have concerns about your child's development, don't wait: speak to your pediatrician about getting your child screened for autism.
What are the most common characteristics of autism?
Every person with autism exhibits a unique combination of autism-related characteristics, and may process and respond to information in unique ways that might seem different to the rest of us. 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 for being alone; aloof manner
- 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 in normal range
What is the difference between Autism and PDD?
PDD is often used interchangeably with the term autism or to describe a less involved form of autism. There actually is no official diagnosis of “PDD.” Autism is one of a number of disorders listed in the Diagnostic and Statistical Manual of Mental Disorders under the umbrella term of Pervasive Developmental Disorders (PDD). Under that umbrella term of PDD, there are three disorders commonly referred to as “Autism Spectrum Disorders.” These are “Classic Autism,” “Asperger’s Syndrome” and “Pervasive Developmental Disorder – Not Otherwise Specified (PDD-NOS).” The specific label or diagnosis given to an individual depends upon how that individual presents at the time of diagnosis.
To receive any of these three Autism Spectrum Disorder diagnoses, an individual must exhibit symptoms in the areas of social ability, communication and behavior. It’s important to remember that how autism presents itself in an individual is more important than which label an individual is given.
What is Asperger's Syndrome?
A diagnosis of Asperger's Syndrome is usually given to a person who has an intact or even high IQ and an absence of language delay. Children with Asperger's may appear to be only mildly affected and frequently have good language and cognitive skills. To someone with little experience, a child or person with Asperger’s Syndrome may seem like a “normal” individual behaving oddly. People with AS have significant difficulty in social interactions, may understand language literally, have difficulty with conventional social rules and behavior and appear to lack empathy.
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 good language skills; they simply use language in different ways. Speech patterns may be unusual, lack inflection, have a rhythmic nature, be formal, too loud or high pitched. Children with Asperger's may not understand the subtleties of language, such as irony and humor, or they may not recognize the give-and-take nature of a conversation.
Another distinction between Asperger's Syndrome and autism concerns cognitive ability. While some individuals with autism experience mental retardation, by definition a person with Asperger's cannot possess a "clinically significant" cognitive delay, and most possess average to above-average intelligence.
Why is early intervention so important?
Early intervention is defined as services delivered to children from birth to age 3, and research shows that it has a dramatic impact on reducing the symptoms of autism spectrum disorders. Studies in early childhood development have shown that the youngest brains are the most flexible. In autism, we see that intensive early intervention yields a tremendous amount of progress in children by the time they enter kindergarten, often reducing the need for intensive supports. While it is important to begin interventions as soon as autism is suspected, there is always room for improvement in functioning no matter when appropriate interventions are begun.
What does it mean to be “on the spectrum”?
“On the Spectrum” is usually a way of referring to the fact that a person has been given a diagnosis of one of the Autism Spectrum Disorders. Autism, as a “spectrum disorder,” means it manifests itself in many different forms: a diagnosis can range from mild to severe, and though people are likely to exhibit similar traits, they are also individuals with their own personalities and unique human qualities.
How common is autism?
According to the Centers for Disease Control, autism affects as many as 1 in 88 children in the United States. Generally speaking, autism spectrum disorders affect boys more than girls in a ratio of about 4:1. Autism is non-discriminatory – it affects people in all strata of life, all socio economic groups, races, religions and ethnicities.
How did my child develop autism?
No one knows for sure. Autism is a complex developmental disorder and to date researchers have not been able to pinpoint a cause (or more likely, causes) of autism. Genes play a key role, but which ones and why is still unkown. What we do know is that autism is a neurobiological disorder and is not caused by bad parenting or something that YOU did.
Are vaccines to blame?
Though the debate over the role of vaccines as a cause of autism continues to rage, researchers have still not found a definitive link between the two. According to organizations such as the Centers for Disease Control and Prevention, the American Academy of Pediatrics and the World Health Organization, there's just not enough evidence to support the contention that vaccines – specifically vaccines containing thimerosal - cause children to develop autism. One study published in the medical journal Lancet faulting the measles-mumps-rubella (MMR) shot has since been questioned by its own authors. Many other studies have also failed to pass scientific muster.
Is there a cure for autism?
No. There are, however, many treatments and therapies that help people with autism to manage or ameliorate many of the symptoms of autism. With education, therapy and the appropriate supports, people with autism spectrum disorders can go on to lead happy, successful lives in the community.
How can I tell if a child has autism?
No two children with autism are alike, but there are some signs that many of them share and that experts agree may be as recognizable as early as the toddler years, or even sooner. Children on the spectrum generally have difficulty relating to others; they may hardly speak, and if they do, they may not communicate in ways that other people can easily understand (they may screech loudly when they're upset, for example, instead of crying). They don't usually sustain eye contact – it's too intense -- and have trouble reading social cues such as playing peek-a-boo, pointing or responding when their name is called. They're also prone to self-stimulating behaviors such as spinning or repetitive behaviors, flapping their hands constantly or uttering the same phrase over and over again. They may also be more sensitive than typically developing children, or dramatically less so, to sights, sounds and touch. Lack of pointing, or sharing an experience or object with another person by using gestures or eye gaze (what we call “joint attention”) is often present as well.
What should I do if I suspect something is wrong with my child?
Don't wait--talk to your doctor about getting your child screened for autism. New research shows that children as young as one may exhibit signs of autism, so recognizing early signs and knowing developmental milestones is important. Early intervention is key.
No. It used to be thought that most people with autism were also intellectually disabled (ID). This is not true. In fact, people with a diagnosis of Asperger’s Syndrome often are intellectually gifted in certain areas. ID affects people with autism more than the general population, but fewer than 50% of people with autism have an intellectual disability.
Many people on the autism spectrum have over-sensitive nervous systems. For these people, it can literally hurt to be touched. This is called “tactile defensiveness” and sensory based therapy can help to control the nervous system and reduce the amount of defensiveness exhibited.
Self-spinning or watching things spin is an activity that stimulates the vestibular system in the body which for some people with autism is very soothing. Spinning oneself or objects isn’t a concern in its own right, but can become an issue when the need for the spinning becomes overwhelming and obsessive and gets in the way of learning, playing or relating to others.
There is no specific medication for Autism, per se. There are many medications that people with Autism can take to help with specific symptoms that they might exhibit – such as aggression, depression, anxiety or other medical issues. As with any medication, oversight by a trusted, knowledgeable professional is required to make sure that the medication is effective in the right dosage and that side effects are monitored.
Many people with Autism have over-sensitive nervous systems which can cause certain foods to taste, smell or feel unappealing to them. Some people with Autism often have muscle issues that mean that chewing and/or swallowing certain textures are difficult. Sensory based therapy and oral motor therapy can help with these issues. Also, many people with Autism prefer what they know and can be rigid about trying new items. Education and therapy can help.