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Understanding Autism


Autism is not a single disorder, but a spectrum of closely-related disorders with a shared core of symptoms. Autism as a spectrum disorder means that there is a wide degree of variation in the way it affects people. The signs and symptoms of autism vary widely, as do its effects. Some children have only mild impairments, while others have more obstacles to overcome. In fact, two kids with the same diagnosis may look very different when it comes to their behaviors and abilities. Every child in the autism spectrum has unique abilities, symptoms, and challenges.

Autism spectrum disorders onsets in infancy and early childhood, causing delays in many basic areas of development such as learning to talk, play, and interact with others.

Every child in autism spectrum has the following "triad of impairment", although the degree may vary:

  • Communicating verbally and non-verbally
  • Relating to others and the world around them
  • Thinking imaginatively and behaving flexibly

You may hear many different terms including high-functioning autism, atypical autism, autism spectrum disorder, and pervasive developmental disorder. These terms can be confusing, not only because there are so many, but because doctors, therapists, and other parents may use them in dissimilar ways.

But no matter what doctors, teachers, and other specialists call the autism spectrum disorder, it's your child that is truly important. His needs are not different from others, it's just that they have to be addressed differently. As there is no diagnostic label to tell you exactly what problems your child has, it is very important to find treatment that addresses your child's needs more than focusing on what to call the problem. So you don't need a diagnosis to start getting help for your child's symptoms.

Types of autism spectrum disorders

The autism spectrum disorders belong to an 'umbrella' category of five conditions known as pervasive developmental disorders (PDD). Some autism specialists use the terms "pervasive developmental disorder" and "autism spectrum disorder" interchangeably. However, when most people talk about the autism spectrum disorders, they are referring to the three most common PDDs:

  • Autism
  • Asperger's Syndrome
  • Pervasive Developmental Disorder - Not Otherwise Specified (PDD-NOS)

Other two pervasive developmental disorders are:

  • Childhood disintegrative disorder, and
  • Rett Syndrome

As both are extremely rare genetic diseases, they are usually considered to be separate medical conditions that don't truly belong to the autism spectrum.

Where does your child fall on the autism spectrum?

The three autism spectrum disorders share many of the same symptoms, but they differ in their severity and impact. Classic or Typical autism is the most severe of the autism spectrum disorders. Milder variants are High-function autism, Asperger's Syndrome, and PDD-NOS or atypical autism. According to the Autism Spectrum Resource Center(U.S.A), only 20% of people in the autism spectrum have classic autism. The overwhelming majority fall somewhere on the milder range of the spectrum.

Since the autism spectrum disorders share many similar symptoms, it can be difficult to distinguish one from the other, particularly in the early stages. If your child is developmentally delayed or exhibits other autism-like behaviors, you will need to visit a medical professional for a thorough evaluation. Your doctor can help you figure out where, or even if, your child fits on the autism spectrum.

Signs and symptoms of autism spectrum disorders

In both children and adults, the signs and symptoms of the autism spectrum disorders include problems with social skills, speech and language, and restricted activities and interests. However, there are enormous differences when it comes to the severity of the symptoms, their combinations, and the patterns of behavior.

Keep in mind that just because your child has a few autism-like symptoms, it doesn't mean he or she has an autism spectrum disorder. The autism spectrum disorders are diagnosed based on the presence of multiple symptoms that disrupt your child's ability to communicate, form relationships, explore, play, and learn.

Signs and symptoms of autism spectrum disorders - Speech and language

Problems with speech and language comprehension are a telltale sign of the autism spectrum disorders. Symptoms may include:

  • Delay in learning how to speak (after the age of 2) or doesn't talk at all.
  • Speaking in an abnormal tone of voice, or with an odd rhythm or pitch.
  • Repeating words or phrases over and over without communicative intent.
  • Trouble starting a conversation or keeping it going.
  • Difficulty communicating needs or desires.
  • Doesn't understand simple statements or questions.
  • Taking what is said too literally, missing humor, irony, and sarcasm.

Signs and symptoms of autism spectrum disorders - Social skills

Basic social interaction can be difficult for children with autism spectrum disorders. Symptoms may include:

  • Unusual or inappropriate body language, gestures, and facial expressions (e.g. avoiding eye contact or taking your hand towards the object they want to get).
  • Lack of interest in other people or in sharing interests or achievements (e.g. showing you a drawing, pointing to a bird).
  • Unlikely to approach others or to pursue social interaction; comes across as aloof and detached; prefers to be alone.
  • Difficulty understanding other people's feelings, reactions, and nonverbal cues.
  • Resistance to being touched.
  • Difficulty or failure to make friends with children the same age.

Signs and symptoms of autism spectrum disorders - Restricted behavior and play

Children with autism spectrum disorders tend to be less spontaneous than other kids. Unlike a typical curious little kid pointing to things that catch his or her eye, children with autism disorders often appear disinterested or unaware of what's going on around them. They also show differences in the way they play. They may have trouble with functional play, or using toys that have a basic intended use, such as toy tools or cooking set. They usually don't "pretend play" engage in group games, imitate others, or use their toys in creative ways.

Children with autism spectrum disorders are often restricted, rigid, and even obsessive in their behaviors, activities, and interests. Symptoms may include:

  • Repetitive body movements (hand flapping, rocking, spinning), moving constantly.
  • Obsessive attachment to unusual objects (rubber bands, keys, light switches).
  • Preoccupation with a specific topic of interest, often involving numbers or symbols (maps, license plates, sports statistics).
  • A strong need for sameness, order, and routines (e.g. lines up toys, follows a rigid schedule). Gets upset by change in their routine or environment.
  • Clumsiness, abnormal posture, or odd ways of moving.
  • Fascinated by spinning objects, moving pieces, or parts of toys (e.g. spinning the wheels on a race car, instead of playing with the whole car).

Related signs and symptoms of autism spectrum disorders

While not part of autism's official diagnostic criteria, children with autism spectrum disorders often suffer from one or more of the following problems:

  • Sensory problems Many children with autism spectrum disorders either underreact or overreact to sensory stimuli. At times they may ignore people speaking to them, even to the point of appearing deaf. However, at other times they may be disturbed by even the softest sounds. Sudden noises such as a ringing telephone can be upsetting, and they may respond by covering their ears and making repetitive noises to drown out the offending sound. Children in the autism spectrum also tend to be highly sensitive to touch and to texture. They may cringe at a pat on the back or the feel of certain fabric against their skin.
  • Emotional difficulties Children with autism spectrum disorders may have difficulty regulating their emotions or expressing them appropriately. For instance, your child may start to yell, cry, or laugh hysterically for no apparent reason. When stressed, he or she may exhibit disruptive or even aggressive behavior (breaking things, hitting others, or harming him or herself). The National Dissemination Center for Children with Disabilities also notes that kids with autism may be unfazed by real dangers like moving vehicles or heights, yet be terrified of harmless objects such as a stuffed animal.
  • Uneven cognitive abilities The autism spectrum disorders occur at all intelligence levels. However, even kids with normal to high intelligence often have unevenly developed cognitive skills. Not surprisingly, verbal skills tend to be weaker than nonverbal skills. In addition, children with Autism spectrum disorders typically do well on tasks involving immediate memory or visual skills, while tasks involving symbolic or abstract thinking are more difficult.

Savant skills in autism spectrum disorders

Approximately 10% of people with autism spectrum disorders have special savant skills, such as the character Dustin Hoffman portrayed in the film Rain Man. The most common savant skills involve mathematical calculations, artistic and musical abilities, and feats of memory. For example, an autistic savant might be able to multiply large numbers in his or her head, play a piano concert after hearing it once, or quickly memorize complex maps.


References

[1] Autism Symptoms and Early Signs. Authors: Melinda Smith, M.A., Jeanne Segal, Ph.D., and Ted Hutman, Ph.D (UCLA Center for Autism Research & Treatment). Website: www.helpguide.org