 Autism
is a Pervasive Developmental Disorder that
impacts primarily the individual’s social and
language functioning as well as a restricted
repertoire of activities and interests. Children
with Autism also engage in repetitive and
unusual behaviors.
The rate of Autism has been estimated at 1 in
every 650 children and it is three times more
common in boys than girls. Autism may or may not
be accompanied by mental retardation but a large
percentage of children with Autism have received
the diagnosis of mental retardation. Some
individuals with Autism have savant skills,
meaning they are highly specialized in specific
skills, such as counting objects, remembering
dates/names/times of people and events, and
drawing images with extreme preciseness. Most
individuals with Autism are also impacted in
other areas of development, such as play skills,
communication skills, motor skills, motor
planning, and self-help/adaptive skills.
 Symptoms
of Autism could vary greatly from individual to
individual. The language and communication
skills of children with Autism could range from
nonverbal to a delay in language development.
However, even if the child with Autism develops
verbal language, they may not utilize their
language appropriately and they may demonstrate
language deficits, such as the inability to
sustain a conversation or demonstrate a
stereotypical and repetitive use of language.
Children with Autism, nonverbal and verbal,
demonstrate marked impairment in their
communication skills. They also have restricted
and stereotypical patterns of play as well as
playing with toys in ways that are not intended
to be played with. For example, the child may
play with a toy truck by turning the wheels and
staring at the wheels rather than rolling the
truck down make shift ramps. When children with
Autism demonstrate some appropriate toy or
social play, their play repertoire is often
limited and lacking in spontaneous make believe
play or social imitative play.
 The
behavioral symptoms associated with Autism
Spectrum Disorders range widely from child to
child. The behaviors symptoms include temper
tantrums, self-stimulatory behaviors, physical
aggression, self-injurious behaviors,
impulsivity, short attention span and
hyperactivity. They may also demonstrate unusual
sensory processing (i.e., in their way of
experiencing their environment), such as having
a high pain threshold, not being able to hold
hands or touch certain textures and being highly
sensitive to isolated sounds. Children with
Autism also experience varied sleep patterns and
gastro-intestinal functioning.
The cause for autism is still unknown. Many
researchers are looking in to genetic influences
while others are looking into their diet, level
of various metals in the bloodstream, and
physiological functioning. Because the cause
Autism Spectrum Disorders is currently unknown,
Autism Spectrum Disorders are diagnosed by the
behavioral symptoms that the individuals
demonstrate.
Diagnostic and Statistical Manual of
Disorders – Fourth Edition (DSM – IV)
According to the DSM – IV, the following is a
behavioral description of the Autistic Disorder.
Diagnostic Features
“The essential features of Autistic
Disorder are the presence of markedly
abnormal impaired development in social
interaction and communication and a markedly
restricted repertoire of activity and
interests.”
Social Skill Deficits:
“The impairment in reciprocal social
interactions is gross and sustained…There
may be failure to develop peer relationships
appropriate to developmental level…There may
be a lack of spontaneous seeking to share
enjoyment, interests, or achievements with
other people.”
Communication and Language Skill
Deficits:
“The impairment in communication is also
marked and sustained and affects both verbal
and nonverbal skills. There may be delayed
in, or total lack of, the development of
spoken language. In individuals who speak,
there may be marked impairment in the
ability to initiate or sustain a
conversation with others, or a stereotyped
and repetitive use of language or
idiosyncratic language. There may be a lack
of varied, spontaneous make-believe play or
social imitative play appropriate to
developmental level…A disturbance in the
comprehension of language may be evidence by
an inability to understand simple questions,
directions, or jokes.”
Play Skill Deficits:
“Imaginative play is often absent or
markedly impaired. These individuals also
tend not to engage in the simple imitation
games or routines of infancy or early
childhood or do so only out of context or in
a mechanical way.”
Behavioral Excesses:
“Individuals with Autistic Disorder have
restricted, repetitive, and stereotyped
patterns of behavior, interests, and
activities. There may be an encompassing
preoccupation with one or more stereotyped
and restricted patterns of interest that is
abnormal either in intensity or focus; an
apparently inflexible adherence to specific,
nonfunctional routines or rituals;
stereotyped and repetitive motor mannerisms;
or a persistent preoccupation with parts of
objects…There is often an interest in
nonfunctional routines or rituals or an
unreasonable insistence on following
routines.
Associated Features
“In most cases, there is an associated
diagnosis of Mental Retardation, commonly in
the moderate range (IQ 35 – 50).
Approximately 75% of children with Autistic
Disorder function at a retarded level. There
may be abnormalities in the development of
cognitive skills…Individuals with Autistic
Disorder may have a range of behavioral
symptoms, including hyperactivity, short
attention span, impulsivity, aggressiveness,
self-injurious behaviors, and, particularly
in young children, temper tantrums. There
may be odd responses to sensory stimuli.
There may be abnormalities in eating or
sleeping. Abnormalities of mood or affect
may be present. There may be a lack of fear
in response to real dangers, and excessive
fearfulness in response to harmless
objects.”
Course
“By definition, the onset of Autistic
Disorder is prior to age 3…In a minority of
cases the child may be reported to have
developed normally for the first year (or
even 2 years) of life. Autistic Disorder
follows a continuous course…Some individuals
deteriorate behaviorally during adolescence,
where as others improve…Available follow up
studies suggest that only a small percentage
of individuals with the disorder go on as
adults to live and work independently. In
about one-third of cases, some degree of
partial independence is possible.”
Treatment for ASD
ASD is a life-long disorder. There is
on-going research exploring various genetic,
biogenetic, chromosomal, and environmental
influences to the cause of ASD but there
continues to be very little certainty as to
the cause.
Without a clear cause, ASD can only be
diagnosed based on a set of specific
observable behavioral symptoms. Because
clinicians and medical doctors view ASD as a
specific grouping of behaviors, naturally
the best approach for treating these
behaviors is to utilize intervention
programs that target these behaviors and are
based on behavior analysis.
Research has shown that behavioral and
educational treatment modalities tend to be
most effective in treating symptoms of ASD.
These treatment modalities can be used to
target the following areas of functioning:
- Cognitive Skills
- Social/Emotional Skills
- Speech and Language Skills
- Communication Skills
- Play Skills
- Self-Help/Adaptive/Functional/Daily
living Skills
- Motor skills
- Behavioral Excesses
Most individuals with autism qualify and
receive special education. They benefit most
from receiving one-on-one intensive
behavioral services in the home, school, and
the community settings. They require
classrooms that are extremely structured
with clear visual environment layout and
cues. Research has shown that behavioral
treatment is the most effective in treating
individuals with autism. Early intervention
is extremely helpful in providing them
necessary developmental skills at an early
age. They also benefit from receiving other
types of services, such as speech therapy,
occupational therapy, physical therapy, and
music therapy.
Autism, Asperger’s and Pervasive
Developmental Disorders (PDD):
According to the DSM – IV, Pervasive
Developmental Disorders (PDD) are a category
of Developmental Disabilities. Children with
PDD demonstrate extreme developmental
abnormalities with the onset within the
first three years of life. PDD includes
abnormal development in the areas of severe
to pervasive impairment in reciprocal social
interactions and communication skills and
with the presence of stereotyped behaviors,
interests and activities.
There are five subtypes of PDD:
- Autistic Disorder – This is
characterized as having impairment in
social interactions, communication and
restricted and repetitive stereotypical
pattern of behavior, interests and
activities.
- Asperger’s Disorder –
Asperger’s Disorder is characterized as
having severe and sustained impairment
in social interactions with restricted,
repetitive and stereotyped patterns of
behavior, interests and activities.
- Rett’s Disorder – This
disorder only impact females. “The
development for children with Rett’s
appears normal throughout the first five
months of life but is then followed by a
deceleration of head growth, loss of
previously acquired purposeful hand
skills with subsequent development of
stereotyped hand movements, loss of
social engagement, appearance of poorly
coordinated gait or trunk movements and
severely impaired expressive and
receptive language functioning.”
- Childhood Disintegrative Disorder
– This disorder is characterized by
normal or typical development through
the first two years of life. Then,
abnormalities results in the following
areas: social interactions,
communication, restricted, repetitive,
stereotypical patterns of behavior,
interests and activities. There is also
a significant loss of previously
acquired skills in areas of expressive
or receptive language, social skills or
adaptive behaviors, such as bowel or
bladder control, play and motor skills.
- PDD – Not Otherwise Specified (PDD-NOS)
– This category includes children who
demonstrate severe and pervasive
impairment in their development of
reciprocal social interactions, verbal
and nonverbal communication skills and
when they engage in stereotyped
behaviors, interests and activities but
these symptoms do not otherwise meet the
criteria of the other listed Pervasive
Developmental Disorders.
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