Autism Spectrum Disorder
Autism is a neurobiological disorder caused by a dysfunction in the central nervous system which leads to disordered development. According to the DSM-IV (APA, 1994) and the ICD-10 (World Health Organization, 1993), the onset of symptoms occurs within the first three years of life and includes three general categories of behavioral impairment.
The three behavioral impairments common to individuals with autism include:
- Qualitative impairments in communication
- Qualitative impairments in social interactions
- Restricted, repetitive and stereotyped patterns of behavior, interests and activities
Qualitative impairments in communication include the following:
- Often lack the understanding of communicative intent
- Receptive language skill deficits often plays a big role in the lack of communication (thus echolalic)
- Lack of non-verbal communication such as gestures, pointing for desired item/activity as well as lack of desire for shared interest
- Verbal perseveration
- Abnormal prosody (rate, rhythm, inflection or volume of speech)
Qualitative impairments in social interactions include the following:
- Lack of joint attention
- Lack of reciprocal social interactions
- Lack of initiative or sustained play with peers
- Difficulty with social situations
- Exhibit difficulty judging appropriate reactions in social situations
- Often difficulty recognizing and appropriately reacting to feeling in others
Restricted, repetitive and stereotyped patterns of behavior, interests and activities include the following:
- Repetitive motor or verbal actions (e.g., flap hands, repetitive finger movements, humming)
- Often preoccupied with small number of activities, interests or objects
- Play tends to be restricted or repetitive (e.g., line up cars/trains, FF/Rewind videos, etc.)
- Some demonstrate compulsive-like behaviors to routines or rituals (preference for sameness)
Other Important Considerations
Other important considerations need to be taken into account when describing autism. Three other symptoms which are not easily covered by the DSM-IV include:
- Unusual response to sensory stimuli
- Behavior
- Cognition
Unusual response to sensory stimuli
Many children with autism experience difficulties with processing and integrating sensory stimuli. Sensory stimulation are the things we see (visual), hear (auditory), feel (tactile), smell (olfactory), taste (gustatory) or do (vestibular or proprioceptive). Furthermore, some children have a hyper-aroused system (little input sets them over the edge) or a hypo-aroused system (needs intense input just for the body to register that something is going on) and/or mixed (some sensory areas are hyper and some sensory areas are hypo). For example, some children may feel pain when lightly touched (hyper-aroused) or squish themselves between couch cushions over and over to feel more organized (hypo-aroused).
Behavior
Many children with autism will experience periods of various types of behaviors. Some behaviors include anxiety or difficulty with attention. Some children may respond to minor changes or frustrations with aggressive outbursts. It is important to understand that for many children with autism who are not able to successfully express themselves, behavioral outbursts may be their current way of communicating.
Cognition
Many children with autism think concretely rather than abstractly. They think in ‘black and white’ where the world works mostly in ‘shades of gray’. Many children and students with autism exhibit extreme difficulty with standardized testing; resulting in the heated debate as to whether or not the degree of children with autism are as cognitively impaired as some researchers believe, or if standardized testing is not able to accurately assess their cognitive abilities and/or limitations.
Autism/PDD vs. Autism Spectrum Disorder (ASD)
In recent years, the definition of autism has broadened so that autism is now seen as a spectrum disorder. The term Autism Spectrum Disorder (ASD) is being used by physicians and service providers to describe the continuum ranging from milder to more severe based on the level of functional skills in the areas such as communication, cognitive abilities, social interaction, etc., (Filipek et. al, 2000; Lord & McGee, 2001).
