What Is Severe Autism
There are three main diagnosable levels of autism, a spectrum disorder. Level 1 is considered high-functioning or less severe, while Level 3 is considered low-functioning and the most severe type.
People with Level 3 autism have significant difficulties socializing and participate in negative and potentially unsafe behaviors. They often have problems speaking and difficulties with nonverbal communication. They may not be able to complete basic life tasks.
Since autism is a spectrum disorder, there is a wide range of severity and disability within the disorder.
Severe autism can often be recognized as early as infancy. Babies may struggle to make eye contact, respond to their name, or babble.
Communication, language, motor skill, and behavioral delays are common in autistic babies and toddlers. While the diagnosis is not considered to be stable until around age 2, parents and caregivers may notice the signs of autism much earlier.
Signs of severe autism can include:
- Impaired social interaction.
Severe autism often co-occurs with other disorders, most commonly fragile X syndrome, epilepsy, and tuberous sclerosis. These comorbid conditions can present additional challenges, such as further developmental delays, speech and language issues, motor skill problems, reduced cognitive abilities, seizures, and tumors.
Early Intervention For Autism Is Important My Son Is Proof Of That
For the first time in 12 years, the American Academy of Pediatrics updated its guidelines this week for diagnosing children with autism, focusing on the importance of intervention and therapy, even in infants.
If there were a poster child who further underscored that, my 5-year-old son would be him.
When my son was diagnosed with autism at about 2 years old, he started therapy immediately. By the time he began kindergarten this year, all of his behavior seemed age-appropriate. He was social and talkative, a ringleader among his peers. In comparison, his 7-year-old brother, also diagnosed with autism as a toddler, still struggles with social interactions, with changes in his routine and with rigid, repetitive behavior classic signs of autism.
I wasnt all that surprised when the developmental pediatrician officially confirmed last week, after additional testing and evaluation, that my youngest son no longer meets the criteria for autism.
Ive started to tell people slowly because Ive been hesitant to perpetuate the idea that he was cured. That suggests there is something inherently wrong with being autistic or something to celebrate now that he isnt. When my youngest son learned he wasnt autistic anymore, he solemnly brought the news home to his brother. Youre autistic, and thats okay, he told his brother. But Im not. Were different. He grieved this loss, of what he perceived to be a shared exceptionalism, for days.
Thats good enough for me.
Why Occupational Therapists Work With Autistic Children
Occupational therapists often work with children who have physical challenges resulting from disorders such as cerebral palsy or traumatic brain injury. Children with autism may not have major physical disabilities, but many are struggling with specific challenges including:
- Low motor tone
- Sensory dysfunction
- Difficulty with motor planning
- Lack of imitative skills that help typically developing children learn play skills and skills of daily living
- Lack of social skills that help typically developing children learn how to engage in physical activities in a group setting
All of these challenges can be addressed through different forms of occupational therapy. Occupational therapists who work with children who have autism spectrum disorder may specialize in play therapy, handwriting therapy, sensory integration therapy, social skills therapy, or even behavioral therapy.
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What Defines Success For Autism Treatments
What makes a successful autism treatment depends on whom you ask. A researcher may judge a treatment based on the results of a clinical trial or on the outcome measure chosen. For an autistic person, the best measure of success might be an improvement in quality of life. To others, no treatment makes sense for autisms core features.
To get a glimpse of such disparate perspectives, we asked three researchers and two autistic people to tell us what a successful autism therapy looks like to them.
Professor, University of Connecticut
Treatment is more likely to be successful if a child had mild traits at the time of diagnosis and received therapy between the ages of 2 and 3.
Editor, Thinking Persons Guide to Autism
Many conditions that co-occur with autism require treatment, but autism in and of itself does not.
Professor, University of California, Los Angeles
Measuring the success of an early intervention should involve metrics that are meaningful for the lives of autistic children.
Director, Spring Harbor Hospital
Success for some autistic children is stripping away the anxiety, the pain, the aggression leaving just autism and its challenges.
Gender Gap Of Autism Diagnosis And What To Watch For
Studies show that girls are diagnosed with Autism Spectrum Disorder significantly less and later than boys. Several studies have tried to determine why this is, but it is important to know that treatment is available for girls at any stage of diagnosis.
There are many potential reasons why girls are “lost” when it comes to identifying and diagnosing ASD in females. It could be that girls with mild symptoms can be missed entirely or misattributed to other developmental disorders. Some have also pointed to a girl’s ability to control or identify emotions and adapt to social changes better than boys.
In any case, parents of girls who could be on the spectrum can look for these signs and confirm them by clinical professionals in the behavior health field. If ASD is confirmed, a Board Certified Behavior Analyst , can then individualize treatment using Applied Behavior Analysis Therapy.
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What Procedures And Tests Diagnose Autism
- There is no lab test or X-ray that can confirm the diagnosis of autism. The diagnosis of autism is based on clinical judgment regarding observations of the individual’s behavior. Information from family members and other observers is of primary importance in making the diagnosis however, the pediatrician may order tests to rule out other conditions that might be confused with autism, such as mental retardation, metabolic or genetic diseases, or deafness.
- A single visit with the pediatrician is not enough to establish the diagnosis of autism.
- The pediatrician observes the child and may do a simple screening test to see if a developmental problem may be present.
Screening tests do not diagnose autism. Done in the office, they are simple tests that indicate a problem may exist. They usually involve simply observing specific behaviors or how a child responds to simple commands or questions . Some widely used screening tests include the Checklist for Autism in Toddlers for children aged 18 months to 4 years of age and the Autism Screening Questionnaire for children aged 4 years and older.
The comprehensive evaluation of a child with autism might include:
- obtaining complete medical and family history
- physical exam
- formal audiology evaluation
- selected medical/lab tests on an individual basis
- speech, language, and communication assessment
- cognitive and behavioral assessments and
- academic assessment .
When The Mild Autism Term Is Used
So, what does a practitioner, teacher, or parent mean when they say a child has mild autism? Since there is no official definition of the term, every person using it has a slightly different idea of what it means.
Sometimes the term is used when an individual is clearly autistic, but also has significant spoken language and other skills. The term may also be used to help explain treatment decisions.
Furthermore, a person with “mild autism” may have advanced communication skills and academic abilities, but have very delayed social skills, severe sensory issues, and/or extreme difficulties with organizational skills . If and when these manifest may also depend on the specific environment or situation.
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Focusing On Early Diagnosis
Now, researchers have turned much of their attention to identifying autism in children as early as possible in hopes of intervening sooner with therapies to try to alter the developmental trajectory of their young brains. While skilled practitioners can diagnose autism in toddlers at 18 to 24 months of age with some research indicating there are detectable signs in babies as young as 6 months most kids arent diagnosed until age 4.
Katarzyna Chawarska, a professor of child psychiatry who leads Yale Universitys Autism Center of Excellence in New Haven, Connecticut, is studying signs of autism in babies. The reason why we are focusing so much on early diagnosis is that it is our hope that by intervening early, we can capitalize on still tremendous brain plasticity that is present in the first, second, third year of life, she said.
The goal, Chawarska said, is to help alleviate the symptoms and make sure that every child with autism reaches their full potential.
If youre trying to get rid of autism, youre trying to get rid of us.
Doctors, for instance, would like to minimize any intellectual disabilities and help patients communicate better and improve socials skills. They also want to quickly identify and address any medical conditions that often accompany autism, such as seizures, gastrointestinal problems, sleep disorders, Attention Deficit Hyperactivity Disorder and anxiety.
The Levels Of Autism: Unique Treatment Approaches For Each
Autism is a disorder where people suffer from a range of social, communication, and behavioral problems. The disabilities occur on a spectrum, which is why autism is also known as autism spectrum disorder.
There are three general levels of autism, ranging from mild impairments that require minimal therapy and intervention, to severe impairments that need intensive, multidisciplinary guidance.
Regardless of the level, autism is a lifelong condition. Even those with only a mild form of the disability will require some degree of ongoing therapy and monitoring for many years.
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Communicate With Your Team
Communicating with the doctor, therapist, teachers, and other healthcare providers can help make your daily tasks a lot easier.
For parents, this can mean asking for suggestions to continue practicing the skills your child is learning in therapy, which makes it easier for them to be more successful.
Symptoms In Boys Vs Girls
The vast majority of people diagnosed with autism are boys and men. This may be, in part, because autism tends to look very different in girls and women and, as a result, it may not be recognized as often.
In general, boys with autism show overt symptoms such as stimming . They may be quite loud, get upset easily, or become angry when required to take part in activities that are outside their comfort zone. These behaviors naturally draw the attention of parents, teachers, and doctors.
Girls and women with autism, on the other hand, tend to be very quiet and withdrawn. They are often loners who choose not to participate in group activities. Because many accept the cultural notion that girls are often quiet and unengaged, these behaviors are much easier to mistake for shyness or normal social reticence.
Of course, there can be wide variations depending on the individual.
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Behavior And Communication Approaches
According to reports by the American Academy of Pediatrics and the National Research Council, behavior and communication approaches that help children with ASD are those that provide structure, direction, and organization for the child in addition to family participation .
Applied Behavior Analysis A notable treatment approach for people with ASD is called applied behavior analysis . ABA has become widely accepted among healthcare professionals and used in many schools and treatment clinics. ABA encourages positive behaviors and discourages negative behaviors to improve a variety of skills. The childs progress is tracked and measured.
There are different types of ABA. Here are some examples:
- Discrete Trial Training DTT is a style of teaching that uses a series of trials to teach each step of a desired behavior or response. Lessons are broken down into their simplest parts, and positive reinforcement is used to reward correct answers and behaviors. Incorrect answers are ignored.
- Early Intensive Behavioral Intervention This is a type of ABA for very young children with ASD, usually younger than 5 and often younger than 3. EIBI uses a highly structured teaching approach to build positive behaviors and reduce unwanted behaviors . EIBI takes place in a one-on-one adult-to-child environment under the supervision of a trained professional.
- Early Start Denver Model
There are other therapies that can be part of a complete treatment program for a child with ASD:
What’s It Like To Have Autism Spectrum Disorder
ASD affects different people in different ways. Some people can’t speak or learn. Their behavior may seem strange they may avoid other people they may pace and move their bodies in unusual ways, like flapping their hands. They may repeat lines from TV shows or movies.
People with less severe ASD are able to talk and learn. But they may have trouble:
- expressing feelings. They may seem cold and distant.
- understanding the feelings of others. They may ignore or misunderstand how other people might feel or behave in a situation.
- reading social cues. They might not understand body language or facial expression they stand too close they ignore signs of boredom or frustration.
- handling sensory information. Loud noises, bright lights, or crowds may bother them.
- handling a new routine. It might be hard for them to sit in a different seat or having a substitute teacher.
Some might get get super-focused on a single topic or hobby, some of which may be unusual .
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Early Autism May Not Last A Lifetime
A new study found that some children correctly diagnosed with autism spectrum disorders at an early age may lose symptoms as they grow older. Further research may help scientists understand this change and point the way to more effective interventions.
ASD includes several related brain disorders, with symptoms ranging from mild to severe. People with ASD generally have trouble with social interactions and communication. ASD affects about 1 in every 88 children.
Optimal outcome a term used when symptoms are lost later in life has been documented in previous ASD studies. However, questions remained about whether the symptoms disappeared or the original diagnosis was wrong.
A research team led by Dr. Deborah Fein at the University of Connecticut, Storrs, sought to investigate whether optimal outcome could be seen in children whod had a confirmed ASD diagnosis before age 5. Optimal outcome participants had to be currently enrolled in regular education classrooms and have a documented report of their earlier diagnosis from a physician or psychologist specializing in autism. To confirm this assessment, the reports were edited to remove all information except the descriptions of behavior. They were then reviewed by an ASD diagnostic expert.
The optimal outcome group appeared to have somewhat milder social problems at an early age than the high-functioning ASD group. However, both had similar communication and repetitive behavior symptoms.
Going Forward Achieving Better Outcomes For All
The World Health Organization declares that the highest attainable standard of health is a fundamental right for all human beings. Leaving aside entirely the idea of a cure for autism, people with autism deserve much better health care and health research than they currently enjoy.
By adequately identifying and addressing medical issues associated with autism, a wide range of individuals challenges and difficulties can potentially be reduced, including anxiety, impulsivity, headaches, poor sleep, depression, aggression, self-injury, obsessive and compulsive behaviours, gastrointestinal problems to name a few.
No one should be expected to suffer a lower standard of health simply because of an autism diagnosis, yet diagnostic overshadowingattributing medical symptoms and conditions to the diagnosis of autism and therefore not offering appropriate investigation or treatmentis widespread.
If an individuals experience of autism does not involve health problems that result in suffering, and if the symptoms of autism are not perceived to be an impediment to happiness, independence, success, an enjoyable social and personal life, and to being in control of their lives, then there would no reason to seek intervention. However, for the majority of those diagnosed with autism, there is sufficient suffering and serious disability to rightfully deserve thorough investigation and appropriate intervention.
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Education For Moderate To Severe Autism
Although children with moderate autism may have some intellectual or learning disabilities, they can often attend school. Because a mainstream classroom is usually overwhelming, children with moderate autism may enroll in an autism support classroom in a traditional school setting or attend a school specifically designed for students with autism.
Special accommodations in the Individualized Education Program provide beneficial supports that help the children maximize strengths, improve weaknesses, and gain valuable academic, social, emotional, and life skills.
Some children with severe autism have intellectual challenges that make learning difficult. A traditional school setting is impossible to navigate and even an autistic support classroom may be overwhelming.
However, small, therapeutic settings in a traditional or autism specific school can provide an environment that helps children with severe autism learn and grow. Here, educators follow a specialized and individualized plan for each child. With these supports, children with severe autism learn valuable skills.
Can Autism Be Treated In Adulthood
Receiving an autism diagnosis in adulthood is validating and empowering for some individuals. Therapies including applied behavior analysis, cognitive behavioral therapy, and social skills training can still be helpful for adolescents and adults seeking treatment. However, itâs worth noting that treatment studies are primarily conducted on children.
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What Is Autism Spectrum Disorder Previously Called Autism And Pervasive Developmental Disorders
Autism spectrum disorder is a neurodevelopmental disorder characterized by the following:
- Difficulties in social communication differences, including verbal and nonverbal communication.
- Deficits in social interactions.
- Restricted, repetitive patterns of behavior, interests or activities and sensory problems
Many of those with ASD can have delayed or absence of language development, intellectual disabilities, poor motor coordination and attention weaknesses.