Restrictive / Repetitive Behaviors May Include:
- Repeating certain behaviors or having unusual behaviors. For example, repeating words or phrases, a behavior called echolalia
- Having a lasting intense interest in certain topics, such as numbers, details, or facts
- Having overly focused interests, such as with moving objects or parts of objects
- Getting upset by slight changes in a routine
- Being more or less sensitive than other people to sensory input, such as light, noise, clothing, or temperature
People with ASD may also experience sleep problems and irritability. Although people with ASD experience many challenges, they may also have many strengths, including:
- Being able to learn things in detail and remember information for long periods of time
- Being strong visual and auditory learners
- Excelling in math, science, music, or art
‘a Diagnosis Gives Parents Knowledge And Support’
I think with delaying an autism diagnosis it can more damaging not just for children, but for parents and carers. Early intervention is essential for children and parents/carers to ensure children are getting the support they need. There are many waitlists for speech therapy, occupational therapy, psychology, behaviour therapy .
Parents of additional needs children can feel very isolated. I think I have isolated myself many times. I think it would be a lot worse if our family didnt have access to services as I wouldnt know how to handle situations
A diagnosis gives parents knowledge and support. Its also for education and getting funding for schools to be able to help students get the services they need in schools.
Some People Use Other Names For Autism
There are other names for autism used by some people, such as:
- autism spectrum disorder the medical name for autism
- autism spectrum condition used instead of ASD by some people
- Asperger’s used by some people to describe autistic people with average or above average intelligence
Unlike some people with autism, people with Asperger’s do not have a learning disability.
Some people call this “high-functioning” autism.
Doctors do not diagnose people with Asperger’s anymore.
But if you were diagnosed with it before, this will stay as your diagnosis.
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Asperger’s Syndrome Is No Longer An Official Diagnosis
Steven Gans, MD, is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.
Asperger’s syndrome, also known as Asperger’s disorder or simply Asperger’s, is a developmental disorder affecting social skills and interactions and involving repetitive patterns of behavior. It was previously used as a diagnosis at the highest-functioning end of the autism spectrum.
Once regarded as one of the distinct types of autism, Asperger’s syndrome was retired in 2013 with the publication of the fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders . It is no longer used by clinicians as an official diagnosis.
Even so, the term is still used in some circumstances and by some practitioners, although people who were once regarded as having Asperger’s syndrome would today be diagnosed as having level one autism spectrum disorder per the revisions in the DSM-5.
Signs And Symptoms Of Autism Spectrum Disorders
Autism spectrum disorder is a developmental disability caused by differences in the brain. Some people with ASD have a known difference, such as a genetic condition. Other causes are not yet known. Scientists believe there are multiple causes of ASD that act together to change the most common ways people develop. We still have much to learn about these causes and how they impact people with ASD.
There is often nothing about how people with ASD look that sets them apart from other people. They may behave, communicate, interact, and learn in ways that are different from most other people. The abilities of people with ASD can vary significantly. For example, some people with ASD may have advanced conversation skills whereas others may be nonverbal. Some people with ASD need a lot of help in their daily lives others can work and live with little to no support.
ASD begins before the age of 3 years and can last throughout a persons life, although symptoms may improve over time. Some children show ASD symptoms within the first 12 months of life. In others, symptoms may not show up until 24 months or later. Some children with ASD gain new skills and meet developmental milestones, until around 18 to 24 months of age and then they stop gaining new skills, or they lose the skills they once had.
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Restricted Or Repetitive Behaviors Or Interests
People with ASD have behaviors or interests that can seem unusual. These behaviors or interests set ASD apart from conditions defined by only problems with social communication and interaction.
Examples of restricted or repetitive interests and behaviors related to ASD can include:
- Lines up toys or other objects and gets upset when order is changed
- Repeats words or phrases over and over
- Plays with toys the same way every time
- Is focused on parts of objects
- Gets upset by minor changes
- Has obsessive interests
- Flaps hands, rocks body, or spins self in circles
- Has unusual reactions to the way things sound, smell, taste, look, or feel
The Truth About Hans Aspergers Nazi Collusion
Simon Baron-Cohen is director of the Autism Research Centre at the University of Cambridge, UK, and president of the International Society for Autism Research.
A ward in the Am Spiegelgrund clinic in Vienna, in the 1940s.Courtesy of the Documentation Centre of Austrian Resistance.
Aspergers Children: The Origins of Autism in Nazi ViennaEdith Sheffer W. W. Norton
The Austrian paediatrician Hans Asperger has long been recognized as a pioneer in the study of autism. He was even seen as a hero, saving children with the condition from the Nazi killing programme by emphasizing their intelligence. However, it is now indisputable that Asperger collaborated in the murder of children with disabilities under the Third Reich.
Historian Herwig Czech fully documented this in the April 2018 issue of Molecular Autism . Now, historian Edith Sheffers remarkable book Aspergers Children builds on Czechs study with her own original scholarship. She makes a compelling case that the foundational ideas of autism emerged in a society that strove for the opposite of neurodiversity.
These findings cast a shadow on the history of autism, already a long struggle towards accurate diagnosis, societal acceptance and support. The revelations are also causing debate among autistic people, their families, researchers and clinicians over whether the diagnostic label of Aspergers syndrome should be abandoned.
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How Is Asd Diagnosed
ASD symptoms can vary greatly from person to person depending on the severity of the disorder. Symptoms may even go unrecognized for young children who have mild ASD or less debilitating handicaps.
Autism spectrum disorder is diagnosed by clinicians based on symptoms, signs, and testing according to the Diagnostic and Statistical Manual of Mental Disorders-V, a guide created by the American Psychiatric Association used to diagnose mental disorders. Children should be screened for developmental delays during periodic checkups and specifically for autism at 18- and 24-month well-child visits.
Very early indicators that require evaluation by an expert include:
- no babbling or pointing by age 1
- no single words by age 16 months or two-word phrases by age 2
- no response to name
- excessive lining up of toys or objects
- no smiling or social responsiveness
Later indicators include:
- impaired ability to make friends with peers
- impaired ability to initiate or sustain a conversation with others
- absence or impairment of imaginative and social play
- repetitive or unusual use of language
- abnormally intense or focused interest
- preoccupation with certain objects or subjects
- inflexible adherence to specific routines or rituals
What Are Some Common Signs Of Asd
Even as infants, children with ASD may seem different, especially when compared to other children their own age. They may become overly focused on certain objects, rarely make eye contact, and fail to engage in typical babbling with their parents. In other cases, children may develop normally until the second or even third year of life, but then start to withdraw and become indifferent to social engagement.
The severity of ASD can vary greatly and is based on the degree to which social communication, insistence of sameness of activities and surroundings, and repetitive patterns of behavior affect the daily functioning of the individual.
Social impairment and communication difficultiesMany people with ASD find social interactions difficult. The mutual give-and-take nature of typical communication and interaction is often particularly challenging. Children with ASD may fail to respond to their names, avoid eye contact with other people, and only interact with others to achieve specific goals. Often children with ASD do not understand how to play or engage with other children and may prefer to be alone. People with ASD may find it difficult to understand other peoples feelings or talk about their own feelings.
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Doctor Behind Asperger’s Syndrome Subject To Name Change
In the book “Asperger’s Children: The Origins of Autism in Nazi Vienna,” Edith Sheffer writes about the doctor who first diagnosed Asperger’s Syndrome. Sheffer tells NPR’s Michel Martin how Hans Asperger’s Nazi ties were hidden for years.
LAKSHMI SINGH, HOST:
Across the country, people have been grappling with how to acknowledge historical moments that are now understood as morally reprehensible. Recently, this has involved emotional debates about statues or names of streets, schools and other public buildings. And now that debate has moved to a medical diagnosis. Asperger’s syndrome, a form of autism that was named after Hans Asperger, a doctor in Nazi Vienna. Although he had long been suspected of Nazi ties, Hans Asperger’s real story was largely unknown until now. And that knowledge has sparked a debate over whether the diagnosis should be renamed. Historian Edith Sheffer tells the story in her new book, “Asperger’s Children: The Origins Of Autism In Nazi Vienna.” And our own Michel Martin spoke with her recently.
MICHEL MARTIN, BYLINE: Professor Sheffer, thanks so much for speaking with us.
EDITH SHEFFER: Thank you so much for having me.
SHEFFER: Thank you so much for having me.
Autistic People May Act In A Different Way To Other People
Autistic people may:
- find it hard to communicate and interact with other people
- find it hard to understand how other people think or feel
- find things like bright lights or loud noises overwhelming, stressful or uncomfortable
- get anxious or upset about unfamiliar situations and social events
- take longer to understand information
- do or think the same things over and over
If you think you or your child may be autistic, get advice about the signs of autism.
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Terms For Types Of Autism That Are No Longer Used Today
When autism was categorized by types, the lines between the different types of autism could be blurry. Diagnosis was, and still is, complicated and often stressful for families.
If you or your child received a diagnosis before the DSM-5 changed, you may still be using the older terminology . Thats OK. Your doctor may continue to use those terms if they help.
A Collaboration Between Children Parents And Professionals
In our experience, it is a collaboration between children, parents, educators, therapists, paediatrician and GPs. Without a diagnosis, Lachlan couldnt be in a support class.
I delayed Lachlan starting school till the age of six years . It was what I felt best for him to get the support he needed. Therapists were organised and regular appointments were made . I looked at schools prior to him starting to find out what school would be best for him. In a mainstream class he could easily fall behind without getting the support he needs.
Stop saying autism can be prevented. What’s important is a diagnosis – and an early one.
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Restricted Behavior And Play
Children with Autism Spectrum Disorder are often restricted, rigid, and even obsessive in their behaviors, activities, and interests. Symptoms may include:
- Repetitive body movements moving constantly.
- Obsessive attachment to unusual objects .
- Preoccupation with a narrow topic of interest, sometimes involving numbers or symbols .
- A strong need for sameness, order, and routines . Gets upset by change in their routine or environment.
- Clumsiness, atypical posture, or odd ways of moving.
- Fascinated by spinning objects, moving pieces, or parts of toys .
- Hyper- or hypo-reactive to sensory input .
Autism Screening And Diagnosis
It can be hard to get a definite diagnosis of autism. Your doctor will focus on behavior and development.
For children, diagnosis usually takes two steps.
- A developmental screening will tell your doctor whether your child is on track with basic skills like learning, speaking, behavior, and moving. Experts suggest that children be screened for these developmental delays during their regular checkups at 9 months, 18 months, and 24 or 30 months of age. Children are routinely checked specifically for autism at their 18-month and 24-month checkups.
- If your child shows signs of a problem on these screenings, theyâll need a more complete evaluation. This might include hearing and vision tests or genetic tests. Your doctor might want to bring in someone who specializes in autism disorders, like a developmental pediatrician or a child psychologist. Some psychologists can also give a test called the Autism Diagnostic Observation Schedule .
If you werenât diagnosed with autism as a child but notice yourself showing signs or symptoms, talk to your doctor.
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Getting Evaluated For Autism Spectrum Disorder
Parent interview In the first phase of the diagnostic evaluation, you will give your doctor background information about your childs medical, developmental, and behavioral history. If you have been keeping a journal or taking notes on anything thats concerned you, share that information. The doctor will also want to know about your familys medical and mental health history.
Medical exam The medical evaluation includes a general physical, a neurological exam, lab tests, and genetic testing. Your child will undergo this full screening to determine the cause of their developmental problems and to identify any co-existing conditions.
Hearing test Since hearing problems can result in social and language delays, they need to be excluded before an Autism Spectrum Disorder can be diagnosed. Your child will undergo a formal audiological assessment where they are tested for any hearing impairments, as well as any other hearing issues or sound sensitivities that sometimes co-occur with autism.
Observation Developmental specialists will observe your child in a variety of settings to look for unusual behavior associated with the Autism Spectrum Disorder. They may watch your child playing or interacting with other people.
Lead screening Because lead poisoning can cause autistic-like symptoms, the National Center for Environmental Health recommends that all children with developmental delays be screened for lead poisoning.
A Surprising New Historical Analysis Suggests That A Pioneering Doctor Was Examining People With Autism Before The Civil War
Billy was 59 years old that spring or summer of 1846, when a well-dressed man from Boston rode into his Massachusetts village on horseback, and began measuring and testing him in all sorts of ways. The visitor, as we imagine the scene, placed phrenologists calipers on his skull, ran a tape measure around his chest and asked many questions relating to Billys odder behaviors. It was those behaviors that had prompted this encounter. In the parlance of the mid-19th century, Billy was an idiot, a label that doctors and educators used not with malice but with reference to a concept that owned a place in the medical dictionaries and encompassed what most of us today call, with more deliberate sensitivity, intellectual disability.
But what diagnosis might have fit better? If Billy were alive today, we think his disability, and that of others documented then in Massachusetts, would likely be diagnosed as autism. True, the actual word autism did not exist in their time, so neither, of course, did the diagnosis. But that does not mean the world was empty of people whose behaviors would strike us, in 2016, as highly suggestive of autistic minds.
Like that man on the horse, whose devotion to hard data, fortunately for detectives of autism history, was far ahead of his time.
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What Are The Symptoms Of Autism
The most obvious symptoms tend to involve communication and interaction with others.
Autistic people may have different ways of learning, thinking, and problem-solving. Intellectually, autistic people can fall on a range from severely challenged to gifted.
Everybody is different. Some people will have many symptoms, and some will have only a few. Signs of autism in a 3-year-old or 4-year-old may look different from those who are teens or adults. Some autistic people may be able to mask their symptoms.
General signs of autism may include:
- not responding to their name
- avoiding eye contact or not showing an awareness when others are speaking
- not understanding sharing or taking turns
- not looking at objects shown to them
- not pointing or responding to pointing
- having difficulty understanding facial expressions
In older children and adults, you might also notice:
- having difficulty reading body language, facial expressions, and other social cues
- not getting sarcasm, teasing, or figures of speech
- speaking in monotone
First Accounts Of Autism: Defining Characteristics
It is likely that autism has existed through the ages, but the first ever clinical account of the disorder was published by Dr. Leo Kanner in 1943.3 Dr. Kanner, who developed the first child psychiatric service at a U.S. hospital, described a group of 11 children eight boys and three girls who had “autistic disturbances of affective contact.”4
Dr. Kanner based his report on direct observation, and much of what he set down has stood the test of time. He vividly depicted the essential features of autism, all of which are echoed in current-day diagnostic manuals. It is interesting to note that, just as in Kanner’s study, the rate of autism in males continues to be much higher than the rate in females.
Hans Asperger, an Austrian pediatrician, was working at nearly the same time as Kanner with a similar group of children on the other side of the Atlantic. A milder form of autism, Asperger syndrome, was named after him.
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