What Is Autism Spectrum Disorder
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.
People with ASD may behave, communicate, interact, and learn in ways that are different from most other people. There is often nothing about how they look that sets them apart from 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 of age 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 lose the skills they once had.
Social Communication And Interaction Skills
Social communication and interaction skills can be challenging for people with ASD.
Examples of social communication and social interaction characteristics related to ASD can include
- Avoids or does not keep eye contact
- Does not respond to name by 9 months of age
- Does not show facial expressions like happy, sad, angry, and surprised by 9 months of age
- Does not play simple interactive games like pat-a-cake by 12 months of age
- Uses few or no gestures by 12 months of age
- Does not share interests with others by 15 months of age
- Does not point to show you something interesting by 18 months of age
- Does not notice when others are hurt or upset by 24 months of age
- Does not notice other children and join them in play by 36 months of age
- Does not pretend to be something else, like a teacher or superhero, during play by 48 months of age
- Does not sing, dance, or act for you by 60 months of age
What Behavioral Therapies Treat Autism Signs And Symptoms In Toddlers And Children
Behavioral therapy is the foundation for most treatment programs for children with autism. More than 30 years of research has shown the benefit of applied behavioral methods in improving communication, learning, adaptive behavior, and appropriate social behavior while reducing inappropriate behavior in children with autism. There is strong evidence that these interventions are most effective when started early, typically in the preschool years. A range of scientifically supported behavioral treatments has been developed that may be helpful for some children with autism. These are mainly based on the principles of applied behavior analysis.
Applied behavior analysis is designed to both correct behaviors and teach skills for dealing with specific situations. It is based on the principle of reinforcement: that behavior can be changed by rewarding desired behavior and removing reinforcement for unwanted behavior. The person will naturally repeat behaviors for which he or she is rewarded. This principle is applied in many different ways, such as discrete trial training, incidental teaching, errorless learning, and shaping and fading. Most treatment programs include a number of ABA therapies.
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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.
Autism And Your Environment
Sometimes, when a situation is too much to cope with due to sensory input , or being asked to do things that cause stress or distress, an autistic person can become overwhelmed.
Meltdowns and shutdowns
When an autistic person becomes overwhelmed and isnt able to use or benefit from their coping strategies, they might have meltdowns or shutdowns.
Its important, for parents of autistic children in particular, to be aware that a meltdown isnt a tantrum. A tantrum is something that a child can control, and tantrums often happen because a child wants something. A meltdown or shutdown isnt something an autistic person can control, and its caused by being overwhelmed.
During a meltdown, an autistic person might try to make themselves feel less overwhelmed. This can include doing things like:
- trying to get away from people for example by running away or hiding
- trying to get people away from them for example by shouting, screaming, hitting, or acting aggressively
During a shutdown, an autistic person might try to block everything out for example by not responding to anything or anyone around them.
Like everyone else, autistic people can display challenging behaviour if theyre in the wrong environment. While it can be challenging for the people around them, this behaviour is often a result of distress or frustration, particularly if an autistic person has difficulty with communicating.
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What Causes Nonverbal Autism
No one really knows why some people with autism can’t, or don’t, use spoken language. It is especially puzzling because quite a few nonverbal people on the spectrum can and do choose to communicate using American Sign Language, picture cards, and a range of digital tools.
Some people with autism also have childhood of speech, a neurological disorder that makes spoken language extremely difficult. But most nonverbal individuals on the autism spectrum don’t have apraxia they just don’t speak.
Until relatively recently, it was assumed that all nonverbal children with autism were intellectually disabled for the simple reason that their IQ scores fell under 70 those who score below 70 are considered intellectually disabled.
It’s recently become clear that typical IQ tests are in poor tools for measuring intellectual ability in children with autismparticularly when those children are nonverbal.The reasons for this are:
Ideally, determining the IQ of a nonverbal child with autism should include both nonverbal IQ tests and non-test-related observations.
The TONI is one example of a nonverbal IQ test that is usually a better option for nonverbal children and for children with autism in general. Observation of nonverbal children in familiar settings can also provide evaluators with real-world information about abilities versus test-taking skills.
The Journey From Classical Autism To Autism Spectrum Disorder
Till about the 1970s, the classical autism studies included all shades of ASD bundled under a generic term Autism.
Today, however, physicians, therapists, and researchers consider each of these five categories while referring to specific autism symptoms:
- Autistic Disorder also known as Classical Autism
- Aspersers Syndrome
- Childhood disintegrative disorder also referred to as CDD
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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
- formal audiology evaluation
- selected medical/lab tests on an individual basis
- speech, language, and communication assessment
- cognitive and behavioral assessments and
- academic assessment .
How Common Is Autism
Autism is always present from birth, but it might not be recognised or diagnosed until adulthood. Early intervention, in the form of support for their individual needs, can be helpful for autistic children.
Even if you arent diagnosed until adulthood, getting a diagnosis can be very helpful for identifying your strengths and the things you struggle with, and finding support.
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Social Communication And Social Interaction Challenges
Autistic people have difficulties with interpreting both verbal and non-verbal language like gestures or tone of voice. Some autistic people are unable to speak or have limited speech while other autistic people have very good language skills but struggle to understand sarcasm or tone of voice. Other challenges include:
- taking things literally and not understanding abstract concepts
- needing extra time to process information or answer questions
- repeating what others say to them
Autistic people often have difficulty ‘reading’ other people – recognising or understanding others’ feelings and intentions – and expressing their own emotions. This can make it very hard to navigate the social world. Autistic people may:
- appear to be insensitive
- seek out time alone when overloaded by other people
- not seek comfort from other people
- appear to behave ‘strangely’ or in a way thought to be socially inappropriate
- find it hard to form friendships.
An Insight Into The Various Types Of Autism
Let us now get a deeper insight into each of the following forms of Autism.
Fig 3: Overlap between Aspergers and PPD NOS
As mentioned at the beginning of this article, the various types of autism spectrum disorders present a significant overlap with one another. The following 3 characteristics are carefully evaluated to arrive at the right conclusion:
- Social skills within families coping with Autism and externally
- Autism Communication Skills
For example, it is extremely hard to discriminate between mild PDD and moderate Aspergers symptoms as a patient may demonstrate both characteristics in the autism spectrum quotient.
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Behavior For Moderate To Severe Autism
Communication and intellectual challenges cause children with moderate autism to exhibit many unusual behaviors. They may flap their arms, rock, hit, bite, scratch, or become obsessed with an object when theyre bored, upset, happy, frustrated, overwhelmed, or unable to share their thoughts or feelings.
While these and other behaviors are a way of communicating, they can be scary and dangerous to family members, onlookers, and the child. Certain behaviors will remain quirks for life, but therapy, communication strategies, and other tools can help children learn to cope and communicate better so they remain safe.
The behaviors of children with severe autism are similar to those exhibited by children with moderate autism to a greater degree. Typically difficult to manage, these behaviors can include a variety of self-soothing, stimulating, or communicative behaviors like rocking, flapping and jumping as well as aggression toward others and self-abuse.
Beneficial therapy can help children with severe autism cope and communicate, but they may continue to exhibit these behaviors on some level throughout their lives.
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.
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Checking For Physical Issues
Few people with severe autism are able to describe physical symptoms or problems. So, it’s a good idea to regularly check for physical things that may be exacerbating problem behaviors.
It’s not uncommon, for example, to discover that a child’s apparently aggressive behavior is actually a response to severe gastrointestinal pain. That pain may go away with the right dietary changes.
Once the pain is gone, they usually find it much easier to relax, engage, learn, and behave appropriately.
Selective Mutism And Autism: Is My Child Mute Or Autistic
Delayed first words and speech irregularities are some of the most common symptoms of autism spectrum disorder . If your child only talks with close family members and friends but shuts down at school or with extended family, you might suspect that autism is the reason.
When a child finds themself unable to speak to certain people, this is called selective mutism. But what causes selective mutism? Is it always linked to ASD? Lets dive into these questions and more.
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Can People Who Are Neurodivergent Be Successful
Yes, many people who are neurodivergent are accomplished and successful.
More and more people who are neurodivergent are talking about their experiences. Some examples of famous and successful people who are neurodivergent include:
- Animal scientist and author Temple Grandin.
- Oscar-winning actor Sir Anthony Hopkins.
- Musician and singer Florence Welch.
- Olympic gold medalist Simone Biles.
- Climate activist Greta Thunberg.
Experts also believe several accomplished historical figures were neurodivergent based on evidence from their lives. Those include:
- Nobel Prize-winning physicist and chemist Marie Curie.
- Nobel Prize-winning theoretical physicist Albert Einstein.
- Artist Vincent Van Gogh.
- Inventor and engineer Nikola Tesla.
Business leaders also have a growing understanding of the value of being neurodivergent. In 2017, the magazine Harvard Business Review published Neurodiversity as a competitive advantage. The article details the benefits of hiring people who are neurodivergent and why more businesses are doing so.
That same article noted that several major national and international corporations have hiring processes that can accommodate people who are neurodivergent. Those corporations include some of the largest names in information technology, the automotive industry, the banking sector and more.
The Significance Of Identity
In research and clinical work, PFL is typically used when taking a recovery orientation to treatment. For example, a doctor refers to patients with cancer rather than cancerous patients because the goal is to treat and eliminate the cancer.
Groups aiming to cure autism tend to use PFL when referring to autism and are generally considered to be a form of eugenics and elevate the voices of non-autistic people while being unresponsive to feedback from the autistic community.
Many autistic people have written and spoken about why IFL is important to them and why it is generally preferred over PFL. PFL implies that the person is the same with or without their diagnosis, and the majority of the autistic community agrees that their autism is a fundamental part of who they are.
Neurodivergent conditions, including autism, are brain differences, meaning that they impact who the person is.
Some autistic individuals prefer PFL or state that they have no preference, so when addressing them, use what they prefer. But when referring to the autistic community at large, the best practice is to determine what the majority of community members prefer because true allies value community voices.
Multiple surveys conducted over the past decade have shown that, while context plays a role in what language is most appropriate to use, IFL is generally preferred by the autistic community.
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What Disorders Are Related To Asd
Certain known genetic disorders are associated with an increased risk for autism, including Fragile X syndrome and tuberous sclerosis each of which results from a mutation in a single, but different, gene. Recently, researchers have discovered other genetic mutations in children diagnosed with autism, including some that have not yet been designated as named syndromes. While each of these disorders is rare, in aggregate, they may account for 20 percent or more of all autism cases.
People with ASD also have a higher than average risk of having epilepsy. Children whose language skills regress early in life before age 3 appear to have a risk of developing epilepsy or seizure-like brain activity. About 20 to 30 percent of children with ASD develop epilepsy by the time they reach adulthood. Additionally, people with both ASD and intellectual disability have the greatest risk of developing seizure disorder.
Consulting People You Know
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