Other Issues Associated With Autism
Older autistic children and teenagers often have other issues as well. These might include:
- difficulty with sleep for example, they might have difficulty falling asleep, or might regularly wake up or have broken sleep patterns
- anxiety or feeling overwhelmed for example, they might feel anxious about going to new places, or being in social situations
- depression older autistic children and teenagers who are aware of their differences are also often aware of how others see them and can feel like outsiders. These feelings of low mood might be intensified by changing hormone levels during puberty
- aggressive behaviour they often have sensory sensitivities that can lead to sudden aggressive behaviour. They might have difficulty understanding whats going on around them, which can lead to frustration building up
- eating disorders for example, they might have difficulty moving to secondary school and might develop an eating disorder to cope with feelings of anxiety
- difficulty with organisational skills they might find the increase in complexity at secondary school hard to manage
- school refusal they might feel overwhelmed or confused at school. They might also be vulnerable to bullying at school
- gender dysphoria autistic children and teenagers can be more likely than other children and teenagers to identify as a gender thats different from the sex they were assigned at birth. If they feel distressed about this its called gender dysphoria.
Social Aspects Of High
Autistic people are prone to commit social faux pas because of an inability to predict others’ reactions. They may also neglect social niceties like knocking or returning a greeting. Similarly, they may be overly trusting or paranoid of strangers. It may be best summed up as an inability to understand/perceive the intent or emotional wants and needs of others around them.
They may appear somewhat removed or dissociated or dreamy at times, especially when in sensory overload or from a perception of extreme social pressure. They may make little eye contact, leading others to conclude that they are shy, uninterested or evasive.
Unlike those with low-functioning autism, people with high-functioning autism are not mentally retarded persons with high-functioning autism have an IQ at the average to above-average range. Although they may have an adequate vocabulary, they may have a delay in communicating events and use less emotional content in their speech. They may also appear not to notice non-verbal cues from others such as when others have become bored with the topic of conversation they appear oblivious and continue.
As with people elsewhere on the autism spectrum, people with high-functioning autism generally prefer routine and order, and this usually begins in early childhood. They may, for example, write an alphabetized index of their comic book collection, or they may stick to a limited wardrobe.
Treatment And Therapy For Low Functioning Autism
A childs first years are crucial to their level of development and future learning and growth. By taking action and getting support right away, parents can help their children realize the best possible outcome. Early intervention also has a positive impact on the parents, by providing them with insight and tools to use as they learn to navigate their relationship with their special needs child.
Every child and adult with autism has varying degrees of symptoms and although they may share similarities, no two people with autism are alike, especially considering the fact that they often are diagnosed with numerous medical conditions that can include suffering from Sensory Processing Disorder, anxiety disorder, ADHD, Tourettes Syndrome, and many others.
Regardless of the childs diagnosis, early intervention is the key to helping children with autism progress. Therapy and intervention can include applied behavioral analysis, speech therapy, augmentative and alternative communication, physical therapy, occupational therapy, dietary restrictions, and treatment and diagnosis of comorbid medical conditions. Some parents also opt for less conventional music therapy and pet therapy.
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Issues With Defining High And Low Functioning Autism
Autism has a complex history. It is an inherently complex condition, and those that live and have lived with it have often faced plenty of stigma and misunderstanding. As complex as it is, it still struggles with generalization and oversimplification.
However, much progress has been made in determining how autism should be defined, and what parents with children on the spectrum can come to expect. But there are still many misconceptions between what autism is like and what it really means, especially when defining capability and functioning.
When people first hear about the spectrum, they assume that either end refers to an extreme one end detailing individuals with low-functioning autism, and the other end detailing high-functioning autism.
However, the spectrum refers to the breadth of symptoms that compose autism, in order to more properly define it not as an illness with a set number of symptoms, but as an umbrella term for a very long list of potential developmental problems faced by more than 3.5 million Americans living with an autism spectrum disorder. Ones ability to function does not determine where on the spectrum they land instead, the spectrum details the many symptoms that are part of the autism diagnosis.
Why We Should Stop Using The Term High Functioning Autism
Intelligence is not a good estimate of functional levels in children diagnosed with autism
It is hard to come across any terms more widely used in our field than âhigh functioning autismâ. While the term was coined by researchers in the 1980s, it is a commonplace label heard in clinics, schools, and even in mainstream media depictions of autism.
The term was originally devised by researchers to distinguish between individuals with and without co-occurring intellectual difficulties . However, âhigh functioning autismâ is not an official diagnostic term in diagnostic manuals. The term was also sometimes used interchangeably with Aspergerâs syndrome until the introduction of Autism Spectrum Disorder in 2013.
New research published by our research team provides evidence to indicate why this term should no longer be used.
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Social Interaction And Autism
Children with autistic disorders find it difficult to interact with the people around them. They rarely make and sustain eye contact, they resist cuddling, reject any form of affection and never look for it, cannot stand being kissed, have difficulty making friends and are mostly unable to play with children their own age.
Oftentimes they will have problems obeying simple rules, which is why they have problems attending a regular school. Normal peer relationships are also diminished due to the lack of social skills. Autistic people also tend to migrate toward exclusive activities. This will also affect their self-help daily living skills . However, it is important to point out that one person with Autism may experience very different symptoms and behaviors than another person with Autism.
Limitations In More Than One Area
Adaptive behavior, or adaptive functioning, refers to the skills needed to live independently . To assess adaptive behavior, professionals compare the functional abilities of a child to those of other children of similar age. To measure adaptive behavior, professionals use structured interviews, with which they systematically elicit information about persons’ functioning in the community from people who know them well. There are many adaptive behavior scales, and accurate assessment of the quality of someone’s adaptive behavior requires clinical judgment as well. Certain skills are important to adaptive behavior, such as:
- , such as getting dressed, using the bathroom, and feeding oneself
- skills, such as understanding what is said and being able to answer
- with peers, members, spouses, adults, and others
Other specific skills can be critical to an individual’s inclusion in the community and to develop appropriate social behaviors, as for example being aware of the different social expectations linked to the principal lifespan stages . The results of a Swiss study suggest that the performance of adults with ID in recognizing different lifespan stages is related to specific cognitive abilities and to the type of material used to test this performance.
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Diagnosis Of Autism In Adults
There are currently no standard diagnostic criteria for adults with suspected ASD, but they are in development.
In the meantime, clinicians primarily diagnose adults with ASD through a series of in-person observations and interactions. They also take into consideration any symptoms the person reports experiencing.
If youre interested in being evaluated for ASD, begin with your family doctor, who will evaluate you to be certain that there isnt an underlying physical illness accounting for your behaviors. Your doctor may then refer you to a psychiatrist or psychologist for in-depth assessment.
The clinician will want to talk with you about any issues you have regarding communication, emotions, behavioral patterns, range of interests, and more. Youll answer questions about your childhood, and your clinician might request to speak with your parents or other older family members to gain their perspectives about your lifelong behavior patterns.
If the diagnostic criteria for children are being used for reference, your clinician can ask your parent questions from that list, relying on their memories of you as a child for further information.
If your clinician determines that you didnt display symptoms of ASD in childhood, but instead began experiencing symptoms as a teen or adult, you may be evaluated for other possible mental health or affective disorders.
Because most autism diagnoses are made in children, it could be a challenge to find a provider who will diagnose adults.
History Of The Autism Diagnosis
The term autism was originally coined in 1911 by psychiatrist Eugen Bleuler, and was at first meant to denote the social withdrawal and detachment that often accompanies schizophrenia . Later, in the 1940s, when both American Leo Kanner and Austrian Hans Asperger were working on defining the childhood disorders they were treating, they came across the concept of autism in their research, and decided it was an apt description for the various symptoms they had been attempting to treat in children. Over time, Kanner realized these children were not actually experiencing schizophrenia, but rather something else, which he dubbed infantile autism. Asperger added onto this body of knowledge by ascertaining that some of the children referred to his child psychiatry clinic were suffering from a condition that had not been hitherto properly described, but which loosely fit what Bleuler had defined as autism . Kanners work was highly accurate and detailed for its time, and formed the cornerstone of future research into autism, particularly after his paper gained widespread recognition in the English-speaking world.
Following Kanners paper, the diagnosis of infantile autism came into popular use as the 1950s and 60s progressed, and Kanners work largely overshadowed Aspergers, who remained mostly unknown outside Europe.
Some debate still exists today around the four main areas of difference that separate Aspergers syndrome from high-functioning autism:
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Associated Difficulties With High
Generally, there are difficulties with social interaction. This might not adversely affect their ability to interact with others on a day-to-day basis at a basic working level, although they may be seen as being overly serious or earnest, and as being without any “small talk” in conversation. In many instances though, these individuals have such severe social delays and difficulties that interaction within a “normal” social setting can be severely hampered.
They may have difficulty initiating love and friendship relationships, often being rejected because potential partners perceive them as being either too “nerdy” or too intelligent. This can lead to low self esteem or loneliness, which further impairs their ability to find meaningful companionship.
People may label high-functioning autism people as “oddballs” or worse, and high-functioning autism people can easily become the target of bullying. This can be especially true from primary school through the late teens. Young, intelligent high-functioning autism people usually do best by seeking out the company of their intellectual peers or by joining hobby groups, while avoiding their age-group peers. Exposure to an age equivalent peer group within the autism spectrum on a regular basis can be especially beneficial.
Some may also nurture a complex habitual movement at which they become adept, for example, pen spinning, while otherwise being prone to clumsiness.
Asperger Vs High Functioning Autism
The difference between Aspergers and High Functioning Autism is that in some places, the former was or is still considered a mild variant of the latter. This is the most significant distinction, and it emerges as a result of the wide range of symptoms or their intensity in relation to the person in question. However, this isnt the only distinction there are a few other variances between the two related to their approaches, suitability, and early diagnosis.
Aspergers Syndrome is another name for Aspergers Syndrome. Most people are diagnosed with this illness before they turn two years old, and theres a chance theyll never be free of the symptoms. The trouble with general communication or expression, as well as a low level of intelligence in the patient, are some of the syndromes unique symptoms. Autism spectrum disorder describes this condition because it is related to behavior that mimics autism.
Autism, on the other hand, is a neurological ailment that is similar to Aspergers but with more severe symptoms and conditions. Severe symptoms, such as low IQ and communication impairments, are more common in people with this disorder. Although there is no cure for this condition, over time, various strategies have been developed to help individuals increase efficiency and reduce symptoms.
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Comparing High Function To Low Function
Autism has an incredible range in terms of the degree of the impairment. In high functioning autism, people are socially aware and they have good language skills. They may even appear to be relatively “normal” when they meet other people. In low functioning autism, people appear to be mentally handicapped and often are socially impaired. Often, one of the best ways to assess the level of autistic symptoms is to notice how well the person is able to function in daily living.
For doctors, though, what a child or an adult appears like is not enough. They define impairment based on the IQ of the individual. Those who have an IQ that is less than 80 are considered low functioning, or LFA. Those who have an IQ greater than 80 are classified for high functioning autism, or HFA.
In evaluating the treatment options for someone with autism, doctors often use a scale. Classification based on IQ testing can help individuals to tailor their education and daily living requirements. IQ classification is not an exact science and often parents find that it does not provide enough understanding of the children themselves.
- Educable: Those with an IQ score from 55 to 70.
- Trainable: Those with an IQ score from 40 to 70.
- Severely Limited: Those with an IQ score from 25 to 40.
- Profound: Those with an IQ score under 25.
A Concise History Of Asperger Syndrome
In the same years of Leo Kanners description of Infantile Autism , Hans Asperger wrote a case report on Autistic Psychopathy , describing children with social-communication impairment, eccentric manners, unusual interests and cognitive domains of hyper-functioning. The American Psychiatric Association did not immediately recognize Autism as a distinct category: it was introduced as Infantile Autism in the third edition of the Diagnostic and Statistical Manual of Mental Disorders and included within Pervasive Developmental Disorders in the DSM-III-R . In 1981, Wing resumed Aspergers researches, renaming the Autistic Psychopathy as Asperger Syndrome . In 1989, the first diagnostic criteria for AS were proposed and in the 1990s, AS appeared in the DSM-IV within PDD .
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Current And Proposed Specifier
At present, DSM-5 allows to use specifiers of language impairment, intellectual impairment and severity levels to distinguish clinical profiles of ASD broader category. Nevertheless, considering the results obtained from the clinical profiles comparison and from the DSM-5 severity levels distinction, it is necessary to consider the risk that, in the severity specifier Level 1 of the DSM-5, many phenotypic variances could be squeezed making this level very heterogeneous. Because of this, any attempts to predict clinical outcomes, develop individualized treatment targets or identify etiological factors may become unreal . Lai et al. underlined that defining autism using the umbrella term ASD, could hide the evident heterogeneity. In order to make progress in autism research and ultimately improve clinical practice, there is the necessity to move forward in the identification of subtypes within the autism spectrum. Maybe, a subtype specifier for HFA and AS could be useful to direct specific age-related paths of treatment .
In the present study, the suggested threshold is lower .
Treatment Of Mental Disorders
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Two large studies done by the Faculty of Health Sciences at Simon Fraser Universityindicates that both behaviour therapy and cognitive-behavioural therapy are equally effective for OCD. CBT has been shown to perform slightly better at treating co-occurring depression.
Considerable policy implications have been inspired by behavioural views of various forms of psychopathology. One form of behaviour therapy has been found to be highly effective for treating tics.
There has been a development towards combining techniques to treat psychiatric disorders. Cognitive interventions are used to enhance the effects of more established behavioural interventions based on operant and classical conditioning. An increased effort has also been placed to address the interpersonal context of behaviour.
Modelling has been used in dealing with fears and phobias. Modelling has been used in the treatment of fear of snakes as well as a fear of water.
Aversive therapy techniques have been used to treat sexual deviations as well as alcohol use disorder.
Contingency contracting has been used to deal with behaviour problems in delinquents and when dealing with on task behaviours in students.
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