What Are The Signs Of Autism
The autism diagnosis age and intensity of autisms early signs vary widely. Some infants show hints in their first months. In others, behaviors become obvious as late as age 2 or 3.
Not all children with autism show all the signs. Many children who dont have autism show a few. Thats why professional evaluation is crucial.
The following may indicate your child is at risk for an autism spectrum disorder. If your child exhibits any of the following, ask your pediatrician or family doctor for an evaluation right away:
History Of Asperger Syndrome
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Asperger syndrome is an autism spectrum disorder . It is a relatively new diagnosis in the field of autism. It was named after Hans Asperger , who was an Austrian psychiatrist and pediatrician. An English psychiatrist, Lorna Wing, popularized the term “Asperger’s syndrome” in a 1981 publication the first book in English on Asperger syndrome was written by Uta Frith in 1991 and the condition was subsequently recognized in formal diagnostic manuals later in the 1990s.
Terminology And Distinction From Schizophrenia
As late as the mid-1970s there was little evidence of a genetic role in autism while in 2007 it was believed to be one of the most heritable psychiatric conditions. Although the rise of parent organizations and the destigmatization of childhood ASD have affected how ASD is viewed, parents continue to feel social stigma in situations where their child’s autistic behavior is perceived negatively, and many primary care physicians and medical specialists express some beliefs consistent with outdated autism research.
It took until 1980 for the DSM-III to differentiate autism from childhood schizophrenia. In 1987, the DSM-III-R provided a checklist for diagnosing autism. In May 2013, the DSM-5 was released, updating the classification for pervasive developmental disorders. The grouping of disorders, including PDD-NOS, autism, Asperger syndrome, Rett syndrome, and CDD, has been removed and replaced with the general term of Autism Spectrum Disorders. The two categories that exist are impaired social communication and/or interaction, and restricted and/or repetitive behaviors.
The Internet has helped autistic individuals bypass nonverbal cues and emotional sharing that they find difficult to deal with, and has given them a way to form online communities and work remotely.Societal and cultural aspects of autism have developed: some in the community seek a cure, while others believe that autism is simply another way of being.
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The More Modern Meaning Of Autism Takes Shape
It wasnt until 1938 that Autism started to take on a more modern meaning and separation from schizophrenia. This evolution was because of Hans Asperger of the Vienna University Hospital’s research in investigating what came to be known as Asperger syndrome.
In 1943, Autism became even more defined when Leo Kanner came up with early infantile autism to describe the behavioral similarities in 11 children he was working with. Some of the behaviors these children shared were autistic aloneness and insistence on sameness.
Between Kanners diagnosis in 1943 and the late 1960’s, there was a lot of confusion around the term Autism, with it getting mixed up with terminology like infantile schizophrenia.
However, in the late 60s to mid 70s, autism started to get more attention, research, and definition. However, some of this research was very off the mark.
An example of this inaccurate research was done by Bruno Bettelheim, who believed that autism was caused by unloving, cold mothers. He coined the term refrigerator mothers, to describe these mothers.
This was countered by Bernard Rimland, who was a psychologist with an autistic child. In 1964, he published Infantile Autism: The Syndrome and its Implication for Neural Theory of Behavior that helped define and direct research at that time.
Treatments used in the 60s and 70s consisted of LSD, electric shock, and behavior change that focused on pain and punishment.
Autism As A Biological Condition
The conceptualization of autism changed course in the later part of the 1970s. In 1977, Susan Folstein and Sir Michael Rutter published a study on twins in which 21 same-sex twin pairs where at least one of the twins had autism were studied. The authors found that there was a 36% concordance rate between twins, meaning that if one twin had autism the probability of the identical twin also having autism is 36%. From this result, the authors concluded there is a significant hereditary component to autism.
In addition to the twin study methodology, the breakthroughs in understanding the hereditary nature of autism occurred due to scientific discoveries in molecular genetics. Scientists had finally answered the question of the physical features of hereditary units, called genes, and how genes are passed from one generation to the next. This concept allowed a greater understanding of a multitude of diseases, such as cancer and autoimmune disorders, but also gave a different explanation to complex behavioral and developmental disorders such as autism.
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History Of Dimensional Approaches
Dimensional approaches to the diagnosis and classification of autism can be traced back many decades. Years before autism was formally recognized in DSM-III as a disorder distinct from schizophrenia, researchers attempted to quantify the symptom profiles of individuals demonstrating the unusual patterns of behaviors as described by Leo Kanner. As research and clinical practice in the field grew, so did the diagnostic measures designed to capture the symptoms. Remarkably, almost 60 years after the introduction of the first autism diagnostic tools, current gold-standard practices largely retain many of the components of earlier versions.
Currently, the Autism Diagnostic Observational Schedule, Second Edition and the Social Responsiveness Scale, Second Edition are among the most widely used dimensional measures to quantify autism severity with relative independence from participant characteristics such as IQ . The ADOS-2s calibrated severity scores and the SRS-2s T-scores have been useful tools for measuring the degree of social communication impairments and repetitive behavior patterns . Dimensional measures such as these can provide information about the phenotypic profiles in autism, both related to autism symptoms as well as non-autism related symptoms, that can contribute to improved treatment planning and better symptom tracking over time .
Then And Now: A Look At Autism Over The Last 20 Years
Thanks to a supportive community, over the last 20 years SARRC has been able to advance the understanding and treatment of autism. But what exactly did the autism landscape look like in 1997? We asked members of SARRCs research team to explained. Heres a glimpse of how far weve come.
What is the prevalence of autism among children in the United States?
In 1997, autism was on the rise and so were peoples concerns, yet there were no dedicated efforts to monitor prevalence rates. Rough estimates suggested that 1 in 2,500 children were likely to be diagnosed with autism. In the year 2000, the Centers for Disease Control and Prevention began carefully tracking prevalence rates through the Autism and Developmental Disabilities Monitoring Network. Today, the CDC reports that one 1 in 68 children has been identified with autism spectrum disorder .
What is the average age children are receiving an autism diagnosis?
The estimated average age of diagnosis in the U.S. was 4 years, 4 months in 1997. While parental concerns were noted in earlier development, it was more common for children to be identified and diagnosed upon reaching school age. Currently, the CDC states the average age of diagnosis in the U.S. is 3 years, 10 months. However, research has shown that a reliable diagnosis of autism can be made as early as 2 years old.
What are the expected outcomes for adults with autism?
How have diagnostic criteria changed in the past 20 years?
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Autism In Developing Countries
While a recent global burden study reported that 95% of all young children with developmental disabilities live in low and middle income countries , the majority remain undiagnosed . Furthermore, relatively little research originates from these countries, which results in their underrepresentation in the broader ASD literature . The low diagnostic rates in poor countries likely stem from the lack of dedicated infrastructure to assist people with ASD , difficulty obtaining referrals to meet with the limited number of specialists , and low levels of parental literacy that limit a parents ability to understand the disorder and to locate services . Families are often forced to manage the care of an individual with ASD on their own, which often involves enlisting the help of extended family and community members . Among the lucky families who find an available and appropriate assessment center, the target children may be brought to the clinic by non-parent adults, which limits the quality and quantity of relevant developmental information that can be shared with the specialist. Thus, given the numerous barriers to assessment, the children who ultimately receive ASD diagnoses are often the children with the most significant impairments and complex phenotypic profiles .
Origin And Diagnosis Of Autism
According to Martin Luther, A 12-year-old boy was affected by autism. Luther thought this boy was possessed by a devil. The earliest case of autism is of Hugh Blair of Borgue in 1747 which is registered as a court case in which his brother requests to annul Blairs marriage to get Blairs inheritance. In 1798, A feral child has some signs of autism who are treated by a medical student Jean Itard with a behavioral program.
In the 1940s, researchers within the United States began to use autism to explain kids with emotional or social issues. A doctor from Johns Hopkins University, Leo Kanner used it to elucidate the behavior of many kids he studied United Nations agency acted withdrawn. Simultaneously, Hans Asperger discovered Aspergers syndrome.
Donald Gray Triplett, born in 1933 in a rural town known as Forest, Mississippi. He is the one whom psychiatrist Dr. Leo Kanner in 1938 has first at Johns Hopkins Hospital. Dr. Kanner was puzzled after seeing his symptom and was initially unable to diagnose him. However, in Dr. Kanners 1943 paper, Autistic Disturbances of Affective Contact, Donald Triplett was registered as Case 1, Donald T.
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History Of Autism Science
Autism Spectrum Disorder might seem to be a fairly new condition, yet written evidences of its existence can be found as far back as the 1700s. The word Autism was coined after the Latin word Autismus in 1910 by Swiss psychiatrist Eugen Bleuler however he applied the word to describing schizophrenia. The Latin word was in turn was derived from a Greek word, autos, meaning self. Once the condition we now know as autism was discovered in 1938, it was labeled with Bleulers word because people who are autistic have been observed to be morbidly self-absorbed to the exclusion of everyone else around them.
In 1938, a psychiatrist from Vienna University Hospital, Hans Asperger, adopted the term autistic psychopaths to what he was researching then, which is now known as Asperger Syndrome. It was not until 1981 that Asperger Syndrome became a specific classification within the autism spectrum.
In 1943, a psychiatrist from John Hopkins University, Leo Kanner, used the term autism in the modern sense. He then made a new classification which he called the Early Infantile Syndrome or Kanner Syndrome. It came about during his observation of 11 children who displayed similar symptoms. He described them as acting with autistic sameness and insistence on sameness.
Up to this day, there is still no scientifically proven single cause of autism.
Causes And Risk Factors
While there is no single cause of ASD, there are certain environmental and genetic risk factors. Specifically, advanced parental age, low birth weight, or fetal exposure to the medicationvalproate may contribute to the risk of ASD. Genetic research continues to explore heritability factors in ASD currently, up to 15 per cent of cases are linked to a known genetic mutation.
A publication in 1998 by British gastroenterologist Andrew Wakefield and his team suggested that there is a link between autism and vaccination with the mumps, measles and rubella vaccine or with other childhood vaccines containing mercury in thevaccine preservative. Despite this study being retracted from the journal in which it was published due to ethical breaches and numerous studies thereafter showing no connection between autism and the MMR vaccine, media coverage of Wakefields theoryfostered a widespread belief in a link between vaccination and ASD.
Research shows that there are some factors that can predict the severity of ASD. One is the individuals cognitive functioning: those with higher cognitive function show significant progress over time in their adaptive and language skills. Early verbaland nonverbal communication can also predict better adaptive behaviour and communication skills. For instance, children with higher IQs and those who develop speech by five years of age tend to have better long-term outcomes.
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Use Of Principles Versus Examples
DSM-IV and ICD-10 criteria had included examples, derived from multiple levels of analyses, that described specific behaviors, such as shared enjoyment, general qualities, and important contexts , through which deficits in ASD could reliably be seen . Recognizing the myriad behavioral presentations among individuals with ASD of varying developmental levels, DSM-5 and ICD-11 introduced broad principles in place of specific examples to better define symptom subdomains. The new principles, each accompanied by a non-exhaustive list of similar examples, present deficits within each subdomain that are applicable across age ranges and developmental levels, thus providing greater systematic sensitivity and specificity. Notably, however, while conceptualized through clinical observation, the DSM-5 and ICD-11 criteria included within each domain are not empirically-defined dimensions .
Why Autism Diagnoses Have Soared
The number of children diagnosed with autism spectrum disorder has risen consistently and dramatically since the 1990s. According to the Centers for Disease Control and Prevention , as of 2016, approximately 1 in 54 children in the United States was diagnosed with autism. In 2000, the corresponding rate was approximately 1 in 150 children. The rate is notably higher in boys than in girls .
There’s no way to pinpoint an exact reason for this increase, but it’s likely that significant changes in diagnostic criteria and reporting practices, in addition to greater awareness and possibly environmental factors, are responsible.
Here’s a look at some of the main theories about why autism is on the rise.
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Will Diagnoses Of Autism Continue To Increase
There is no way to know for sure if autism rates will continue to rise. As diagnostic criteria evolve, it could lead to either more or fewer children being qualified for an autism diagnosis.
Some experts, for example, expected a decline in autism diagnoses once Asperger’s syndrome and PDD-NOS were eliminated as catch-all options. Others expected an increase as awareness and services improve. For now, the number and rate of children diagnosed with autism continue to rise.
When Was Autism Discovered
The earliest, well-documented first case of autism goes back to a 1747 court case where Hugh Blair of Borgues brother petitioned to annul Blairs marrying to his wife to get to Blairs inheritance.
The court documents describing Blair show very strongly that he had Autistic symptoms.
Then next case is that of The Wild Boy of Aveyron, who was a feral child who lived in the wild for seven years and was brought back into society in 1798. Very good notes were taken about this boy and peoples attempts to teach him language and social skills.
Reviewing the notes has led modern-day researchers to believe that the boy had Autism based on his ability to learn to communicate and some of his behaviors.
There is not a lot of history between those first two cases and when Bleuler coined the term Autism in the early 1900s.
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Aspergers Disorder And The Broader Autism Spectrum
Aspergers disorder and the broader autism spectrum have their own interesting and complex, and to some extent, interrelated, histories. In some respects, Aspergers original report stood in contrast to Kanners earlier paper. The cases that Asperger described, all boys with marked social difficulties , somewhat presaged the awareness over the past decades of the broader autism phenotype . This awareness has also reflected the similarly growing awareness of the complexity of the genetics of autism . Until Wings review of Aspergers original paper , however, there was relatively little awareness of the condition . Wing herself saw the condition as clearly being part of the autism spectrum and her paper became the inspiration for what can only be described as a plethora of differing diagnostic views on the concept , with no fewer than 5 distinctive approaches to Aspergers disorder emerging .
Autism Spectrum Disorders Defined
Autism spectrum disorder refers to a range of disorders of brain development. Commonly known as autism, these conditions are characterized by difficulties in social skills, both verbal and nonverbal communication, repetitious movements, delayed child development and other unique strengths and challenges. In the phrase autism spectrum disorder, spectrum refers to the variation in presentation of symptoms and assets of each individual with autism.
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The notion that autism is a spectrum of disorders is a relatively new phenomenon. Before 2013, autism spectrum disorders, such as Aspergers syndrome and Kanners syndrome, were thought of as distinct disorder classes with independent treatments. In the latest revision of the Diagnostic and Statistical Manual of Mental Disorders in 2013, the American Psychiatric Association combined subcategories of autism and related conditions into one unified category with different characteristics and severity. Autism is now understood to be on a continuum with overlapping symptomology, caused by a multitude of complex genetic and environmental factors. This progression of the classification and etiology mirrors that of evolving treatment approaches for individuals with autism. Treatments have changed in the last century due to changing theoretical conceptions, new philosophies, and research advances in the field, ranging from biochemical to social and behavioral methods.
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