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Introduction to Autism


Autism and Related Pervasive Developmental Disorders

A Neurological Illness Characterized by Social, Communication and Behavioral Deficits

Autism is a neurological disorder (a "brain" disease) characterized by the presence of severe communication, language and social deficits in affected persons. It is the most well known of several pervasive developmental disorder (PDD) diagnoses which begin in early childhood and continue throughout life, affecting most every aspect of life along the way. While autistic peoples' cognitive (thinking and language) and social skills are typically developmentally delayed compared to their peers, their motor (movement) skills develop in a more normal fashion.

Specific social interaction, communication and behavioral deficits must be present before the diagnosis of autism is appropriate. Though all people with Austim people show the same specific pattern of impair...More

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What are Pervasive Developmental Disorders

  • Pervasive Developmental Disorders (PDDs), or sometimes, autism spectrum disorders include Autism, Rett's Disorder, Childhood Disintegrative Disorder, and Asperger's Disorder.
  • All of the pervasive developmental disorders are characterized by communication and social impairments. They are differentiated from one another on the basis of research suggesting different causes for the underlying impairments, and by different impairment profiles and intensities of impairment typical of each condition.
  • Though the terms "autism spectrum disorders" and "pervasive developmental disorders" have the same meaning, a person can have a pervasive developmental disorder and not carry the diagnosis of autism in particular.

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What is autism?

  • Autism is a neurological disorder (a "brain" disease) characterized by the presence of severe communication, language and social deficits in affected persons.
  • From a very early age, children with autism demonstrate a difficulty in processing social and non-verbal forms of communication, such as eye contact and facial expression.
  • Children with autism are also typically delayed (sometimes severely so) in their development of spoken language and conversational skills.
  • Those with autism frequently act with indifference towards others, and remain isolated from their surroundings.
  • Symptoms of autism usually become apparent between 18-36 months of age with 40% of cases being diagnosed by age three.
  • Autistic symptoms continue into adulthood with symptoms ranging in severity (across individuals) from relatively mild to severe and debilitating.
  • The rate of occurrence of autism has risen from 5 in every 10,000 in the mid 1990's to 1 in every 166 in 2005.
  • There is no known reason for the dramatic increase, but awareness of the condition may play a significant role.
  • It is important to recognize that Autism is not mental retardation, a lack of intelligence or Obsessive-Compulsive Disorder.

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What are the symptoms of autism?

  • Autistic deficits cluster into three groups: communication-related, social and physical deficits.
  • Communication deficits include difficulty using spoken language and gestures, inability to initiate and sustain appropriate conversation and use of inappropriate, repetitive language.
  • Social deficits include a tendency towards isolation, difficulty making eye contact, inability to develop appropriate peer relationships and apparent lack of empathy.
  • Physical deficits take the form of stereotyped repetitive movements and unusual body posturing.
  • For a diagnosis of autism, delays or abnormal functioning occurs in at least one of the following areas, with onset prior to 3 years of age: (1) social interaction (2) language as used in social communication (3) symbolic or imaginative play.

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What are the causes of Autism?

  • Originally it was thought that autism occurred as a result of poor parenting, specifically as a result of neglectful parents who failed to stimulate their children enough.
  • It is definitively known today that no amount of abuse or neglect can result in autism.
  • The best evidence available today appears to support a diathesis-stress model of causation.
  • Diathesis is a fancy work for vulnerability.
  • Diathesis-stress theories of illness basically suggest that it takes two events to cause an illness to occur.
  • First, a vulnerability towards getting that illness must be present and second, some stressful environmental event (or events) must occur that release the vulnerability and get the disease process going.
  • The exact nature of the vulnerability involved in causing autism is not clear at this time.
  • It is known that children who have siblings diagnosed with an autism-spectrum disorder have a greater risk of themselves becoming diagnosed with an autism spectrum disorder.
  • The reason for this increased vulnerability risk appears to be genetic in nature, involving a heightened risk for chromosomal abnormalities.
  • Research on the environmental causes of autism is ongoing and a variety of environmental stressors, including various environmental pollutants, toxins, viruses and the like, have been proposed to be capable of performing an activating role in autism.
  • A UK-based article published in 1998 stated that autism might be created in vulnerable people through exposure to a mercury compound (Thimerosal) formerly used as a preservative in normal childhood vaccines such as the MMR (Measles, Mumps and German Measles/Rubella) vaccine.
  • In 2004, 10 of the study's coauthors made a partial retraction of the research, and in January 2011, it was determined that the original research study that proposed this controversial theory had been proven to be fraudulent and the study author was stripped his clinical and academic credentials for dishonesty.
  • Whatever the actual causes of autism may turn out to be, it appears beyond question at this time that autism itself is a fundamentally biologically based disease.

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How are Autism Spectrum Disorders diagnosed?

  • Autism Spectrum Disorders are difficult to recognize because symptoms come on slowly and gradually and parents are seldom motivated to assume the worst about their children's atypical behavior and symptoms until they become impossible to ignore.
  • Though symptoms might be visible early on to an experienced eye, most parents do not bring their children in for formal diagnosis until they are between eighteen months and three years of age.
  • To make it easier for parents to know what specific signs to look for, the National Institute of Child Health and Human Development has provided a list of warning signs and milestones all revolving around the crucial theme of communication deficits.
  • The presence of any one of the following should raise a flag that a child might benefit from professional assessment and help.
    • The child does not babble or coo by twelve months.
    • The child does not use gestures to communicate and the child does not wave.
    • The child does not grasp objects or point to objects by twelve months.
    • The child does not say single words by the age of sixteen months and does not say two-word phrases on his or her own by 24 months.
    • The child has a loss of any language or social skills at any age.
  • Typically, parents become concerned about their child's behaviors or developmental delays, and take their child to see a pediatrician who conducts a medical exam, and notices symptoms consistent with an autism spectrum disorder. The pediatrician will then often refer the family to a child psychiatrist or psychologist for further assessment.
  • A variety of tests and questionnaires help parents and doctors measure autism symptoms so as to determine if symptoms of autism or other PDDs are present.

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How are Autism Spectrum Disorders treated?

  • There is no cure for autism or pervasive development disorder (PDD) diagnoses.
  • They are chronic lifelong conditions that can only be treated and moderated with appropriate intervention.
  • It is crucial to intervene as early as possible when autism or another PDD is present, because (with the exception of Asperger's disorder) these conditions interfere with normal language development. Without therapeutic assistance, children with these conditions will not learn language properly or at all.
  • A wide variety of interventions have been developed for children with autism or PDD diagnoses. A few of these include:
  • Selected approaches address each child's specific needs as determined by educators and clinicians whose findings are formalized as an individualized treatment plan.
  • Each child's treatment plan outlines that child's strengths and needs and also lists long-term and short-term goals for the child to reach.
  • The treatment plan also outlines specific interventions that are to be used to help the child meet these goals.

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How can families cope with an autism spectrum disorder diagnosis?

  • Raising a child who has been diagnosed with autism or a related pervasive developmental disorder is a daunting and exhausting task.
  • There are many appointments to keep with some families coordinating between 20 and 40 hours of therapy each week.
  • They are visited by therapists, behavior specialists, case managers and support staff.
  • They deal with their children's isolation, anxiety and tantrums, as well as their own often troubling emotional reactions.
  • In short, families need support to help them cope.
  • Respite services help families caring for children with autism to have a break from caregiving, usually for just long enough so that caregivers can catch their breath.
  • Advisory Board on Autism and Related Disorders (ABOARD) provides information and resources to caretakers and it helps families who are waiting for diagnosis, educational support and therapeutic interventions.
  • Support groups are mutual self-help groups, run either by peers (other parents of autistic children), or by professionals working in the autism or PDD field.
  • Wraparound is a temporary, physician prescribed service that brings therapy directly to needy families and is used to help children with autism work towards independence.

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What is adulthood like for those with autism?

  • Autism is a life-long, chronic disorder that can significantly impact affected people's social and cognitive development and as a result, adult functioning is frequently compromised.
  • Some adults with autism learn to function well in society and are able to earn degrees and to maintain employment.
  • Others never develop the communication and self-help skills necessary to live independently.
  • When children with autism reach the age of fourteen, their caregivers and teachers create a transition planning review in collaboration with the school district that covers issues like education and training as well as career planning.
  • Living arrangements and income are some of the major issues facing adults with autism. While some are able to manage independently, others must be supervised around the clock in order to ensure their safety.
  • Even if adults with autism are able to maintain a job and groom themselves independently, they may not be able to deal with everyday situations requiring good social skills like meeting new people, asking appropriate questions or maintaining interpersonal relationships.
  • The ideal jobs for adults with autism are usually quite structured in nature. Many high-functioning adults with autism or PDD find employment in computer-related fields, some like the repetition of assembly line work, and others prefer working with animals.
  • Many adults with autism are able to function quite well in group homes that provided assisted living support, while others live with family members throughout their lives.

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