Autism Spectrum Disorder

The Nurturing Womb (2017) by Amrit Khurana, a young artist on the autism spectrum

Source: Amrit Khaurana @ Not Just Art: A Youth4Jobs start-up

Autism Spectrum Disorder (ASD)

Autism, also called Autism Spectrum Disorder (ASD), is a complicated condition that includes problems with communication and behavior. It can involve a wide range of symptoms and skills. ASD can be a minor problem or a disability that needs full-time care in a special facility.

People with autism have trouble with communication. They have trouble understanding what other people think and feel. This makes it hard for them to express themselves, either with words or through gestures, facial expressions, and touch.

People with autism might have problems with learning. Their skills might develop unevenly. For example, they could have trouble communicating but be unusually good at art, music, math, or memory. Because of this, they might do especially well on tests of analysis or problem-solving.

More children are diagnosed with autism now than ever before. But the latest numbers could be higher because of changes in how it’s diagnosed, not because more children have a disorder.

What are the Signs of Autism?

Symptoms of autism usually appear before a child turns 3. Some people show signs from birth. Common symptoms of autism include:

  • Lack of eye contact - little or inconsistent eye contact

  • Narrow range of interests

  • Intense interest in certain topics

  • Repeating certain behaviors, words, or phrases - doing something over and over, like repeating words or phrases, rocking back and forth, or flipping a lever;

  • Sensory Sensitivities - high sensitivity to sounds, touches, smells, or sights that seem ordinary to other people

  • Talking at length without gauging the interest of others - not looking at or listening to other people

  • Not sharing enjoyment of objects or activities by pointing or showing things to others

  • Not wanting to be held or cuddled

  • Difficulty with back and forth communication - problems understanding or using speech, gestures, facial expressions, or tone of voice;

  • Flat tone of voice - talking in a sing-song, flat, or robotic voice

  • Trouble adapting to changes in routine

  • Problems in sleeping

  • Difficulty responding to adult attempts to gain attention

  • Difficulty with perspective-taking

Some children with autism may also have seizures. These might not start until adolescence.

Typical Strengths of Many Autistic People

While autistic people may face many challenges, they may also have differences that many would consider strengths. These include:

  • superior memory for facts and figures

  • specialist knowledge in topics of interest

  • high level of motivation and enthusiasm in activities of interest, with a drive to share this enjoyment and enthusiasm with others

  • high degree of accuracy in various tasks

  • innovative approaches to problem solving

  • exceptional attention to detail

  • ability to follow instructions accurately, under appropriate guidance

  • exceptional creative skills

  • ability to see the world from an alternative perspective and therefore offer unique insights

  • a tendency to be nonjudgmental, honest, and loyal in social relationships

  • unique sense of humor

What are the Types of Autism Spectrum Disorders?

These types were once thought to be separate conditions. Now, they fall under the range of autism spectrum disorders including:

  • Asperger's Syndrome. These children don't have a problem with language; in fact, they tend to score in the average or above-average range on intelligence tests. But they have social problems and a narrow scope of interests.

  • Autistic Disorder. This is what most people think of when they hear the word "autism." It refers to problems with social interactions, communication, and play in children younger than 3 years.

  • Childhood Disintegrative Disorder. These children have typical development for at least 2 years and then lose some or most of their communication and social skills.

  • Pervasive Developmental Disorder (PDD or atypical autism). Your doctor might use this term if your child has some autistic behavior, like delays in social and communications skills, but doesn’t fit into another category.

What Causes Autism?

Exactly why autism happens isn't clear. It could stem from problems in parts of your brain that interpret sensory input and process language.

Autism is four times more common in boys than in girls. It can happen in people of any race, ethnicity, or social background. Family income, lifestyle, or educational level doesn’t affect a child’s risk of autism. But there are some risk factors:

  • Autism runs in families, so certain combinations of genes may increase a child’s risk.

  • A child with an older parent has a higher risk of autism.

  • Pregnant women who are exposed to certain drugs or chemicals, like alcohol or anti-seizure medications, are more likely to have autistic children. Other risk factors include maternal metabolic conditions such as diabetes and obesity. Research has also linked autism to untreated phenylketonuria (also called PKU, a metabolic disorder caused by the absence of an enzyme) and rubella (German measles).

There is no evidence that vaccinations cause autism.

How Is Autism Diagnosed?

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, they’ll 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 (ADOS).

If you weren’t diagnosed with autism as a child but notice yourself showing signs or symptoms, talk to your doctor.

How Is Autism Treated?

There’s no cure for autism. But early treatment can make a big difference in development for a child with autism. If you think your child shows symptoms of ASD, tell your doctor as soon as possible.

What works for one person might not work for another. Your doctor should tailor treatment for you or your child. The two main types of treatments are:

  • Behavioral and communication therapy to help with structure and organization. Applied Behavior Analysis (ABA) is one of these treatments; it promotes positive behavior and discourages negative behavior. Occupational therapy can help with life skills like dressing, eating, and relating to people. Sensory integration therapy might help someone who has problems with being touched or with sights or sounds. Speech therapy improves communication skills.

  • Medications to help with symptoms of ASD, like attention problems, hyperactivity, or anxiety.

Complementary treatments may help boost learning and communication skills in some people with autism. Complementary therapies include music, art, or animal therapy, like horseback riding and even swimming with dolphins. Therapy also aims to reduce challenging behaviors and build upon strengths.

Some autistic adults are unable to live independently. An autistic culture has developed, with a minority of individuals seeking a cure, and others believing autism should be accepted as a difference to be accommodated instead of cured.

Applied Behaviour Analysis (ABA)

Applied Behaviour Analysis (ABA) is the only proven intervention to be deemed effective when working with individuals with autism. ABA focuses on the observable relationship of behaviour to the environment. By looking at this relationship, the methods of ABA can be used to change behaviour. Though you may hear of a variety of other strategies to help individuals with autism, none have the research behind it to prove their efficacy.

  • ABA is Applied, meaning it targets behaviours that are socially significant.

  • ABA is Behavioural, studying observable, measurable events.

  • And ABA is Analytic as it demonstrates reliable factors controlling behaviour.

  • ABA will help to:

    • Teach new skills

    • Reduce maladaptive behaviours

Source: Strengths and Skills in Students with Autism

Hans Asperger (1906–1980)

Leo Kanner (1894–1981)

Early Understanding of Autism

The word autism first took its modern sense in 1938 when Hans Asperger of the Vienna University Hospital adopted Bleuler's terminology autistic psychopaths in a lecture in German about child psychology. Asperger was investigating an ASD now known as Asperger's Syndrome, though for various reasons it was not widely recognized as a separate diagnosis until 1981.

Leo Kanner of the Johns Hopkins Hospital first used autism in its modern sense in English when he introduced the label early infantile autism in a 1943 Autistic Disturbances of Affective Contact of 11 children with striking behavioral similarities. Almost all the characteristics described in Kanner's first paper on the subject, notably "autistic aloneness" and "insistence on sameness", are still regarded as typical of the autistic spectrum of disorders. It is not known whether Kanner derived the term independently of Asperger.

A few examples of autistic symptoms and treatments were described long before autism was named. The Table Talk of Martin Luther, compiled by his notetaker Johannes Mathesius between 1531 and 1546, contains the story of a 12-year-old boy who may have been severely autistic.

The earliest well-documented case of autism is that of Hugh Blair of Borgue, as detailed in a 1747 court case in which his brother successfully petitioned to annul Blair's marriage to gain Blair's inheritance.

The Wild Boy of Aveyron, a feral child caught in 1798, showed several signs of autism; the medical student Jean Itard treated him with a behavioral program designed to help him form social attachments and to induce speech via imitation.

Mary Temple Grandin

Mary Temple Grandin (b 1947) is an American scientist, academic and animal behaviorist. She is a prominent proponent for the humane treatment of livestock for slaughter and the author of more than 60 scientific papers on animal behavior. Grandin is a consultant to the livestock industry, where she offers advice on animal behavior, and is also an autism spokesperson.

Grandin is one of the first autistic people to document the insights she gained from her personal experience of autism. She is currently a faculty member with Animal Sciences in the College of Agricultural Sciences at Colorado State University.

In 2010, Time 100, an annual list of the 100 most influential people in the world, named her in the "Heroes" category. She was the subject of the Emmy- and Golden Globe-winning biographical film Temple Grandin made in a 2010 by Mick Jackson and starring Claire Danes as Temple Grandin.

Grandin has been an outspoken proponent of autism rights and neurodiversity movements.

Victor of Aveyron (1788–1828) was a French feral child who was found at the age of around 9. Not only is he considered the most famous feral child, but his case is also the most documented one.

Victor's portrait from the front cover of the book about him

Characteristics and Symptoms of Autism

In 1938, Hans Asperger, a pediatrician at the University of Vienna, described numerous children he observed as “autistic.”

Understanding the Characteristics of Autism