Autism Spectrum Disorder (ASD) and autism are both general terms for a group of complex disorders of brain development.Autism is a developmental disability and autistic people may communicate, interact, behave, and learn in ways that are different from most other people.The learning, thinking, and problem-solving abilities of autistic people can range from gifted to severely impaired.Some autistic people need high support (a lot of help and intensive intervention) while others need low support (less help and less intensive intervention).
Autism is thought to have a genetic component which results in atypical neurological development and functioning. A lot of research is being done to try and find the cause of autism, but as yet there are no definite answers. There is agreement however that autism is no-one’s fault. It is not a parent’s fault that their child has been born with autism. It is NOT a psychological or emotional disorder. It is NOT the result of bad parenting and autistic children do NOT choose to misbehave. Misbehaviour are often reactions to the environment and are expressions of the difficulties autistic people experience.
Recent diagnostic changes With the May 2013 publication of the DSM-5 diagnostic manual, all autism disorders were merged into one umbrella diagnosis of Autism. A diagnosis of autism now includes several conditions that used to be diagnosed separately:- Autistic disorder.- Pervasive development disorder (PDD-NOS).- Asperger Syndrome.
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Autism is a lifelong, complex condition that occurs as a result of disordered brain growth, structure and development. Autism is believed to stem from a genetic predisposition triggered by environmental factors and affects 4-5 times more boys than girls. There are a vast number of ways that a person can manifest their autism and as a result this condition is now more often referred to as “Autism Spectrum Disorders” (ASD).Autism Spectrum Disorder is a lifelong, extremely complex condition that appears to result from a genetic predisposition that is triggered by environmental factors. Autism Spectrum Disorder is a new DSM-5 name that reflects a scientific consensus that four previously separate disorders are actually a single condition with different levels of symptom severity in two core domains. Austism now encompasses the previous DSM-IV autistic disorder (autism), Asperger’s disorder, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified.Autism is characterized by 1 deficits in social communication and social interaction and 2 restricted repetitive behaviours, interests, and activities (RRBs).Because both components are required for diagnosis of austism, social communication disorder is diagnosed if no RRBs are present.
Regardless of the manifestation of Autism Spectrum Disorder, ALL people on this spectrum, are affected in different degrees, by the “Quadrant of Impairments” that causes a disturbance in quality of development in the following areas:-Language and Communication. 40% of people with “Kanner/Classic autism” never speak nor understand verbal communication. Even those across the full spectrum who do have speech, often still have severe problems understanding the normal process of reciprocal communication;
Autistic people, due to the altered chemistry and functioning within the brain, literally cannot fully understand other people s emotions, reactions and the complexity of social relationships (Mindblind). This can result in autistic people reacting inappropriately by our “normal” standards, thus being shunned by society, which sadly can then result in these people becoming confused and isolated from those around them;Imagination and Creative Play. Autistic people usually becomes trapped by rigid thought patterns and behaviours, a limited range of imaginative activities, as well as a poor understanding of day-to-day concepts, jargon and the abstract.
Autistic people will have either heightened or lowered sensory perception; this may affect one or more senses.
Parents should ask their child’s family doctor for referral to a developmental paediatrician for assessment if there are concerns with any of the following:
No babbling by 11 months of ageNo simple gestures by 12 months (e.g., waving bye-bye) No single words by 16 monthsNo 2-word phrases by 24 months (noun + verb – e.g., “baby sleeping”)No response when name is called, causing concern about hearingLoss of any language or social skills at any age
- Odd or repetitive ways of moving fingers or hands- Oversensitive to certain textures, sounds or lights- Lack of interest in toys, or plays with them in an unusual way (e.g., lining up, spinning, opening/closing parts rather than using the toy as a whole)- Compulsions or rituals (has to perform activities in a special way or certain sequence; is prone to tantrums if rituals are interrupted)- Preoccupations with unusual interests, such as light switches, doors, fans, wheels- Unusual fears
- Rarely makes eye contact when interacting with people.- Does not play peek-a-boo.- Doesn’t point to show things he/she is interested in.- Rarely smiles socially.- Intellectual Disability (Intellectual Developmental Disorder) Diagnostic criteria for intellectual disability (intellectual developmental disorder) emphasize the need for an assessment of both cognitive capacity (IQ) and adaptive functioning. Severity is determined by adaptive functioning rather than IQ score. The term mental retardation was used in DSM-IV. However, intellectual disability is the term that has come into common use over the past two decades among medical, educational, and other professionals, and by the lay public and advocacy groups.
Diagnostic criteria for intellectual disability (intellectual developmental disorder) emphasize the need for an assessment of both cognitive capacity (IQ) and adaptive functioning. Severity is determined by adaptive functioning rather than IQ score. The term mental retardation was used in DSM-IV. However, intellectual disability is the term that has come into common use over the past two decades among medical, educational, and other professionals, and by the lay public and advocacy group.
The DSM-5 communication disorders include language disorder (which combines DSM-IV expressive and mixed receptive-expressive language disorders), speech sound disorder (a new name for phonological disorder), and childhood-onset fluency disorder (a new name for stuttering). Also included is social (pragmatic) communication disorder, a new condition for persistent difficulties in the social uses of verbal and nonverbal communication. Because social communication deficits are one component of Autism, it is important to note that social (pragmatic) communication disorder cannot be diagnosed in the presence of restricted repetitive behaviours, interests, and activities (the other component of Autism). The symptoms of some patients diagnosed with DSM-IV pervasive developmental disorder not otherwise specified may meet the DSM-5 criteria for social communication disorder.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.Autism Society of Maine. (No date). Autism. [Brochure]. Gardiner, ME: Author. Klinger, L. & Dawson, G. (1996). Autistic disorder. In Marsh, E. & Barkley, R. (eds.), Child Psychopathy (pp 311 – 339). New York: Gilford Press.