What is Autism?

Autism is an unusual pattern of development that begins in infancy. It is defined by deficits in language development and social interaction and is exhibited by stereotypic behaviors.  

All autism spectrum disorders fall under the classic umbrella of "Pervasive Developmental Disorders." There are five subcategories of these disorders.  Each has their own set of criteria, yet they all share similar symptoms and fall under the umbrella of "PDD."  The terms Autism Specturm Disorders (ASDs) and Pervasive Developmental Disorders (PDD) are used interchangeably.  

To be diagnosed with an ASD, a child must be exhibiting the following symptoms:

• Impaired social interactions
• Impaired communication
• Repetitive and restrictive patterns of behavior and interests

Indicators of these symptoms include:

• Obessive about certain topics or objects
• Fixating on specfic routines and rituals
• Repetiitive actions or movements (stereotypies)
• Heightened sensitivities to certain sights, smells, sounds and textures 

Autism Disorder

To be diagnosed with Autistic Disorder an unusual pattern of development will emerge during infancy or as a toddler.  Parents will typically report concerns with their child during their first year.  Early symptoms of Autistic Disorder are: 

• Lack of eye contact
• Lack of pointing at objects
• Lack of responding

Indicators of Autistic Disorder include: 

• LIttle to no interest in making friends or establishing relationships with other children or adults
• More interest in objects than people
• Not engaging in typical pretend play
• Trouble communicating due to repetitive or idiosyncratic speech
• Ritualistic, stereotypic behaviors such as hand flapping or rocking

Asperger's Disorder

Children diagnosed with Asperger's Disorder represent similiar symptoms, yet the disorder is often referred to as high functioning Autism.  A determination of Asperger's depends on the realm of communication observed.  A child with Asperger's will have stronger verbal skills than a child with Autism.  These children will also have higher IQ's than a child with Autism. Other symptoms will include awkward motor skills, repetitive behavior and difficulty relating to others.  Asperger's is often referred to as a social disability.  

Rett's Disorder

Another disorder that falls under the umbrella of PDD is Rett's Disorder.  Rett's Disorder was named after Dr. Andrea Rett.  It is a rare genetic disorder that is most often seen exclusively in girls.  A child will develop normally from around six to eighteen months and then will begin to regress or become stagnate in their development.  The symptoms for Rett's include.

• Lack of communication skills
• Regression of hand movements and skills
• Stereotypic behaviors (e.g. repetitive hand movements)
• A lack of coordination making it difficult to walk
• Growth of head and body slow down
• Difficulty sleeping
• Seizures
• Difficulty breathing
• Can develop into severe mental retardation

Childhood Disintegrative Disorder (CDD)

Childhood Disintegrative Disorder was discovered by Theodore Heller.  The disorder is very rare and is 100 times less likely than Autism Disorder.  Males are four times more likely than females to be at risk.  The child will go through typical development until the gradual or sudden onset of the following symptoms: 

• The loss of speech and the inability to carry on a conversation
• The loss of social interactions
• The loss of everyday functioning (e.g. dressing and feeding themselves)
• Repetitive behaviors (e.g. hand flapping)
• Seizures
• Profound mental retardation

Pervasive Developmental Disorder - Not Otherwise Specified (PDD_NOS)

PDD-NOS is sometimes referred to as Atypical ADD or Atypical Autism.  This disorder is confusing and difficult to diagnose.  However, children with PDD-NOS are more likely to be diagnosed with full autism disorder in their early years than later diagnosed with PDD-NOS as they get older.  PDD-NOS will show some of the criteria for Autism, Asperger's, CDD or Rett's Disorder, but not all. 

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Autism spectrum disorders are being diagnosed at an alarming rate.  However, researchers do attribute part of the increase in diagnosis to a greater awareness from professional and parents, as well as the increased efficacy of standard screening tests. The availability of federal funding for both education and the treatment of children with a disability has also attributed to the rising trend in the diagnosis of autism.

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Diagnosing Autism

There have been considerable advances in the diagnosis and treatment of autism.  For a child to be evaluated for an ASD, they must first meet the criteria from the Diagnostic Statistical Manual (DSM-IV-TR). An assessment of all developmental areas will be evaluated independently.  An assessment is essential to determine the child's strength's and weaknesses.  Throughout the evaluation, the child's intellectual, communcation, behavioral and functional adjustment will be assessed as well. 

Part of the assessment will include oberservations in both a structured and nonstructured environment.  Historial information will also be taken from the parents or caregivers that include family history, neonatal and postnatal information (if available), social interactions, communication skills and motor skills.  Additional information needed will include whether the child has experienced seizures, has deficits in hearing and vision or the other senses, whether the child has been prescribed behavior modifying medications or if there are psychological factors and a family history of psychiatric illness.

There are several methods used to evaluate and diagnose autism spectrum disorders.  To be diagnosed with an ASD, criteria from the DSM-IV-TR must first be met.  Instruments used during these diagnostic evaluations include:

1. Autism Behavior Checklist (ABC) - the checklist is completed by the parents and teachers. 

2. Childhood Autism Rating Scale (CARS) - assesses the child's primary sensory motor behaviors.

3. Autistic Diagnostic Observation Schedule (ADOS) - measures the child's social communication     development.

4. Checklist for Autism in Toddlers (CHAT) - identifies autism behaviors in children 18 months of age.

5. Child Behavior Checklist (CBCL) - is used to identify the most frequent behavioral problems in     children. 

While these are not the only tools used to diagnose and assess children with Autism they are the most commonly used at the present time.  

Autism is often referred to by professionals and parents as an "invisible disability" because it can sometimes go unnoticed to the human eye.  However, it can be a debilitating disorder if not diagnosed and treated early.  Early intervention has been proven to lessen the effects of autism.  Researchers also believe that delaying treatment may compromise a child's outcome.