Autism is one of five disorders under the general classification of Pervasive Developmental Disorders (PDD), a category of neurological disorders characterized by severe and pervasive impairment in several areas of development. Autism is a spectrum disorder, meaning it affects everyone differently; some are mildly affected, but most are significantly impaired and require lifelong supervision and care. Many children with autism will never be able to tell their parents they love them.
Autism is the most common of the Pervasive Developmental Disorders, affecting an estimated 1 in 166 births according to the Centers for Disease Control Prevention. This means that as many as 1.5 million Americans have some form of autism, making it the second most common developmental disability after mental retardation. According to statistics from the U.S. Department of Education and other governmental agencies, autism is growing at a startling rate of 10 to 17 percent per year. Yet despite the strikingly high and increasing prevalence, autism research remains one of the lowest funded areas of medical research by both public and private sources.
There is no known single cause for autism, but brain scans show differences in the shape and structure of the brain in autistic children. Researchers are investigating a number of theoretical causes, including a possible link between heredity, genetics and other medical problems. While no single gene has been identified as causing autism, there appears to be a pattern of autism or related disabilities in many families, further supporting a genetic basis to the disorder.
Autism can usually be detected by the time a child is 3 years old, and in some cases as early as 18 months; however, it is estimated that only 50 percent of children are diagnosed before kindergarten. In some children, hints of future problems may be apparent from birth; but in most cases the problems in communication and social skills become more noticeable as the child lags further behind other children the same age. Some parents report the change as being sudden; in other cases, there is a gradual leveling of development. All children with Autism Spectrum Disorders (ASD) demonstrate deficits in social interaction, verbal and nonverbal communication, and repetitive behaviors or interests. In addition, they often have unusual responses to sensory experiences, such as certain sounds or the way objects look. A child may be autistic if he or she:
Does not babble, point, or make meaningful gestures by one year of age
- Does not respond to his or her name
- Loses language or social skills
- Makes poor eye contact
- Doesn’t seem to know how to play with toys, excessively organizes toys, or is overly attached to one particular toy or object
- Doesn’t smile
- Insists on sameness and is resistant to change
- Repeats words or phrases in place of normal, responsive language
- Laughs (and/or cries) for no apparent reason, and shows distress for reasons not apparent to others
- Has difficulty socializing with others, prefers to be alone; is aloof
- Throws excessive tantrums
- Does not want to cuddle or be cuddled
- Is over-sensitive or under-sensitive to pain
- Does not display any real fear of danger
- Displays physical over-activity or extreme under-activity
- Develops uneven gross/fine motor skills
- Is unresponsive to verbal cues; acts as if deaf, although hearing tests in normal range.
Autistic children need, and demand, absolute consistency in their environment. A slight change in any routine – mealtimes, dressing, bathing, or the route taken to school – can be extremely disturbing. Many are highly attuned or even painfully sensitive to certain sounds, textures, tastes, and smells. The brain also seems unable to balance the senses appropriately; some autistic children are oblivious to extreme cold or pain, and may fall and break an arm, yet never cry. Another may bash his head against a wall and not wince, but a light touch may make him scream with alarm.
Diagnosis and Treatment When evaluating a child, clinicians rely on observed behavior to make a diagnosis, and the parents’ own experience and concerns are essential in helping to screen the child. If any of the possible indicators of ASD are found, further comprehensive evaluation by a team of specialists is necessary in order to accurately diagnose or rule out an ASD or other developmental problem. Every state guarantees special education and related services for children with ASD. The Individuals with Disabilities Education Act (IDEA) is a federally mandated program that assures free and appropriate public education for children with diagnosed learning deficits.
An effective treatment program should build on the child’s interests, provide a predictable schedule, teach tasks as a series of simple steps, actively engage the child’s attention in highly structured activities, and provide regular reinforcement of behavior. Parental involvement is a major factor in treatment success and more programs are beginning to train parents to continue the therapy at home. The degree of independence and integration into mainstream society an autistic individual is capable of ultimately depends on the degree of their autism and the level of therapy they receive.