Autism is a spectrum disorder, and although it is defined by a certain set of behaviors, children and adults with autism can exhibit any combination of these behaviors in any degree of severity. Two children, both with the same diagnosis, can act completely different from one another and have varying capabilities.
“Autism is a complex, developmental disability that typically appears during the first three years of life and is the result of a neurological disorder that affects the normal functioning of the brain; impacting development in the areas of social interaction and communication skills.”
Both Children and adults with autism, typically show difficulties in verbal and non-verbal communications, social interactions and leisure or play activities. One should keep in mind however, that autism is a spectrum disorder and it affects each individual differently and with varying degrees – because of this, early diagnosis is crucial for the correct form of development.
“By learning the sings, a child can begin benefiting from one of the many specialised intervention programs.”
Autism is one of five disorder that falls under the umbrella of Pervasive Developmental Disorders (PDD), a category of neurological disorders characterised by “severe and pervasive impairment in several areas of development.”
The five disorders under PDD are:
- Autistic Disorder
- Asperger’s Disorder
- Childhood Disintegrative Disorder (CDD)
- Rett’s Disorder
- PDD-Not Otherwise Specified (PDD-NOS)
You may hear different terms used to describe children within this spectrum, such as autistic-like, autistic tendencies, autism spectrum, high-functioning or low-functioning autism, more-abled or less-abled; but more important than the term used to describe autism is understanding that whatever the diagnosis, children with autism can learn and function normally and show improvement with appropriate treatment and education.
Every person with autism is an individual. Like all individuals, they have a unique personality and combination of characteristics. Some of the individuals that are only mildly affected, may exhibit only slight delays in language but still be challenged by social interactions; this is often described as talking ‘at’ others rather than to them – a one-way conversation on a favourite subject that continues despite attempts by others to interject. They could also struggle with initiating and/or maintaining conversations.
People with autism also process and respond to information in unique ways. In some cases they may respond aggressively and/or self-injurously.
For most people, the integration of the senses help them to understand what it is that we are experiencing. Our sense of touch, smell and taste work together holistically to reach a detailed understanding. For children with autism, sensory integration problems are common, which can throw their senses off; be that over or under active. The soft fuzz, of a peach’s skin could be painful and the smell may make a child gag. Some children with autism are particularly sensitive to sound, finding even the most ordinary daily noises, painful. Many professionals believe that these autistic behaviours like the ones previously mentioned, are due to difficulties surrounding sensory integration.
There are also many myths and misconceptions about autism. Contrary to popular belief, many autistic children do make eye contact; it may just be less often or different from a non-autistic child. Many children with autism can develop good functional language and others can develop their own means in doing so, such as sign language or use of pictures. Children do not ‘outgrow’ autism, but symptoms may lessen as the child develops and received relevant treatment
Persons with autism may also exhibit some of the following traits:
- Insistence on sameness; resistance to change
- Difficulty in expressing needs, using gestures or pointing instead of words
- Repeating words or phrases in place of normal, responsive language
- Laughing (and/or crying) for no apparent reason showing distress for reasons not apparent to others
- Preference to being alone; aloof manner
- Difficulty in mixing with others
- Not wanting to cuddle or be cuddled
- Little or no eye contact
- Unresponsive to normal teaching methods
- Sustained odd play
- Spinning objects
- Obsessive attachment to objects
- Apparent over-sensitivity or under-sensitivity to pain
- No real fears of danger
- Noticeable physical over-activity or extreme under-activity
- Uneven gross/fine motor skills
- Non responsive to verbal cues; acts as if deaf, although hearing tests in normal range.
For most of us, the integration of our senses helps us to understand what we are experiencing. For example, our sense of touch, smell and taste work together in the experience of eating a ripe peach: the feel of the peach’s skin, its sweet smell, and the juices running down your face. For children with autism, sensory integration problems are common, which may throw their senses off they may be over or under active. The fuzz on the peach may actually be experienced as painful and the smell may make the child gag. Some children with autism are particularly sensitive to sound, finding even the most ordinary daily noises painful. Many professionals feel that some of the typical autism behaviors, like the ones listed above, are actually a result of sensory integration difficulties.
There are also many myths and misconceptions about autism. Contrary to popular belief, many autistic children do make eye contact; it just may be less often or different from a non-autistic child. Many children with autism can develop good functional language and others can develop some type of communication skills, such as sign language or use of pictures. Children do not “outgrow” autism but symptoms may lessen as the child develops and receives treatment.
One of the most devastating myths about autistic children is that they cannot show affection. While sensory stimulation is processed differently in some children, they can and do give affection. However, it may require patience on the parents’ part to accept and give love in the child’s terms
What is asperger?
Asperger’s Disorder was first described in the 1940s by Viennese pediatrician Hans Asperger who observed autistic-like behaviors and difficulties with social and communication skills in boys who had normal intelligence and language development. Many professionals felt Asperger’s Disorder was simply a milder form of autism and used the term “high-functioning autism” to describe these individuals. Professor Uta Frith, with the Institute of Cognitive Neuroscience of University College London and author of Autism and Asperger Syndrome, describes individuals with Asperger’s Disorder as “having a dash of Autism.” Asperger’s Disorder was added to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) in 1994 as a separate disorder from autism. However, there are still many professionals who consider Asperger’s Disorder a less severe form of autism.
What distinguishes Asperger’s Disorder from autism is the severity of the symptoms and the absence of language delays. Children with Asperger’s Disorder may be only mildly affected and frequently have good language and cognitive skills. To the untrained observer, a child with Asperger’s Disorder may just seem like a normal child behaving differently.
Children with autism are frequently seen as aloof and uninterested in others. This is not the case with Asperger’s Disorder. Individuals with Asperger’s Disorder usually want to fit in and have interaction with others; they simply don’t know how to do it. They may be socially awkward, not understanding of conventional social rules, or may show a lack of empathy. They may have limited eye contact, seem to be unengaged in a conversation, and not understand the use of gestures.
Interests in a particular subject may border on the obsessive. Children with Asperger’s Disorder frequently like to collect categories of things, such as rocks or bottle caps. They may be proficient in knowing categories of information, such as baseball statistics or Latin names of flowers. While they may have good rote memory skills, they have difficulty with abstract concepts.
One of the major differences between Asperger’s Disorder and autism is that, by definition, there is no speech delay in Asperger’s. In fact, children with Asperger’s Disorder frequently have good language skills; they simply use language in different ways. Speech patterns may be unusual, lack inflection or have a rhythmic nature or it may be formal, but too loud or high pitched. Children with Asperger’s Disorder may not understand the subtleties of language, such as irony and humor, or they may not understand the give and take nature of a conversation.
Another distinction between Asperger’s Disorder and autism concerns cognitive ability. While some individuals with Autism experience mental retardation, by definition a person with Asperger’s Disorder cannot possess a “clinically significant” cognitive delay and most possess an average to above average intelligence.
While motor difficulties are not a specific criteria for Asperger’s, children with Asperger’s Disorder frequently have motor skill delays and may appear clumsy or awkward.
Diagnosis of Asperger’s Disorder is on the increase although it is unclear whether it is more prevalent or whether more professionals are detecting it. The symptoms for Asperger’s Disorder are the same as those listed for autism in the DSM-IV. However, children with AS do not have delays in the area of communication and language. In fact, to be diagnosed with Asperger, a child must have had normal language development as well as normal intelligence. The DSM-IV criteria for AS specifies that the individual must have “severe and sustained impairment in social interaction, and the development of restricted, repetitive patterns of behavior, interests and activities,” that must “cause clinically significant impairment in social occupational or other important areas of functioning.”
The first step to diagnosis is an assessment, including a developmental history and observation. This should be done by medical professionals experienced with Autism and other PDDs. If Asperger’s Disorder or high functioning autism is suspected, the diagnosis of autism will generally be ruled out first. Early diagnosis is also important; children with Asperger’s Disorder who are diagnosed and treated early in life have an increased chance of being successful in school and eventually living independently
Adults with Asperger Disorder
The transition for individuals with Asperger’s Disorder from federally-mandated services through the school system to adult services can be a challenge. While entitlement to public education ends at age 18, the IDEA requires that transition planning begins at age 14 and becomes a formal part of the student’s Individualized Education Plan (IEP). This transition planning should include the student with AS, parents and members of the IEP team who work together to help the individual make decisions about his/her next steps. An Individualized Transition Plan (ITP) is developed that outlines transition services that may include education or vocational training, employment, living arrangements and community participation, to name a few.
The first step in transition planning should be to take a look at the individual’s interests, abilities, and needs. For example, what type of educational needs must be met? College, vocational training, adult education? Where can the young adult find employment and training services? What types of living arrangements are best?
Whether an adult with Asperger’s Disorder continues to live at home or moves out into the community, will be determined in large part by his/her ability to manage every day tasks with little or no supervision. For example, can he handle housework, cooking, shopping, and bill paying? Is she able to use public transportation? Many families prefer to start with some supportive living arrangement and move towards increased independence.
Supervised group homes usually serve several individuals with disabilities. They are typically located in residential neighborhoods in an average family home. The homes are staffed by trained professionals who assist residents based on the person’s level of need. Usually the residents have a job, which takes them away from home during the day.
A supervised apartment may be suitable for individuals who prefer to live with fewer people, but still require some supervision and assistance. There is usually no daily supervision, but someone comes by several times a week. The residents are responsible for going to work, preparing meals, personal care and housekeeping needs. A supervised apartment setting is a good transition to independent living.
Independent living means just that individuals live in their own apartments or houses and require little, if any, support services from outside agencies. Services may be limited to helping with complex problem-solving issues rather than day-to-day living skills. For instance, some individuals may need assistance with managing money or handling government bureaucracies. It is also important for those living independently to have a “buddy” who lives nearby that can be contacted for support. Support systems within the community might include bus drivers, waitresses, or coworkers.
Many people think of adulthood in terms of getting a job and living in a particular area, but having friends and a sense of belonging in a community are also important. Individuals with Asperger’s Disorder may need assistance in encouraging friendships and structuring time for special interests. Many of the support systems developed in the early years may continue to be useful.