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What is Autism Spectrum Disorder?
Commonly referred to as (ASD)
Autism is a developmental disability which affects communication, social interaction and behaviour.
Asperger Syndrome or Pervasive Developmental Disorder - Not Otherwise Specified (PDD - NOS)
are related developmental difficulties.
These conditions are known as Autism Spectrum Disorders. People with these disorders are affected differently,
and many may require specialised assistance and support.
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from the AUSTRALIAN AUTISM HANDBOOK
SMITH / BENISON O'REILLY, SEAN |
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Definitions
DIAGNOSIS & DEFINITIONS
Extract below from Autism Victoria website
Diagnosis
There is no specific diagnostic test for Autism Spectrum Disorder. The best way to get a diagnosis is via a multi disciplinary assessment. For children, this involves having your child tested by a number of professionals, who will provide you with the information you need to make decisions about program and treatment approaches. For adults, either a psychologist or psychiatrist experienced with Autism Spectrum Disorders can make a diagnosis.
The age of diagnosis these days ranges from approximately 18 months through to adulthood, depending on circumstances. A diagnosis of Autism Spectrum Disorder will only be made if the 'autistic like' pattern of behaviour is apparent before the age of three years. Sometimes a provisional diagnosis is made if the child is very young, and a reassessment at a later date is recommended.
Definitions
The way people think about autism has changed in recent years. It is best described as a group of disorders with a similar pattern of behaviour in three key areas - communication, social interaction and imaginative thought.
The currently favoured term is Autism Spectrum Disorder, with the word 'spectrum' used because no two people with an Autism Spectrum Disorder are exactly alike.
What is an Autism Spectrum Disorder?
As the term suggests, there is no one diagnosis or label. Rather there are several labels that place people at different points on the spectrum. At one end of the spectrum diagnostic labels such as "Asperger Syndrome", "High Functioning Autism" and "PDD-NOS" are used. At the other end of the spectrum you will find labels such as "Autism", "Classic Autism" and "Kanner Autism".
What are the common everyday diagnostic terms or labels?
• Autism (or Autistic Disorder)
• Asperger Syndrome (or Asperger Disorder)
• Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS)
• Atypical Autism
• High Functioning Autism
What are the international classification guides?
There are two international classification guides used
to determine the diagnostic criteria for Autism Spectrum Disorders.
DSM IV - Diagnostic and Statistical Manual of Mental Disorders Fourth Edition,
1994, published by the American Psychiatric Association
and/or the
ICD 10 - International Statistical Classification of Diseases and Related Health Problems Tenth Edition,
1992, published by the World Health Organisation.
Terms Explained
The term Autism Spectrum Disorder is used because there is great variation from person to person depending on the severity and combination of each area of impairment. Autism Spectrum Disorder may also coexist with other conditions or disorders, including intellectual disability, speech and language disorders, anxiety and depression (especially in adolescents and adults), epilepsy, attention disorders, Tourette Syndrome and Down Syndrome. (See also "Why is Autism Spectrum Disorder so hard to understand?")
Autism
In Autism the impairments in the social and communication areas are severe and sustained and clearly present before the age of three years. The child is often anxious, has poor attention and motivation, responds unusually to many different stimuli and is observed as being 'different' from other children. Speech is delayed, or largely absent. A strong reliance on routine is apparent, and the child can have a range of ritualistic behaviours such as toe walking, hand flapping and finger gazing. The child/adult with autism may also be intellectually disabled. Sometimes, clinicians will refer to Classic Autism or Kanner Autism. This is because they believe the child or adult fits the early descriptions of Autism published by Dr Leo Kanner in the 1940's.
High Functioning Autism
High Functioning Autism is a loosely used term (not defined in the diagnostic criteria) to describe a child or adult who meets the criteria for a diagnosis of Autism, but is not as severely affected as the more classically autistic person.
Asperger Syndrome
In Asperger Syndrome there are severe and sustained social impairments, but impairments are not as severe in the language and communication area. Speech usually develops within the normal age range, but the ability to communicate effectively (known as language pragmatics) is impaired. The impairments seem more subtle in the very young child, and become more apparent as the child reaches pre school and school age. The Asperger person is usually in the normal intelligence range.
PDD-NOS
Pervasive Developmental Disorder - Not Otherwise Specified (PDD-NOS) is the diagnosis given for children who present with some of the characteristics of either Autism or Asperger Syndrome, but not severe enough for a diagnosis of either of these conditions. In the ICD 10 and previous editions of the DSM this diagnosis was referred to as Atypical Autism.
Most important of all
Irrespective of the diagnosis or where they fit on the spectrum, each child or adult diagnosed with an Autism Spectrum Disorder is developmentally delayed, has significant difficulties participating in day-to-day life and requires sensitive understanding and specialist support and intervention.”
Reference: Autism Victoria website: http://www.autismvictoria.org.au/diagnosis/
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Frequently Asked Questions (FAQ)
What is autism?
Autism is a life-long developmental disability that affects the individuals understanding of what he/she sees, hears and
senses. This results in problems of social relationships, communication and behaviour. It is generally accepted that
autism is an organic brain disorder.
What causes autism?
The cause or causes of autism are as yet unknown. No factors in the child’s psychological or family environment cause autism.
What are the characteristics of autism?
The degree of severity of characteristics differs from person to person, but usually include disturbances in the following:
1. Communication
• Delay or absence in language development
• Difficulties understanding speech
• Difficulties using language
• Difficulties understanding and using gesture
2. Social Interaction
Difficulties with the following :
• understanding social relationships
• relating to others, may appear to “tune out”
• maintaining eye contact
• forming friendships
• understanding other peoples thoughts and feelings
• co-operative play
3. Unusual Sensory Responses
• may appear to be deaf
• may appear to have selective hearing
• may use peripheral vision
• may show extreme fear reactions
• apparent insensitivity to pain
• may show lack of responsiveness to cold or heat
• may overreact to any of these
4. Intellectual Functioning
• uneven pattern of skills
• some things may be done quite well in relation to overall functioning eg. memorising dates, numbers, advertising jingles.
the majority of people with autism have varying degrees of intellectual disability.
What are the four main criteria used for diagnosis?
• Qualitative impairment in verbal and non verbal communication
• Qualitative impairment in reciprocal social interaction
• Markedly restricted number of activities and interests and impaired imaginative play
• Evident during first 30 months of life
Activities and Interests
Restricted range of activities and interests:
• unusual repetitive body movements eg. hand flicking, spinning or rocking, walking on tip-toe
• rigidity in routines
• obsessive and ritualistic behaviour eg. peeling paint/wallpaper; smelling food before eating
• resistance to and difficulty adapting to change
Play
• lack of imaginative play (eg. make believe games)
• play inappropriate to the function of the toy eg. spinning wheels, lining up textas
• may have difficulty learning through imitation
Is autism hereditary?
Research indicates that genetic factors play a part in causing autism in some individuals. Most researchers agree that
autism probably results from many separate causes. These may include dietary and environmental factors.
What is the prognosis?
Studies have indicated that many people with autism may require varying degrees of support throughout their lives. It
appears that an individuals intellectual ability may be an important factor in the long term prognosis.
What is the incidence of autism?
The quoted incidence of autism in research findings varies from 2 to 21 per 10,000 births. In California in 2001 the
incidence of autism spectrum disorders is 1 per 65 children. (1 in 167)
Who is affected with autism?
Autism is distributed throughout the world among all races, nationalities and social classes. There are 3-4 times as
many boys affected with autism than girls.
Is it known why there are more autistic males than females?
The reason why there are more autistic males than females is not known. However, this high ratio of boys to girls is
found in a number of allied disorders involving language and learning problems.
Does autism occur in conjunction with other disabilities?
Autism can occur by itself or in association with other disorders such as intellectual disability, learning disability,
epilepsy, rubella, Fragile-x syndrome, Down syndrome, deafness, visual impairment, Rhett’s syndrome, William’s
syndrome, Floating Harbor syndrome, Angelman’s syndrome, Tourette’s Syndrome, autoimmune diseases etc.
A significant number of individuals with autism will develop epilepsy prior to adulthood.
What is the difference between autism and intellectual disability?
Intellectually disabled people tend to have delayed language whilst the language of people with autism tends to be
both delayed and disordered. Many have immediate or delayed echolalia (repetition of words or phrases). There is
confusion over the use of pronouns and a tendency to interpret language literally.
What kind of approach is the most appropriate for teaching language?
The most appropriate approach for teaching language is that which best suits the individual. This can include signing,
symbols, printed word, photos, verbal communication, or any combination of these.
How can people with autism be helped?
Behavioural methods are helpful in enhancing development in social, language, self-help, Co-operation and other
basic skills. Special educational approaches with consistent, predictable and organised routines can help most children
make gains in learning.
Can medication be useful with autistic individuals?
Medication has no specific role in autism and cannot be used in a curative sense, although anticonvulsants are required if epilepsy develops. In some cases where aggressive behaviour or depression develops, medication may be prescribed by a suitably qualified medical practitioner.
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What is Asperger Syndrome?
Asperger Syndrome
Asperger Syndrome is a is a neurobiological disorder first described by Hans Asperger in 1943. Individuals with AS
perceive the world very differently. Behaviours that seem unusual are due to neurological differences. They are not
due to rudeness, bad behaviour or bad parenting. Individuals with AS can exhibit a variety of characteristics ranging
from mild to severe. Adults with Asperger’s Syndrome may not be diagnosed, but are often very successful. They may
have jobs and families, but often experience great difficulty in maintaining the relationships required by these experiences.
Language Development: People with AS generally do not show a significant delay in language development, often
having a very extensive vocabulary, however they may use language in unusual ways and have difficulties with
pragmatic language. They may have a very formal mode of expression, and a flat, expressionless voice.
Social Development: Many people with Asperger Synrome desire some interaction with others, but have difficulty
understanding social rules or nonverbal cues (body language). Difficulty in making eye contact is also common.
People with Asperger Syndrome often report that they can make eye contact or listen, but not both at the same time.
Motor Co-ordination: Many people with AS have poor motor skills and problems with balance. Some may have difficulty
writing or drawing. Many find sports, particularly team games, very challenging.
Special Interests: People with AS may have a limited range of interests, and may be preoccupied with a particular
subject. They often have a very good memory for facts.
Change: Individuals with AS may dislike changes in daily routine. They often engage in repetitive or ritualistic behaviours.
Sensory Sensitivities: Often people with AS are sensitive to sounds, tastes, smells, and sights.
Soft clothing and a restricted range of foods may be preferred. Sounds, light and colour may cause discomfort.
Personal Characteristics: Often people with AS have difficulty coping with demands of day-to-day life.
They may be very self-critical and easily stressed. High levels of stress can lead to severe depression and anxiety..
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