Autism Spectrum Disorders - Early Identification
The early identification of Autism and other Pervasive Developmental Disorders (Autism Spectrum Disorders) is the first step in designing effective interventions to support successful participation in home, school and community environments.
We can look for the following behaviors that signal a need to evaluate a child
for an autism spectrum disorder :
A doctor should evaluate a child for autism if he or she displays any two of the following after his/her first birthday:
Autism Spectrum Disorders:
- Does not gesture (point, wave, etc.).
- Does not respond to his/her name when called.
- Does not show an interest in other children.
- Does not bring objects to show to an adult.
- Does not look at a toy pointed out across the room
- Does not imitate facial expressions or actions
- Does not babble or coo by 12 months of age
- Does not say single words by 16 months of age
- Does not say two-word phrases on his/her own (rather than just repeating what someone says to him/her) by 24 months of age
- Has any loss of any language or social skill at any age
The Diagnostic and Statistical Manual of Mental Disorders IV (DSM IV) defines autism under the category of “pervasive developmental disorder” (PDD).
These disorders are commonly referred to as “Autism Spectrum Disorders”. Pervasive developmental disorders include:
- Autism / Autistic Disorder
- PDD-NOS (not otherwise specified)/Atypical Autism
- Childhood Disintegrative Disorder (CDD)
- Rett Syndrome
- Asperger Syndrome
Autism is a disability category is defined as :
… a developmental disability significantly affecting verbal and nonverbal communication and social interaction, generally evident before age 3 that adversely affects a child’s educational performance. Other characteristics often associated with autism are engagement in repetitive activities and stereotyped movements, resistance to environmental change or change in daily routines, and unusual responses to sensory experiences. The term does not apply if a child‘s educational performance is adversely affected primarily because the child has an emotional disturbance.
The term ASD or autistic spectrum disorders is commonly used to describe the full range of the autism spectrum and reflects the general consensus that autism is a complex developmental disability whose symptoms and characteristics present in a wide variety of combinations, from mild to severe.
ASD are present from birth or the child‘s very early development, and affect essential human behaviors such as social interaction, the ability to communicate ideas and feelings, imagination, and the establishment of relationships with others . Current research and literature consistently refer to a basic triad of central deficits in ASD: social reciprocity and interaction; communication; and repetitive behavior . Additional characteristics may include sensory issues, anxiety, resistance to environmental change or change in routine, and stereotyped movements.
It is referred that the developmental diversity of autism, and other research studies and evidence similarly indicate that autism includes a variation of symptoms and uneven development both within and among individuals. However, most experts in the field appear to agree that the key defining symptom across the spectrum is a substantial impairment in social interaction.
Although autistic spectrum disorders are unique in their pattern of deficits and areas of relative strengths, the triad of central deficits mentioned above generally have lifelong effects on how individuals learn to be social beings, to take care of themselves and to participate in the community. There is no cure for autism, but many individuals on the spectrum become highly productive, loving and contributing adults.
ASD may occur with other symptoms or disabilities, such as mental retardation and language disorders, as well as with genetic disorders such as Fragile X Syndrome, William‘s Syndrome, Landau-Kleffner Syndrome, and Tourette Syndrome.
Although individuals with ASD experience many challenges throughout their lives, it is important to recognize that not all of the traits associated with this disorder are negative. Many individuals on the spectrum become highly productive contributing adults. Individuals on the spectrum should be accepted for their unique needs and strengths. Some exhibit splinter skills while others may display extraordinary skills in very specific areas such as rote memorization, the arts, and so on. Individual strengths often serve students with ASD well in overcoming or compensating for difficulties.
The following is an overview of the major abilities and strengths common among individuals with ASD:
- Understand concrete concepts very well.
- Memorize rote material easily and quickly
- Recall visual images and memories easily
- Think in a visual way
- Learn chunks of information quickly
- Learn to decode written language at an early age (hyperlexia)
- Have extraordinarily good long-term memory
- Understand and use concrete rules and sequences
- Be perfectionistic in approach to tasks
- Be very precise and detail oriented
- Be depended upon to maintain schedules and to be on time
- Have average or even way above average intelligence
- Be honest, even to a fault
- Be extremely focused, if it is a pleasurable task, (and which may be the tasks others do not want to do)
- Be charming in their innocence
- Have difficulty being devious
- Have a strong sense of integrity
- Have an excellent sense of direction
- Be very compliant when expectations are clearly understood
- Be very genuine; may not understand the motive behind trying to impress others, and
therefore don‘t bother
The origin of autism is generally agreed upon in the current research and literature. That is, autism is a developmental disorder of neurobiological origin that is defined on the basis of behavioral and developmental features. Recent biological research, such as genetics, points to important implications for families of children with autistic spectrum disorders. However, there is no clear evidence that autism is due to a single cause, and it is not a disorder caused by poor parenting.
The hazard can be of many kinds, including faulty genes, chromosome abnormality, metabolic disorder, viral agents, immune intolerance and anoxia from perinatal problems. We can assume that any of these hazards has the potential to create havoc in neural development. Owing to the upheaval, lasting harm may be done to the development of specific brain systems concerned with higher mental processes. The harm may be mild or severe, but always involves the developmental arrest of a critical system at a critical point in time. It is our hypothesis that only then will autism occur.
Finally, and most important, is the clear evidence in the research and the literature that autism is not an emotional disturbance.
Autistic Spectrum Disorders
Childhood Disintegrative Disorder
Characterized by normal development for at least the first two years, significant loss of previously acquired skills.
A progressive disorder which, to date, has been found only in girls. Period of normal development and then loss of previously acquired skills, loss of purposeful use of hands replaced with repetitive hand movements beginning at the age of 1-4 years.
Impairments in social interaction, communication, and imaginative play prior to age 3 years. Stereotyped behaviors, interests and activities.
Pervasive Developmental Disorder – Not Otherwise Specified
Commonly referred to as atypical autism, a diagnosis of PDD-NOS may be made when a child does not meet the criteria for a specific diagnosis, but demonstrates a severe and pervasive impairment in specified behaviors.
Characterized by impairments in social interactions and the presence of restricted interests and activities, with no clinically significant general delay in language, and testing in the range of average to above average intelligence (American Psychiatric Association, 1994).