"Education is the most powerful weapon which you can use to change the world." -Nelson Mandela
What is autism?
Autism is a developmental disorder that affects communication, social interactions with other, and behavior. There is a wide range of symptoms from mild and subtle to profound and obvious to the casual observer. It's a "spectrum." Symptoms are generally present from early childhood, cannot be explained by other disability or traumatic event, and are pervasive meaning are present across settings, situations, and people.
If you know what autism is and don't want to be bored with the specifics, skip here.
You can find the medical diagnosis here. Here is a synopsis:
Deficits in social communication and social interactions
Social-emotional reciprocity: back-and-forth conversation, shared interests, understanding emotions of others, low social initiation and response.
Non-verbal behavior: lack of eye contact, lack of understanding of gestures, body language, and facial expressions.
Relationships: adjusting behavior to different situations, imaginative play, lack of age-appropriate making of friends, not interested in peers.
Repetitive, restrictive patterns of behavior and interests
Stereotypical or repetitive motor movements or vocalizations: flapping, toe-walking, spinning, vocal sounds like humming, grinding teeth, spinning or lining up objects, repeating words and phrases.
Insistence on sameness: inflexible, strong adherence to routines, difficulty with transitions.
Restricted and fixated interests: preoccupation with unusual objects or subjects, wanting to talk about or only do one thing.
Hyper- or hypo-sensitivity to sensory input: indifference to pain, adverse to sunlight, seeking out spinning activities, excessive smelling or touching, visual preoccupations, limited food choices, seeks heavy blankets or weights to calm.
Symptoms must be present in early development
Symptoms have to impact the person in their daily life functioning.
Symptoms not better explained by other disability (with the exception of intellectual disability; person can have both) or traumatic event.
Also, both Social Communication and Restrictive Behaviors need to be given a "Level." These levels are independent of each other. In other words, a person can be a Level 1 Social Communication and a Level 3 Restrictive Behavior. Here is a synopsis of the levels:
Basically, a person with autism is affected by their challenges with social communication and connections and with challenging behaviors in some form (be it restricted interests, inflexibility, repetitive behaviors, etc.). Here are some examples:
James is an 8-year-old boy presenting with profound deficits in language, social, and behavior skills. He is non-verbal but does use an iPad to communicate simple mands (requests) and respond to basic questions. He does not initiate a social interaction unless he needs something, but he will respond to someone when prompted to do so. James, when left to his own devices, will rip small pieces of paper or play with a loose string for long periods of time. James requires a very structured schedule, otherwise he engages in self-injurious behavior and loud protests.
Diagnosis: 299.0/F84.0 Autism Spectrum Disorder Not associated with known medical disorder or genetic condition Requiring very substantial support (Level 3) for deficits in social communication and requiring very substantial support (Level 3) for restricted, repetitive behaviors With accompanying language impairment—nonverbal With accompanying intellectual impairment (low cognitive abilities and low achievement scores) Not associated with any other neurodevelopmental, mental, or behavioral disorders
Jamie is a 10-year-old girl presenting with delays in language, social, and behavior skills. She is verbal but uses primarily rote phrases and delayed echolalia. She can carry on a simple conversation around a familiar topic. Jamie will participate in a group setting with other children her age and interact in simple situations, but she is also hindered by an inability to maintain attention for more than 30 seconds at a time unless a preferred topic or activity. Jamie needs to be up and moving, and when she is, she is more interactive and responsive. Jamie has also been diagnosed with a seizure disorder and has petite mal (absence) seizures anywhere from 3 to 10 times a week. She currently takes medication to reduce these. After an identified seizure, she is likely be lethargic and less responsive for up to an hour.
Diagnosis: 299.0/F84.0 Autism Spectrum Disorder Associated with seizure disorder Requiring substantial support (Level 2) for deficits in social communication and requiring substantial support (Level 2) for restricted, repetitive behaviors With accompanying language impairment—phrase speech, receptive and expressive delays With accompanying intellectual impairment (low cognitive abilities and low achievement scores) Associated with Attention Deficit Hyperactivity Disorder
David is a 20-year-old male who is living independently at college. He has a history of language delays (receptive and expressive) and social cognitive challenges and received intensive services until he was about 15 years old. He currently can carry on an age-appropriate conversation but has some dysfluencies in his speech and can sound pedantic and overly formal. He does not make friends easily because he appears awkward and “nerdy,” however, he has a couple of close friends who understand his quirks. Also, David does not readily seek out friendships and seems content to live an independent life. Most people don’t know David has autism; they just know he is “quirky.” David struggles in school not intellectually but in organization and forethought. He lets assignments slip away and doesn’t plan appropriately. When presented with a difficult task, he is likely to “give up” rather than seek out help and problem-solve. David still gets caught up in “younger” activities such as video games and Pokémon and will at times let those activities overtake his life responsibilities.
Diagnosis: 299.0/F84.0 Autism Spectrum Disorder Not associated with known medical disorder or genetic condition Requiring support (Level 1) for deficits in social communication and requiring substantial support (Level 2) for restricted, repetitive behaviors Without accompanying language impairment Without accompanying intellectual impairment (high cognitive abilities and high average achievement scores) Not associated with any other neurodevelopmental, mental, or behavioral disorders
See my Blog posts To New Parents Part I and Part II to see some of thoughts about those first months after an ASD diagnosis.
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