Autism Spectrum Disorders

 

Definition:

An Autism Spectrum Disorder (ASD) is a developmental disorder that affects multiple aspects of a child’s functioning. The disorder is characterized by difficulties in communication, impairment in social interactions and imaginative play, and behavioral symptoms involving repetitive behaviors and/or a restricted range of interest in activities.

 

Autism is often referred to as a spectrum disorder due to the variety of characteristics and the range of severity that is unique to each child. Even though children diagnosed with ASD share a common set of behavioral characteristics, no two individuals are alike. Each can act very differently from one another and have a varying set of skills. Children may have milder or more severe symptoms. Children with ASD may also exhibit different symptoms over time, or from one situation to the next.

 

A variety of diagnoses may be used for children on this spectrum:

 

Autistic Disorder- Children meet full criteria for the disorder according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Children in this group vary quite a bit, however they each have difficulties in all three areas of communication, social interactions, and repetitive behaviors that are sufficient in number and severity to meet criteria for the disorder.

 

Pervasive Developmental Disorder-Not Otherwise Specified (PDDNOS)-

Children with this diagnosis typically have many features of autism, such as severe and pervasive difficulties in social interactions and either communication difficulties or restricted interests/repetitive behaviors, but do not meet the full criteria for Autistic Disorder. This diagnosis may also be given to very young children who do not yet meet full criteria for autism.

 

Asperger’s Disorder- This is typically diagnosed in school aged children who have social and behavioral symptoms of autism without a language delay. Measured intelligence is in the average to above average range. Frequently, these children show an almost obsessive interest that is unusual in intensity and focus.

 

Additional Disorders- Pervasive Developmental Disorders can occur by themselves or in combination with other disabilities. Often, symptoms of

Attention Deficit Hyperactivity Disorder (ADHD) are present in children with ASD. These symptoms may not require a separate diagnosis as they are considered part of the pervasive developmental disorder. Children may also experience learning disabilities (LD), anxiety disorders, obsessive-compulsive disorder (OCD), blindness, deafness, epilepsy or mental retardation. It is estimated that up to 70% of those diagnosed with an Autism Spectrum Disorder are also diagnosed with mental retardation ranging from mild to severe, although this number has recently been questioned.

 

Characteristics:

A child with ASD may display only a few, or several, of the following characteristics:

 

Communication

- No speech or delayed speech

- Lack of use of gestures (e.g., pointing) to compensate for delays in   communication

- Repetitive speech or unusual use of language (such as repeating strings of words from movies or things that others have said at other times)

- Limited imitation of others

- Limited symbolic play

Social Interaction

- Difficulty with back and forth interactions with adults and children

- Minimal interest in pointing, sharing, showing, or getting others’ attention

- Limited eye contact, poor use of eye contact, gestures, and facial expressions for communication

- Difficulty playing with other children

- Difficulty in responding to teaching efforts; dislike of being directed in play, being read to, etc.

 

Behavioral Symptoms

- Restricted range of interests or a preoccupation with parts of objects

- Strong attachment to particular objects

- Repetitive behaviors such as jumping, walking on toes, hand flapping, holding objects too close to eyes, etc.

 

Associated Features that may be present

- Oversensitivity to sound, light or touch

- Lack of sensitivity (to hearing name, pain)

- Eating limited variety of food

- Highly developed memory skills

- Abnormal sleeping patterns

- Self-injurious behavior

- Seizure disorder

- Discrepancy between verbal and nonverbal IQ

- IQ falling within range of mental retardation

 

Red Flags for Autism in Toddlers...

 

Behaviors	Examples
Delayed development of spoken language	Child has a vocabulary of less than 50 single words and/or no 2-word phrases
Failure to use nonverbal forms of communication to compensate for delayed language development	Child demonstrates inconsistent use of eye contact, gestures (such as pointing or shaking head), and facial expressions to convey needs and desires
Inconsistent response to sounds	Child may not respond to his/her name being called; deafness may be suspected
Failure to direct the parent's attention to objects or events to share interest	Child may point to juice to request, but does not point to the sky to share interest in an airplane. Child may bring a toy to the parent for help, but does not hold up a toy to show it to the parent for the purpose of conveying interest
Failure to imitate simple adult movement	Child does not wave good-bye or imitate hand movements in games like pat-a-cake
Failure to interact in a reciprocal, back-and-forth manner	Child may interest only on his/her terms. May initiate games (or affection) but not respond when parents initiate them
Lack of interest in simple social games	Child may be more interactive during physical games with parents, such as swinging or tickling, than during social games such as peek-a-boo
Lack of interest in other children	Child may show limited interest in watching or playing with other children
Repetitive and restrictive toy play	Child may show limited interest in toys, may play with toys in an unusual manner (for example, lining them up), may play with toys the same exact way each time, and/or may show limited imaginative