What is Autism?

Good Question! Here are a couple of clinical definitions:

From the Autism Society

“Autism is a complex developmental disability that typically appears during the first two years of life and is the result of a neurological disorder that affects the functioning of the brain, impacting development in the areas of social interaction and communication skills. Both children and adults on the autism spectrum typically show difficulties in verbal and non-verbal communication, social interactions, and leisure or play activities.

Autism is one of five disorders that fall under the umbrella of Pervasive Developmental Disorders (PDD), a category of neurological disorders characterized by ’severe and pervasive impairment in several areas of development.’ ”

From the Mayo Clinic

“Autism is one of a group of serious developmental problems called autism spectrum disorders (ASD) that appear in early childhood — usually before age 3. Though symptoms and severity vary, all autism disorders affect a child’s ability to communicate and interact with others.

It’s estimated that three to six out of every 1,000 children in the United States have autism — and the number of diagnosed cases is rising. It’s not clear whether this is due to better detection and reporting of autism, a real increase in the number of cases, or both.

What is clear is that though there is no cure for autism, intensive, early treatment can make an enormous difference in the lives of many children with the disorder.”[ad#Google Adsense Wide]

Here’s what it means for us:

Autism means our 4 year old is developmentally delayed, and spends most of his time in his own world, which apparently looks and sounds different to him. It means he can’t connect the dots between thoughts and feelings. It means he doesn’t make eye contact. It means he doesn’t sense danger. It means he doesn’t have a natural desire to please, imitate, or connect with us. One day he may be “clear headed” and make verbal requests and follow directions; the next, he may stare at us like he has no idea what we are asking or how to tell us what he needs. It means that parenting is a whole lot more complicated than it used to be. And it means that we’re going to have to be curious, creative, tenacious, and patient in our training.

What does autism look like?
Autism looks different depending on each person and the severity of autism. That’s why it is now referred to as Autism Spectrum Disorder (ASD). One individual will probably not display all of the following symptoms, but many of these are common to Jackson or children with ASD who we know.

Symptoms of autism
avoids eye contact
flaps hands/fingers/objects
doesn’t respond to name
reacts strongly to touch, smells, tastes, lights or visual stimuli, sounds, or pain
avoids peer interaction
plays with toys or other objects inappropriately *
displays inappropriate, unprovoked, or seemingly random emotional outbursts (laughter, aggression, crying, screaming)
engages in head banging or other self-injurious behavior
seems unresponsive or may appear to have a hearing loss
doesn’t follow directions
displays lack or loss of vocabulary
echoes scripted lines of movies with incredible accuracy (echolalia)
seems to forget routines or previously used language
seems to be either hyperactive or unusually lethargic
has physical delays in fine and large motor coordination
has balance issues

*inappropriate play: Jack would prefer to hold a spatula to a toy car or teddy bear, and if we did get a toy in his hand, he would use it to bang on the window instead of playing with it the way it should be (sitting on the ball instead of rolling or tossing it, banging cars together instead of pushing them on the floor).

When would we notice warning signs of ASD?

According to the National Institute of Child Health and Human Development’s Autism Facts, “a doctor should definitely and immediately evaluate a child for autism if he or she:
Does not babble or coo by 12 months of age
Does not gesture (point, wave, grasp, etc.) by 12 months of age
Does not say single words by 16 months of age
Does not say two-word phrases on his or her own (rather than just repeating what someone says to him or her) by 24 months of age
Has any loss of any language or social skill at any age.”

What does regressive autism look like?
The child usually displays fairly typical development until about 18 months, then withdraws, loses vocabulary and eye contact, often begins engaging in self stimulatory behavior, and may display other symptoms of ASD. Jack falls into this category, except the onset of regression was a bit later, happening after he turned two. We have identified a couple of developmental delays around 12 months: Jack didn’t go through the stage of bringing objects to us repeatedly, and he didn’t point to objects, both showing a lack of the social skill referred to as “joint attention.”
Jack’s vocabulary expansion had slowed enough by age two that I was slightly alarmed, but his vocabulary of over 30 words disappeared between age 2 and 2 and 1/2, leaving him with only two phrases: “all-done” and “Jack ready to get down.”

The following is from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM IV):
A. A total of six (or more) items from (1), (2), and (3), with at
least two from (1), and one each from (2) and (3)
(1) qualitative impairment in social interaction, as manifested by at least two of the following:
a) marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction
b) failure to develop peer relationships appropriate to
developmental level
c) a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people, (e.g., by a lack of showing,
bringing, or pointing out objects of interest to other people)
d) lack of social or emotional reciprocity ( note: in the
description, it gives the following as examples: not actively
participating in simple social play or games, preferring solitary
activities, or involving others in activities only as tools or
“mechanical” aids )

(2) qualitative impairments in communication as manifested by at least one of the following:
a) delay in, or total lack of, the development of spoken language
(not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)
b) in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
c) stereotyped and repetitive use of language or idiosyncratic
d) lack of varied, spontaneous make-believe play or social
imitative play appropriate to developmental level

(3) restricted repetitive and stereotyped patterns of behavior,
interests and activities, as manifested by at least two of the
a) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in
intensity or focus
b) apparently inflexible adherence to specific, nonfunctional
routines or rituals
c) stereotyped and repetitive motor mannerisms (e.g hand or finger flapping or twisting, or complex whole body movements)
d) persistent preoccupation with parts of objects

B. Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years:
(1) social interaction
(2) language as used in social communication
(3) symbolic or imaginative play

C. The disturbance is not better accounted for by Rett’s Disorder or Childhood Disintegrative Disorder

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