AUTISM DEFINED

Autism Spectrum Disorder (ASD) is a group of five different autism related conditions:

  • Autistic disorder
  • Rett’s disorder
  • Childhood disintegrative disorder
  • Asperger’s disorder
  • Pervasive developmental disorder not otherwise specified (PDDNOS)

The three most common forms of ASD are autism, Asperger’s, and PDDNOS.

Individuals with ASD have unusual behaviors like obsessions, preoccupations, rituals, self-stimulations, and a strong need for sameness. They have trouble communicating and problems with relationships especially with non-family members.

The three primary features that are characteristic of people with ASD are:
  • impairments in social interactions,
  • impairments in communication, and
  • restricted, repetitive, stereotyped interests and activities with an insistence on sameness.

Sensory abnormalities like hypersensitivity to sounds and tactile defensiveness are also often found in children and adults with ASD. On the other hand, they may appear insensitive to sensory information coming to them from the environment.

There may be motor skill issues that effect either/and gross motor skills and fine motor skills. They may appear clumsy and uncoordinated with an awkward gait. Motor deficits may make life difficult and frustrating. It may be difficult to master basic life skills or interact with peers in activities like bike riding or playing sports.

The most striking feature of individuals with ASD is their social impairment. Some individuals are totally disconnected form other people, often treating them like a piece of furniture. Others are passive in how they accept social overtures from others but rarely if ever initiate interactions. Some individuals with ASD have social behaviors that center on their obsessions and concerns. Other interpersonal difficulties include insensitivity to the feelings of others and a failure to understand why people act the way they do.

People with ASD experience a different sense of themselves in relation to the world – a narrow and restricted sense of self. They fail to see other people as beings like themselves. They have difficulties both with self-awareness and with identifying with others. It has been speculated that this deficit in self-other awareness is what has led to problems with later cognitive development, e.g., mindblindness and executive functioning problems.

Because ASD includes the large ill-defined category of PPDNOS, its prevalence is often cited as one person in 250. However, a recent government study estimated that 1 out of every 91 children may have ASD. Autistic disorder on the other hand is estimated to occur in about 1 per 2000 people while Asperger’s is about one in 3800. The prevalence of males to females is much higher with four to one for all ASDs.

Since autism is a spectrum disorder, it encompasses a wide range of intellectual ability. The most commonly used descriptive terms for this range of abilities is low functioning autism (LFA), moderate autism, high functioning autism (HFA), and Asperger’s Syndrome (AS). Low functioning autism has been also described as classic autism, Kanner’s autism and severe autism. There is continuing debate about whether HFA and AS are the same or two distinct syndromes. In the past it was widely believed that about 75% of individuals labeled autistic also had intellectual disabilities. With the shift to the broader spectrum conceptualization of ASD, the estimate is now about 25%. This means the majority of people with ASD have normal levels of intellectual functioning.

It is unclear at this time if there is an actual increase in the incidence of ASD. One thing is clear – there has been an increase in the diagnosis of autism. Awareness of autism has increased. Additionally, ASD is being diagnosed earlier and the diagnostic guidelines have changed resulting in higher figures. But there are also strong arguments that ASD is increasing in numbers. Recent studies have shown a huge increase in autism in California and other parts of the country. The rates in Canada and Britain also show large increases in the rate of ASD. But these increases may also be influenced with the push on the part of some parent to have their “unusual” child labeled autistic in order to receive more educational services.