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Unit 1.1
Introduction to Autism
Welcome to the Class! Overview: What is Autism? What is a Child with Autism Like? Disorders Within the Autism Spectrum Symptoms of Autism Diagnosis of Autism Homework
Welcome to the Class!
Welcome to Virtual University's Introduction to Autism course. My name is Karen, and I will be your guide to the journey we shall take into unlocking the mystery behind the condition. Over the next few weeks, we will explore the many facets of this disorder. You will learn:
- What autism is and is not
- Its history within the psychology field
- Current theories on its causes and the debate on its cure
- Current treatment options for those with autism
Autism is a Pervasive Developmental Disorder. Pervasive means the symptoms persist throughout life. Some people with autism can learn to compensate and cope with the symptoms with fair effort in adulthood. Other times, autism can be so severe that a person is not able to live without constant adult assistance. Psychologists define a developmental disorder as a condition that impairs the ability to develop age-appropriately. In the case of autism, this includes the areas of social, emotional, behavioral, motor skills, self-help skills, and sensory integration. A person with autism can be affected in a few, several, or all of these areas. Autism is a spectrum disorder. In other words, a group of people who all have autism can sit in the same room, and each of them may function at varying levels. The spectrum for autism is much like an umbrella, consisting of several sections where different disorders exist, and yet all with this diagnosis sit under it in respect to common symptoms. The prevalence of autism in the general population is estimated to be as high as 1 to 3 in 500 people. Most reported cases of autism occur in children. What is a Child with Autism Like?
Anna is 13 years old, beautiful, tall, with long brown hair and blue eyes. She is an only child of parents who divorced when she was young. Her parents have joint custody, and she shares her time equally between their households. Anna's mother recently remarried, and Anna adores her new stepfather. Anna loves the color red, reading comics, drawing, swimming, and baseball. She attends a local junior high where her favorite subjects are math, science and art. She has developed some typical teenage habits, including experimentation with glitter gel and nail polish, and sassing her parents about chores. Anna also has autism. She was diagnosed while in preschool, after her parents and teachers became concerned about her behaviors, and her unwillingness to play with her peers. She preferred to line up toy cars, contort her body in strange movements, and flap her hands in front of mirrors. She wouldn't toilet train. Trying to get her to tell you the word for something she wanted would trigger screaming fits that would last hours. Yet, at the same time, she had learned to read by the age of two. Some family members, not knowing better, said that Anna was just "spoiled." Her regular pediatrician didn't seem to know much more, guessing at first a hearing problem, then Attention Deficit Disorder. Her parents finally received a referral to a university team who had a program for diagnosing childhood disorders. They evaluated Anna and told her parents she had middle-functioning autism. Today, Anna has made tremendous progress. She has conquered many of her past difficulties, and continues to make progress that astounds everyone who works with her. Anna still has some challenges. Socializing remains a painful task, especially with the advent of puberty. So many times she prefers to be alone. She still has tendencies to tantrum in the classroom, sometimes requiring her to leave. At home, chores such as cleaning her room can leave her feeling paralyzed because she cannot mentally break things down into smaller tasks and make them easier for herself. Nevertheless, Anna has a very good prognosis. She may still require some assistance through social services, but chances are good she will be able to function fairly well in adult society. Disorders Within the Autism Spectrum
Researchers have made significant discoveries about autism, and they have begun to break it the mysterious conditions down into a number of different syndromes or disorders. These include:
- Autistic Disorder — This is the "classic" form of autism and it encompasses the greatest number. People with this diagnosis can range from low to mild functioning.
- Kanner's Syndrome — Includes higher functioning individuals. It is sometimes called high functioning autism (HFA). Kanner's was the original label for most individuals on the spectrum.
- Asperger's Syndrome (AS) — Another high functioning type of autism that is somewhat higher on the spectrum than Kanner's, but with differences in the symptoms; namely, ability in verbal expression and social and emotional development.
- Pervasive Developmental Disorder, Not Otherwise Specified (PDD-NOS) — Those diagnosed with this condition display many of the symptoms of autism, but do not meet the criteria sufficiently to receive the official diagnosis. It is also known as atypical autism. The joke among some parents in the autism community is that this is a doctor's way of saying, "Your child has autism, but we really don't want to say so."
- Childhood Disintegrative Disorder — Those diagnosed with CDD consist of children who show normal development until approximately 24 months of age.. Then they regress and lose their developmental skills, displaying autistic behavior.
- Rett Syndrome — A genetic degenerative disorder seen in girls, where the patient functions normally until about 18 months, and then suddenly regresses. By adolescence, most Rett Syndrome sufferers are wheelchair-bound and completely non-verbal. However, their intelligence level is likely retained.
- Fragile X Syndrome — Another genetic disorder seen in boys. The X chromosome is damaged — literally broken — in these patients, resulting in symptoms that include autistic tendencies and mental retardation.
- Hyperlexia — Hyperlexia is an ability to decode words and numbers much earlier than the normal reading age for children. For example, a hyperlexic child may read simple words by age 2, and progress to grade level books by 3 or 4. However, this ability does not include comprehension. Some argue that this is a separate disorder, but popular belief still holds that this is simply a trait that sometimes accompanies autism.
- Autism is NOT an automatic indictor of special or "savant" talents. Rain Man only had it partly right. Many can naturally pick up talents, such as art or music. However, most do not have this ability, instead demonstrating aptitude of average or lower scale, depending on their functioning.
- Autism is NOT a marker of mental retardation. It is currently being intensely debated if lower functioning autistics are retarded at all, and some higher functioning individuals have very high IQ's.
- Autism is NOT the overall makeup of a person's identity. They have their own personalities, differences, and skills. People with autism are just as much individuals deserving respect as each of you taking this course.
- Autism is NOT anyone's fault. Bad parenting or trauma, such as abuse, is not the root cause. We will discuss the theoretical origins of this condition in a later lesson.
- Autism is NOT a disorder that makes a person "unemotional." To the contrary, many with autism have quite a few emotions, and they can be very intense, to the point where these feelings are overwhelming.
- Autism is NOT a condition that a child "outgrows." Many high functioning adults today do not even have a diagnosis — the official diagnosis of autism was reserved for the most severe cases until only a decade ago. Ironically, adults are likely the greatest population within the autism community — they just don't know it!
- Autism is NOT curable, and may never be. This is yet another topic that we will discuss in a later lesson.
- Last, but not least, autism is NOT a sentence of doom. Autism is complicated, but it is not a condemnation. Many adults with autism have jobs, achieve higher education, and even marry and have families. Even those individuals on the lower end of the spectrum have many opportunities not available before.
Regardless of where a person with autism falls within the spectrum, most of them exhibit similar symptoms before they reach preschool. The following are the most common symptoms used to diagnose autism:
Lack of age-appropriate social interaction. This may include
a diminished or a complete lack of eye contact, playing parallel to
other children instead of playing with them, a desire to be alone
rather than with peers, laughing inappropriately. Many times this
issue can come across as rejection of peers or family members, but
this does not represent how the person feels about others.
Insistence on sameness, resistance of changes in routine. This
can include wanting the same foods, toys, etc., demanding to watch the
same video over and over again, refusal to try new activities, and
a tendency to become extremely anxious or upset when pressured to do so.
If a child with autism is verbal enough, he or she may ask for a favorite
game, music tape, or video repeatedly, or may ask to visit a person's
house over and over.
Fixation on certain topics or objects. An autistic person
will obsess on certain topics or begin to
perseverate on a specific object. For example, verbal children with
autism are known to be much like "little professors," spewing detailed
information through long monologues on a topic that fascinates them.
Or they may collect something that absorbs their
interest; for example, a teenage boy described in Donna Williams'
Like Color to the Blind collected miniature figures of appliances
that made lots of noise, such as washing machines.
Sustained odd play. The child may play with certain toys or other
objects inappropriately, i.e. chewing on stuffed animals, or tying
doll clothes together in knots instead of putting them on the doll. He
or she can become attached to objects, yet not show any preference for
people. Sometimes the child becomes fascinated with parts of toys or
objects, especially spinning parts. A classic example is instead of
driving a toy car around, the child turns it upside down and spins the
wheels, sometimes for hours if permitted.
Not responsive to normal stimuli. A person on the
autistic spectrum seeks or avoids certain sensory
stimuli. Examples of this include a disregard for safety or danger, no
response to verbal cues (acts as if deaf), no response to normal
teaching methods, and/or apparent insensitivity to pain. A child
with autism may seek stimuli such as pressure on the body,
jumping, bouncing, flapping, rocking, spinning, and so forth.
Conversely, avoidance of sensory stimuli can include an aversion to certain
clothing (the fabric can feel like sandpaper on the skin), foods
(textures can make the child gag), smells, sounds, light, and colors,
due to overdeveloped senses in these areas.
Communication difficulties. The child may not verbalize needs or
wants, or even verbalize at all. In the case of not speaking needs or
wants, the child most times will point at an object, or grab an
adult's hand and point it towards the object instead. Echolalia is
another example of communication delay in an autistic child — he
or she will repeat words and phrases out of context during attempted
conversation, either by repeating exactly what someone just said, or
rote sounds and spoken lines from movies and songs the child has heard
previously.
Emotional difficulties. An autistic child frequently throws
tantrums or displays unreasonable fear. This is due primarily to the
frustration and anxiety that builds up from not being able to
verbalize wants and needs, but it can also happen when their need
for sameness and routine is somehow violated. The latter can occur
from something as simple as taking a different route to school, or
saying "no" when the child asks to watch their favorite Disney movie
for the tenth time in a row. Inappropriate emotional expression
falls under this area; for example, laughing when others are crying.
This can be due to their confusion in reading facial expressions.
Diagnosis of AutismThe diagnosis of autism is best left to qualified professionals, such as developmental pediatricians, pediatric neurologists, psychologists, and other health care professionals with background and training in dealing with persons in the autistic spectrum. Many universities also have teams of doctors dedicated to autism research. An example is UCLA's Neuropsychiatric Institute (NPI). This program has been in place for about thirty years, and has developed a strong reputation in the Los Angeles area for being one of the best places to receive an evaluation, or for short-term hospitalization of autistic children who may be experiencing a crisis in their behavior. Evaluations usually include examining childhood history, interviewing others when possible, observing the individual, and interviewing the person being evaluated, if possible. In the United States, criteria from the DSM-IV diagnostic manual for autism and other spectrum disorders are the baseline used to detect autism. Other countries, as well as the World Health Organization, have sets of standards very similar to the DSM-IV, some more detailed, others not.
The following Web sites provide information about autism. Select at least two Web sites to visit and read. Many of these sites have links to other sites that can provide even more information. Explore these additional links if you wish. http://www.exploringautism.org/autism/index.htm
http://www.mkdowney.com/characteristics.html
http://www.udel.edu/bkirby/asperger/aswhatisit.html
http://www.nichcy.org/pubs/factshe/fs20txt.htm
http://www.hyperlexia.org/
http://www.autism.org/savant.html
After you have completed the above learning challenge, please write at least two paragraphs on why you decided to take this course, and if you have learned anything in this introductory lesson that breaks any stereotypes or notions you may have had about autism prior to taking this class. Post your answer to the class bulletin board.
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