Autism TreatmentAutism Information for Parents, Practitioners & Professionals…

Autism Information for Parents, Practitioners & Professionals…

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What You Need To Know About Autism
DEFINITION: Autism is the name for a group of brain developmental disorders sharing three common features: (1) Deficits in social understanding and social skills (2) Deficits in understanding and expressing language and (e) tendency to engage in repetitive non-functional behavioral routines, and excessively focused on highly specific, rigid topics and activities. The term “autism” is often used interchangeably with “autism spectrum disorders.” Most experts today believe autism is really a continuum not discrete disorders. The onset is before 3 years of age and highly variable in expression. Among many children diagnosed at 3 or 4 years of age, parents recognized clear differences in their child by 6 months to 1 year of age.

CAUSES: Most evidence indicates autism is a complex genetic disorder produced by genetic susceptibility plus increased risk contributed by other genes or factors such as prenatal drug exposure or infections.

PREVALENCE: Actual autism prevalence (the number of children with autism as a proportion of the number born) is about 1 per 150. In the past it was believed to be much lower, 1 per 1000. The difference is due to increased identification of higher functioning children with ASDs

PROGNOSIS: Studies over the past 20 years indicate about half of children with autism can function near the typical range in most domains after receiving 2-3 years of Early Intensive Behavioral Intervention started between 2 and 6 years of age. While this does not cause recovery or cure, it enables such children to function well among their typical peers. The other half benefit from early intervention but less dramatically. Older children also benefit from behavioral educational intervention but not as markedly. The long term prognosis into adulthood will likely depend on the availability of appropriate supports for people with autism in the community.

DIAGNOSIS: There is no valid and reliable laboratory blood or brain-imaging test for autism. Autism is diagnosed by a licensed psychologist, pediatrician, child psychiatrist or pediatric neurologist based on a combination of information obtained from interview with parents, and forms (scales and paper and pencil ratings) completed by parents, teachers and psychologists, and directly observing your child. Most professionals require a standardized psychologist test like the Autism Diagnostic Observation Scales (ADOS) or the Autism Diagnostic Interview Revised (ADIR). Other rating scales or checklists like the Checklist for Autism in Toddlers or the Childhood Autism Rating Scales are used to screen for autism or to confirm a test already given by another professional. Professional observations focus on the three core autism symptoms: Communication deficits, Social deficits, and Repetitive behaviors and rigid routines. According to the National Research Council, a well-trained professional should be able to diagnose autism reliably by around 2-2 1/2 years of age.

AUTISM TYPE: There are currently three clinical diagnostic autism categories, though that may change in 2013 when the new DSM-5 is published by the American Psychiatric Association: Autistic Disorder, Asperger Disorder and Pervasive Developmental Disorder Not-Otherwise-Specified (PDD-NOS, which is called Atypical Autism in many other countries). Autistic disorder usually has more severe challenges in all three domains, communication, socialization and repetitive behavior. Children with Asperger disorder have nearly typical language development (though their language may have an odd intonation), but exhibit significant social skills deficits and often exhibit highly rigid, compulsive routines. Children who exhibit some but not all characteristics of Autistic Disorder may be diagnosed with PDD-NOS. All three are prone to tantrums when preferred activities are disrupted or when especially anxious.


1. There is an autism epidemic.

As noted above this incorrect impression due to changes in diagnostic criteria and the availability of the first reliable autism diagnostic test in 1989. In addition, widely varying prevalence numbers have been created by relying on inaccurate data from public school enrollment records which are affected by school financing, administrative policies, and qualifications of school staff. It now appears autism has always been much more prevalent than thought in the 1960s and 70s. It is now estimated autism prevalence is about 1:150 to 1:300 births.

Autism is a psychological condition cause by “cold mothering.”

This destructive idea was proposed by child psychiatrist Bruno Bettleheim and has been proven false. There is no evidence parenting style is causally related to autism. While parenting methods can improve or worsen symptoms, they do not cause autism.

Autism is caused by MMR vaccine.

This erroneous notion was promoted by an English gastroenterologist who falsified information in a journal publication. He has subsequently been banned from practicing in England. There have been over 20 studies by independent groups in many countries that have all shown the same thing: There is no association between MMR vaccine and autism.

Autism can be cured.

There is currently no biological or biomedical cure for autism. Symptoms of autism can be greatly reduced or reversed among about half of children treated with intensive early behavioral intervention, but they nearly always persist is exhibiting some more subtle autism characteristics, including a tendency toward rigidity, social anxiety and somewhat odd, pedantic sounding speech. These children are usually placed with typical peers in school, but may receive some paraprofessional support. Among about half of treated children, their symptoms are greatly reduced but they continue to have significant autism symptoms, cognitive and language delays and are usually served in special education classrooms in school.

Children with autism, especially with Asperger Disorder have an exceptional hidden talent.

This notion has been fueled by such reports as
Rain Man, who had Savant skills, which are very unusual. A small percentage of children with Asperger Disorder are exceptionally bright and may have special interests, such as science, technology or art, but that is the exception rather than the rule. Most other children on the Autism spectrum are like any other child who has interests, but no highly developed talent waiting to emerge. It is always a good idea to cultivate a child’s interests, but don’t expect miracles.

People with autism don’t have feelings like other people.

Individuals with autism have feelings just like everyone else. They are prone to exaggerated negative feelings (e.g. fear, anxiety, alarm, anger) but often have very limited way to appropriately express their feelings. Through effective intervention, most children with autism can improve these skills. Positive feelings (such as affection) are often expressed somewhat naively and perhaps too directly, but can be improved with time. It is very important young people with autism are taught how to more appropriately express their affectionate feelings for teachers and friends.

People with autism are incapable of developing social relationships.

That is a false idea due to the fact that earlier intervention methods were ineffective. Many children with higher functioning autism, PDD-NOS or Asperger Disorder have warm, close relationships with their families and friends, but typically they have far fewer close relationships than their peers. Many people on the autism spectrum are very comfortable spending a good deal of time by themselves and are often not as driven to seek out friends to “hang out” with as are typical teenagers.

As adults, most people with autism live in institutions or specialized treatment centers.

Today, most young adults with autism live with their families longer than same age peers, but increasingly they are living either alone or in supported living arrangements with typical peers or occasional support by a professional who helps look after their finances and health issues. Some are living in transition arrangements similar to college dorms. Before the advent of autism early intervention in 1987 many adults with autism ended up languishing in state institutions.