Understanding Autism

The increase of children diagnosed with autism has been the subject of many recent newscasts and newspaper articles. As the fastest growing developmental disability in the United States, autism occurs in as many as one in 166 births. It is a disorder that impacts our communities on many different levels - families are facing huge challenges and school systems are strained by the need and cost of more specialized services.

So what is autism? It is a lifelong neurological disorder that affects brain functioning and may be present at birth with symptoms that may develop before the age of three. Autism is one of several pervasive developmental disorders and affects areas in the brain that control reasoning, social interactions, behaviors and communication skills. Seventy-five percent of individuals with autism also have mental retardation. The word autism comes from the root word “auto” referring to self. Individuals with autism are often described as being completely indifferent to the world around them, living only within themselves.

No two individuals with autism look or behave alike. Children and adults with autism have different degrees of difficulty communicating, relating to the outside world, and problem solving. However, the common characteristics include:

Severe delays in language development
Language is slow to develop, if it develops at all. If it does develop, it usually includes peculiar speech patterns or the use of words regardless of their normal meaning. Those who acquire language may still use unusual metaphors to speak or do so in a formal, robotic tone.

Severe delays in understanding social relationships
A child with autism often avoids eye contact, resists being picked up and seems to “tune out” the world. This results in a lack of peer relationships, and an inability to understand other people’s feelings.

Marked restriction of activity and interests
A child with autism may perform repetitive body movements, such as hand flicking, twisting, spinning or rocking. The need to follow the same routine, by following the same route, the same order of dressing, or the same schedule everyday becomes very important.

Inconsistent patterns of sensory responses
The child may appear to be deaf and fail to respond to words or other sounds. At other times, the same child may be extremely distressed by an everyday noise such as a telephone ring. The child may also show insensitivity to pain and a lack of responsiveness to cold or heat, or may over-react to any of these.

Uneven patterns of intellectual functioning
The majority of children with autism have varying degrees of mental retardation. Only 25% of individuals have average or above average intelligence. However, most will have splinter skills where some abilities are well above their overall functioning.

Emotional Reactions
Some individuals will show almost no emotions, while others may laugh or smile, cry or go into tantrums without a known reason. Some may be quite fearful and others will show no sense of fear at all.

Resistance to Change
Variation in routine may be extremely upsetting to children with autism. If objects are changed, the order of doing something altered, or objects are re-arranged in a room, a high degree of distress could ensue.

In addition to severe communication, behavioral and socialization problems, people with autism often exhibit extreme hyperactivity or unusual passivity in relation to parents, family members and other people. Behavior problems range from mild to very severe; the latter can take the form of highly unusual, aggressive, and in some cases, even self-injurious behavior. These behaviors may persist and be difficult to change.

Diagnosis, education, early intervention and intensive services are critical to treating autism effectively. A thorough diagnostic work-up requires a multi-disciplinary team assessment that considers communication skills, relationships with peers and adults, comprehension, cognitive functioning, coordination, use of senses, routines and schedules, responses to medications, level of learning, unusual interests, and behaviors.

Because every individual with autism is different, the best treatment is one that is individualized and tailored to the child’s needs. When a program meets the needs of the whole child, extends into the home, school and/or day programs and includes the participation of parents/family, a child with autism can be supported in reaching his or her potential.

Cynthia Dodge, Ph.D., is Director of Clinical Services for Spurwink Services, a mental and behavioral health agency which serves individuals with autism through the following services: Treatment, Evaluation and Diagnostic Clinic; Case Management; Residential Treatment; Special Purpose Schools; and a Therapeutic Preschool. To learn more about Spurwink Services, go to www.spurwink.org.