Symptoms of Autism spectrum disorders.

Part of my Developmental Psych Assignment (written in high school)

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Symptoms of Autism spectrum disorders.

For a child to receive the diagnosis of ASD under DSM-V, the child must meet 2 criteria.

1) deficits in social communication and social interaction and

2) restricted repetitive behaviors, interests, and activities (RRBs).

Because both components are required for the diagnosis of ASD, Social Communication Disorder is diagnosed if no RRBs are present.

Communication deficits and restrictive behaviors can often result in challenging behaviors.  Autism is a spectrum disorder meaning that it can range from very severe (non-speaking and/or challenging behaviors) to very almost indistinguishable from peers (verbal with slight deficits in social skills etc). Some individuals can be very gifted in a particular area and they are called Savants. The textbook is actually inaccurate in equating Savants with Aspergers (Aspies) as Savants range in their level of symptoms across the board from mild to significant. An example is the severely autistic Stephen Wiltshire who is nonspeaking and lives in London. Stephen can reproduce entire cityscape views in his paintings after just having seen them aerially for a few minutes from a helicopter. Another example of a savant is from the movie Rainman.

As a person who is pretty severely affected by autism, I have to disagree with a lot of what the author states about autism.  For example Berger in page 275 states,  “Children with any form of autism find it hard to understand emotions… do not want to interact with anyone.. do not understand romantic love .. slow to develop a theory of mind.”  Such broad generalizations are misleading and do not result in effective treatment. I believe the issue is one of communication challenges which make it hard to develop coping mechanisms that typical people use to be able to react in a socially appropriate way. Cognitively understanding an issue should not be confused with sensory-motor execution of a task, which is the observable behavior. I also feel very strongly about the lack of Theory of Mind and Autism and I hope to do more research down the line to debunk this theory. The problem is that when such broad generalizations are used in textbooks, the resultant students come out with a mindset that is not open to other possibilities and the affected autistic individuals suffer from ‘more of the same.’ I’ve had therapist after therapist work with me who seemed to have their head stuck in the sand because that is what they were taught about how autism should be. The kids who don’t fit the mindset profile of autism are written off as unable to improve.

 What do we know about the causes of Autism?

It’s been 16 years since my ASD dx, I’m nowhere close to a breakthrough, so the answer is that we don’t know nearly enough about the causes - there just seems to be too much confusion and too much debate. The fact that its a spectrum disorder makes it all the harder - it’s like searching for a single solution to 100,000 problems. Every breakthrough helps a fraction of the population, the ones that fit that cure’s physiological profile.

 Explanations for the rapid rise in Autism numbers in the US in recent years.

Almost 6% of special education students in the US have the ASD dx and another 6% as developmentally delayed.

A few guesses for rise in numbers

1.    Changes in criteria between DSM-IV and DSM-V means that  ASD (Autism Spectrum Disorder) now includes

• Aspergers. Diagnosis formely given to folks with no intellectual disability and no language deficits. The aspie community is apparantely unhappy about being clubbed with autism and consider it a major downgrade.
•  PDD-NOS (Pervasive Developmental Disorder- Not otherwise specified). A dx usually give to more individuals who did not meet all the Autism criteria.
• Childhood Disintegrative Disorder. Dx given to kids who developed normally till age 3 then regressed.
• Mental Retardation is now often called severe autism or intellectual disability.

2.    Early intervention: The word autism is ubiquitous in mainstream media and most new parents are aware that it is a serious childhood disorder. So many parents push pediatricians / neurologists or developmental psychologists to give them an ASD diagnosis if there is even the slightest sign of some developmental delay as they want to access to and start early intervention services. Professionals on their part also want to be proactive as early intervention can make a significant difference for many kids. Even children who would have been considered speech delayed in the past are thus getting the ASD diagnosis.  There are thus greater number of diagnosed kids. This also means there are great numbers of children who are ‘recovering’ from autism because this specific subgroup needed only that early timely intervention, which lets them overcome that hump.

3.    Educational Dx. Many school districts classify children as ASD so that they can fit into existing special education classroom models. Many kids with Cerebral Palsy and similar issues progress to an ASD diagnosis as they improve their physical symptoms. For example, my friend had severe CP (umbilical cord wrapped around his neck, cutting off oxygen flow) at birth. But with intensive therapy, he learned to walk by around age 6-7. His school district changed his dx to autism so that he could be put in an autism classroom rather than the one for CP kids who were wheelchair users.

4.    Access to Services. Till age 22, autistic children are covered by IDEA (Individuals with Disabilities Act) which theoretically allows special education services like behavior modification, LRE (least restrictive environment) classroom, smaller classrooms, higher staff ratio extra coaching (resource) and a few other safeguards. A diagnosis of ADHD on the other hand, may not qualify for special education services under IDEA and may only qualify for Section 504 of the ADA (Americans with Disabilities Act). So some parents may push for the ASD diagnosis as it will give their child the extra support which they may not otherwise receive.

5.    Then there are the reported cases of some parents who seek the diagnosis, as it gives their child extra advantages and preferences in terms of individualized learning, testing accommodations etc. This is unfortunate in some ways and could well be heresay, which makes the topic somewhat controversial.

6.    When services are deemed better in a particular location, it naturally draws people from other countries to that place seeking those services for their developmentally disabled child. That child may not have received the ASD dx in the home country due to lack or knowledge or other factors.  This naturally increases the ASD numbers. Both Australia and Canada do not allow a non-citizen child with a disability to enter or their country. News articles have highlighted case of immigrant parents who were asked by Australia to leave their disabled child behind in their native country. Luckily the USA is far more humane and does not impose such restrictions. Similarly non-Canadian citizen with disabilities cannot live in Canada. Essentially I would not be allowed to live in Canada or Australia despite being born in the US and a US citizen.

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Comments
Wow, this is really great. I like how you debunk popular theories about autism.
I hope you write more and more articles in the future. - From Little Hari Balaji