What is autism?
Autism is considered a developmental disorder in which sensory messages are impaired. People with autism have difficulties in communication, social behaviour and perception of the world we live in. Autism is present at birth and the characteristics become evident in the first three years. Parents are often aware of early signs in their child’s lack of communication, play and in their limited responses to love and affection.
Autism was first described by Leo Kanner in 1943.
How common is autism?
Autism occurs in approximately one in one thousand people. There are four times as many males diagnosed with autism as females.
Are there different types of autism?
Each person with autism is different in many ways from others with the same diagnosis. Autism may present in varying degrees from very mild to severe. Estimates vary but it would appear approximately 75% are intellectually disabled.
On what basis is a diagnosis of autism made?
For a diagnosis of autism to be made the child will show symptoms in the following four areas before 36 months of age.
Relating
The child with autism often has extreme difficulties in relating to other people. The child will often avoid such basic communication as eye contact and is frequently described as being in a world of their own. Attempts to break into their world can provoke frustration and may lead to tantrums. The child with autism often resists being held and is generally indifferent to the social approaches of others.
It is not unusual for the child with autism to treat other people as inanimate objects or as tools for their use (eg using someone’s hand to open a door).
Restricted activities or interests
There is a lack of normal play development. Most children with autism have no imaginative play and the few who do, tend to repeat the same theme and rarely extend their games. When left to themselves, children with autism spend much of their time in repetitive and apparently pointless activities which absorb them to the exclusion of all else. Typical activities include rubbing surfaces, toe walking, flicking string, odd hand movements, smelling things or spinning. Children with autism strongly resist attempts to redirect them from these activities.
In higher functioning people this behaviour is reflected in their restricted interests (eg bus routes, timetables, dinosaurs) and routines. People with autism feel tremendous anxiety at the unpredicability of daily life and these rituals and routines remove some of the uncertainty about what will happen next.
Perception
People with autism seem to have difficulty in making sense of their environment. This may account, in part, for the obsessive nature of their behaviour. They are reducing the world to those parts which they can understand and with which they feel safe. These reactions can vary from day to day.
Often a child who will not respond to his name or a loud noise, will become distressed by a seemingly normal or sudden sound. Children with autism also have unusual responses to touch, pain and the temperature. They may either under or over react to these sensations.
Communication
The lack of response by an autistic child sometimes raises the suspicion that the child is deaf. People with autism do not communicate easily; some do not speak at all. Others simply echo back what is said to them (echolalia), while others use language in an odd and limited manner. Another speech characteristic is pronoun reversal where the child will say ” You want a drink” instead of “I want a drink”. Rhythm, tone and pace of speech can be affected with the resulting speech sounding odd.
The person with autism may use language mainly to name objects and has little understanding of conversation. There are also difficulties in understanding other people’s communication and in the ability to comprehend other people’s thoughts and feelings. This lack of awareness is sometimes called theory of mind or mind- blindness.
What is the cause of autism?
There has been no single cause of autism discovered. It is believed that the difficulties of autism are biological in origin and that there is an abnormality in the brain. This is probably caused by one or by a combination of factors. These factors can include genetics, viral infections or complications during pregnancy. Other causes such as the effect of vaccinations are also being investigated.
A theory which has been proved wrong says that autism is caused by the parents; this created much heartbreak and confusion. Bruno Bettelhiem and Niko Tinbergen both wrote books which subscribed to these theories, but with the increase of publications in autism these books are not recommended. For current theories please refer to our suggested reading section.
Can autism be inherited?
Although most siblings of children with autism develop normally, it has been estimated that 2-3% of families with one child with autism have two children with autism.
Is autism associated with other disorders?
Autism is sometimes associated with other disorders which include Fragile X, tuberous sclerosis, Rett’s Syndrome and epilepsy. Around 30% of children with autism also have epilepsy.
How does autism effect the family?
The knowledge that their child has autism can have a significant effect on parents. Parents often react to the diagnosis with shock, grief, anger and guilt. All parents have differing reactions and need to be listened to and supported. For the family, the upbringing of the child with autism places enormous pressure and strain on the parents, brothers and sisters. Social activities and everyday outings can be extremely difficult. One of the most distressing characteristics for parents is that their child with autism may not respond in the usual way to affection, and therefore may have difficulty forming social relationships.
What is the treatment for a person with autism?
At present there is no cure for autism. However early diagnosis followed by a structured education and behaviour management programme will assist the person with autism to lead a meaningful and productive life. Many problem behaviours can be reduced by a firm and consistent management programme. Social skills and independent living programmes can make a great difference in the day-to-day functioning of people with autism.
There is no medical treatment for autism itself, but some medications have been found to be useful in reducing particular symptoms. The effect of medication is specific to the individual and, as with all therapies, what works with one person may not be successful with another. Self-injurious behaviour and anxiety are two symptoms greatly helped by medication.
Are there therapies that help people with autism?
There have been many therapies used with people with autism. Some claim to have “miraculous results” while others emphasise more modest progress. It is recommended that any therapy is thoroughly investigated before making a commitment to it. A good starting point is the booklet “Approaches to autism” 2nd by the National Autistic Society, London or Elizabeth Gerlach’s book “Autism treatment guide” Eugene, Oregon : Four Leaf Press, 1993.
Some therapies include:
Auditory Integration therapy
Sensory Integration
Lovaas therapy
Music therapy
Giant Steps
Relaxation techniques
TEAACH (structured teaching)
Do people with autism have special abilities?
Some people with autism can perform well in particular areas. These skills are sometimes called islet of intelligence. Drawing, music, calendar calculation and memory are the most likely skills. These savant talents, while fascinating, represent a very small percentage of people with autism.
What is the outlook for a person with autism?
This will vary considerably and will be influenced partly by intellect and verbal skills, and by education and mangement programmes. Children with autism grow up to be adults with autism, although behaviours and skills may change over time. Education, support and advocacy need to continue throughout adulthood.
When the time comes to leave the family home, options range from small group homes with 24-hour care to independent living. Job opportunities are scarce and while some may gain employment in the open work force, most will require support at work.
What is Asperger Syndrome?
Asperger Syndrome falls within the spectrum of autism. People with Asperger Syndrome have difficulties in the same developmental areas as people with autism. While their speech tends to be more fluent, the content is often pedantic and, while they may have an impressive vocabulary, it is limited to favourite subjects.
A lack of understanding of non-verbal communication may result in unusual and often naive social behaviour. Social interaction is difficult due to an inability to grasp the complex rules of everyday social behaviour. People with Asperger Syndrome may appear rude and antisocial. They seem very self-centred, unable to perceive how their behaviour affects others. Through teaching and practice, social skills can be learnt and used appropriately.
People with Asperger Syndrome appear to cope best when their environment is predictable.
While most children with Asperger Syndrome attend mainstream schools, their odd or eccentric behaviour may result in teasing or victimisation. Many young adults with Asperger Syndrome may encounter difficulties in their employment, particularly with social interactions with others.
Suggested reading:
Attwood, Tony (1993) Why does Chris do that? : some suggestions regarding the cause and management of the unusual behaviour of children and adults with autism and Asperger Syndrome. London : National Autistic Society.
Baron-Cohen, Simon and Bolton, Patrick (1993) Autism : the facts. Oxford : Oxford University Press.
Berzel, Anne (1995) The student with autism / Asperger Syndrome in the school community. Adelaide : DECS
.Brill, Marlene Targ (1994) Keys to parenting your child with autism. New York : Barron’s.
Frith, Uta (ed) (1991) Autism and Asperger Syndrome. Cambridge : Cambridge University Press.Frith, Uta (1989) Autism : explaining the enigma. Oxford : Blackwell.
Grandin, Temple (1986) Emergence : labelled autistic. Novato, CA : Arena Press.
Happe, Francesca (1994) Autism : an introduction to psychological theory. London : UCL Press.
Powers, Michael (1989) Children with autism : a parents guide. Rockville, MD : Woodbine House.
* Source : Autism SA
