What is Autism?

I don't have any children of my own yet, unless you count pets, so I can only imagine how frightening it must feel to notice that something is "off" in your baby or toddler. But, what do you do when you sense that something isn't right? Do you ignore it and hope you're just being overly concerned? What do you do if your friends "diagnose" your child? Do you start all the fad therapies and hope for the best?

There are lots of questions and lots of answers. Let's start with one question and one answer: What is Autism? Autism Spectrum Disorder is a neurodevelopmental disorder; criteria for diagnosis are in a manual called the DSM (Diagnostic and Statistical Manual of Mental Disorders) by the American Psychiatric Association, and include:

A. Deficits in social communication and social interaction across multiple contexts, as manifested by the following:

1. Deficits in social-emotional reciprocity, for example: Failure to initiate or respond to social interactions, deficits in back-and-forth conversation, reduced sharing of interests, emotions or affect.

2. Deficits in nonverbal communicative behaviors used for social interaction, such as: poor eye contact, abnormalities in body language, deficits in understanding and using gestures, lack of facial expression.

3. Deficits in developing, maintaining, and understanding relationships, ranging, for example, from: difficulties adjusting behavior to suit the current situation and difficulties making friends to a complete absence of interest in peers.

B. Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least 2 of the following:

1. Stereotyped or repetitive motor movements (such as hand flapping, body rocking, toe-walking), use of objects (like lining up toys or spinning wheels on toy cars), or speech (including echolalia, scripting, or idiosyncratic speech).

2. Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior. For example: extreme distress when small changes are made, difficulties with transitions, greeting rituals, need to eat the same food every day.

3. Highly restricted, fixated interests that are abnormal in intensity or focus, such as preoccupation with unusual objects (attic insulation, or ceiling fans), perseverative interests (wanting to ride an elevator to the point of obsession).

4. Hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment; for instance, visual fascination with lights or movement, unusual adverse responses to specific sounds or textures, excessive smelling or touching of objects,

Symptoms MUST be present in t he early developmental period, although they may not fully manifest or be masked until later in life. Symptoms MUST also cause significant impairment in social, occupational, or other important areas of current functioning.

All that sounds fancy, but what should a parent look for?

Some signs of Autism (although every case of Autism manifests differently; remember, Autism is a spectrum) are:

  • Impairment in social skills.
    • Questions to ask yourself:
    • Does my child respond to his/her name?
    • Does he/she make eye contact?
    • Does he/she show interest in other people?
    • Does he/she play with others or toys appropriately?
  • Impairment in communication.
    • Questions to ask yourself:
    • Does my child use gestures to indicate wants or needs?
    • If he/she speaks, do they speak with correct intonation?
    • If he/she doesn't speak, is he/she compensating by learning other methods?
  • Repetitive behaviors.
    • Questions to ask yourself:
    • Does my child engage in unusual motor movements?
    • If my child speaks, does he/she engage in unusual or repetitive speech?

If you see red flags, or you've checked out DSM-5 diagnostic criteria and you feel that your child may be on the Autism spectrum, what do you do next? Schedule an appointment with your child's pediatrician and have a frank chat. Discuss your child's developmental milestones and if he/she is hitting them. Discuss your concerns with your doctor.

An important thing to note, here, is that a diagnosis is a label that is important for some things and not important for others. It's important for potential insurance coverage and other funding sources for financial help with treatment. It's not important for defining your child as a person.

Leave a Reply

Your email address will not be published. Required fields are marked *