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Autism Spectrum Disorder

AUTISM SPECTRUM DISORDERS

Autism is a developmental disability that affects communication, social interaction, and patterns of behavior. Autism is four times more common with males than females. Signs of autism are usually seen by age 3, for some children as early as 18 months. Autism Spectrum disorders (ASD) can range from severe to more a more milder form (Asperger syndrome). Sometimes the diagnosis of ASD is delayed because teachers or doctors believe the child is just “a little slow” and will catch up.

Children who are diagnosed with ASD demonstrate atypicality in 3 areas: 1) social interaction, 2) verbal and nonverbal communication, 3) repetitive behavior or interests. Each of these atypical behaviors can range from mild to severe. Each child may experience different effects. Children with this disability may follow typical child development patterns for the first year or so and then show less typical patterns. Some children with ASD find it hared to engage in the give and take of everyday social interaction and are not able to play with other children. It can also be hard for some people with ASD to regulate their emotions. Some children do not speak and some become very disturbed if a routine is interrupted in any way. Many children with ASD experience increased sensitivity as the brain seems unable to balance the senses. Facial expression, movements, and gestures may not match verbal communication. Tone of voice is sometimes high-pitched, or flat and robot-like. Tone of voice may not match emotion. Frustration, anxiety and depression may occur as children become more aware of their difficulties in communicating with others.

Generally, diagnostic evaluation is made by a multidisciplinary team including a psychologist, a neurologist, psychiatrist, a speech therapist, a social worker, or other professionals who diagnose children with ASD. Children with ASD are guaranteed special education and services under the Individuals with Disabilities Education
Act (IDEA) and public schools must develop an Individualized Education Program (IEP) to meet the child’s needs. Early intervention is important in identifying child and family needs and building on the child’s and family’s strengths. Intervention can help build communication and social interaction skills. In middle and high school years, services can help address work, living, and recreation activities.

Reference
National Institute of Mental Health
Http://www.nimh.nih.gov/publicat/autism.cfm

Asperger’s Syndrome is a life-long neurobiological disorder. Due to many common characteristics, it is often considered to be an Autism Spectrum disorder although the debate goes on as to whether it should be classified separately. First mentioned by Hans Asperger in 1944, this disorder was not commonly diagnosed until the mid 1990’s. Individuals with Asperger’s Syndrome are typically on the average to high end of the intellectual scale. According to Dr. R. Kaan Ozbayrak in A Guide for Parents, the prevalence rate for this disorder is 36/10,000 , typically affecting males much more frequently than females (4:1). There is current evidence that genetics plays a part in the occurrence of this disorder. Some famous people thought to have Asperger’s include Albert Einstein, Thomas Edison, Leonardo da Vinci, and Beethoven.

Individuals with Asperger’s vary greatly both in the characteristics of their disorder and in it’s severity. According to the DSM-IV-TR, criteria for the disorder are qualitative impairments in social interaction and restricted repetitive and stereotyped patterns of behavior, interest, and activities causing significant impairment in social, occupational, or other important areas of functioning with onset occurring before the age of three. It is important to note here that not all individuals consider this to be a disorder. Some refer to those without the disorder as “neuro-typical” individuals and themselves as “Aspies”.

Diagnosis is usually made based on a combination of early developmental history, displayed behaviors, and reports from parents, caregivers, and other involved entities. Since diagnosis of this disorder is fairly recent and the first to be diagnosed were children, many adults were either not diagnosed, or misdiagnosed. Criterion for diagnosis in adults is still being developed. It is not uncommon for those with Asperger’s to have a dual diagnosis of Depression and/or Anxiety disorders.

Characteristics vary with difficulty with social relationships being a commonality. Children will benefit from Social Skills Training. In addition to problems with social interaction, individuals often have problems reading non-verbal cues, are concrete not abstract thinkers, and are oversensitive to stimuli (i.e.: noise, taste, smell, and feel). Stimuli may become overwhelming for the individual resulting in inappropriate behaviors. It is important to have a “safe” spot where the individual may retreat to when they feel overwhelmed. Making eye contact may be difficult especially in the case of children. Their preoccupation with certain interests/activities may lead to them being considered by others as rude, geeks, or bores. It is through these very same limited interests/activities that many attempt to communicate. Theses interests/activities may therefore be used as an affective means of “connecting” with the client.

Adults have often learned to use their strengths to mask different aspects of their disorder. Adults often run into problems in understanding emotions (theirs and/or others), in work and intimate relationships, social situations, etc. One individual stated that he “learned” how to appropriately respond in social situations, but could not apply that to close relationships where emotions came into play. Adults’ limited focus of interests/activities often influences their choice of employment. Inability to remain in this general area becomes more of a crisis for these individuals than the majority of the population. As with children, the effort of attempting to appear “normal” may be emotionally and physically exhaustive.

Since this is a neurobiological disorder with individuals ranging from average to gifted intelligence, their disability is not as apparent to most individuals as a physical disability. It is difficult for parents, teachers, and others to understand how someone who is so intelligent and knowledgeable in certain areas has issues/difficulties with others. For example, there may be strengths in areas of verbal ability with weaknesses in non-verbal areas. The important thing to remember is that everyone is an individual with different strengths and weaknesses. Everyone has their own special gifts. Building on these strengths along with Social Skills training are important aspects of working with individuals with Asperger’s.