Most of my blog posts are based on my home life, but sometimes I like to tap into my career, too. I graduated in 2008 with a doctorate in education. I majored in special education with a minor in autism. This week, I will be reviewing a book regarding sensory processing disorder and writing a separate post about seeking sensory input, so I thought I would introduce this topic by providing an overview of some of the basic characteristics of autism.
The DSM-V was released earlier this year, with updated criteria and information regarding autism. This is written from a very academic/professional perspective and is not user-friendly as it contains excessive jargon. I am going to take what the DSM-V provides, simplify the descriptions, and provide concrete examples. As with all my blog posts, please feel free to ask any questions in the comments below.
Let me begin by explaining the following:
1. Everyone, to some degree, exhibits autistic-like behaviors. This does not mean everyone should be diagnosed with autism. If the behaviors do not inhibit an individual’s ability to function independently (at his/her developmental level), you may not need to be concerned. Alternately, an individual can be diagnosed with autism without exhibiting every symptom described below. If you have any doubts/questions, seek out professional guidance.
2. Autism is a spectrum disorder. Some individuals rely on the assistance of others for all aspects of daily living, while other individuals with autism are multi-millionaires, running successful corporations. There is no “face” of autism.
3. Quick overview…Autism and Asperger’s were both identified independently of one another in the 1940s by two Austrian researchers. The incidence then was much lower than now. Even during my childhood, autism was identified in about 1 in every 10,000 individuals. Now, according to the Center for Disease Control, approximately 1 in every 88 children is diagnosed with autism (and it happens 5 times as often in boys than girls). We can endlessly debate if this is due in part to over-diagnosis, better diagnostic tools, and about a zillion other factors, but that doesn’t change the numbers that we see.
So…how do you know if your child exhibits signs of autism? Here’s a breakdown of the characteristics divided into 5 categories:
I. Deficits in verbal and non-verbal communication.
- Difficulty with social interactions – Individuals with autism may appear to be socially-awkward. Some individuals will approach anyone and initiate a conversation, without following the guidelines of typical social exchanges, while other individuals with autism are incredibly reserved and attempt to avoid socializing as often as possible. The language used in conversation may appear to be too elevated for the particular conversation. Additionally, children with autism often lack play skills, such as understanding the rules of the game, turn-taking, sharing, engaging in imaginative play, appropriate toy use, etc.
- Difficulty with non-verbal communication – Everyone seems to associate poor eye contact with autism. I have known countless individuals with autism who make typical eye contact. Reading nonverbal cues may be different, though. This refers to reading facial expressions and gestures and understanding that body language can relay thoughts and emotions. This is often addressed through social skills training, which can bring awareness to non-verbal cues that are used to communicate.
- Difficulty in maintaining relationships. Individuals with autism tend to lack empathy, the ability to relate to and understand the emotions and thoughts of others. They are often unable to see that the individual who they are attempting to engage may not enjoy playing certain games, discussing particular topics, etc.; may not understand the give and take ‘rules’ of friendship; may lack interest in pursuing meaningful friendships altogether.
II. Repetitive behaviors, interests, and/or activities.
- Repetitive motor movements and/or language – Individuals with autism tend to engage in repetitive behaviors (this may be referred to as “stimming”). This can include flapping hands, opening/closing doors, spinning items, and similar behaviors. They may also engage in repetitive language. This may be repeating something right after it is said, repeating the same phrase multiple times later on, or repeating portions of TV shows, movies, commercials, etc. at times that do not seem to be logical or to convey real meaning.
- Difficulty handling change; enjoying the same routine. Children with autism desire a need for sameness. Transitions and new activities are very challenging for children with autism. The child may tantrum during transitions and when faced with change. They tend to be rigid in their thinking, and any changes to a schedule or routine may take a great deal of preparation beforehand and adjustment afterwards.
- Limited interests. Children with autism tend to perseverate over one item, character, show, movie, activity, etc. They will probably want to talk about it frequently and may carry something representing that interest often. For example, a child who likes Spongebob may talk about episodes or recite portions of episodes and carry around a Spongebob keychain. They tend to be drawn to technology as well, so a tablet, laptop, or video game system may be what a child prefers for entertainment.
- Hyper- or hyposensitivity to different types of sensory input. This section on its own can be an entire blog, but here’s a very brief overview. We have 7 sensory systems: olfactory (smell), visual (sight), auditory (hearing), gustatory (taste), tactile (touch), proprioceptive (understanding the position of the body in regard to other bodies/object), and vestibular (motion). Children with autism may be overly-sensitive in some ways, under-sensitive in other ways. This could mean the child is sensitive to loud noises (and regulates this by covering his/her ears), but does not feel pain in the same way others do (children seem unfazed by injuries unless they are very painful). A child may appear to be hesitant to explore new textures, either through touch or taste, but enjoys a lot of physical input, like tight hugs and deep-pressure massages. Children with autism tend to be ‘clumsy’ because they are unaware of where their bodies are in relation to others/objects. They also may appear to have low muscle tone, which is evident in different fine and gross motor skills/activities (e.g. poor handwriting, w-sitting on the floor, lack of coordination when playing sports and dancing, etc. )
III. Symptoms begin in young children (but perhaps not to the same degree as when children begin to mature). More severe cases of autism are generally diagnosed before a child enters preschool, but higher-functioning individuals may not be recognized until after the child enters elementary school.
IV. Symptoms affect an individual’s ability to function socially, at school, at work, and in other important areas. We can look at this as the individuals daily living skills and adaptive behaviors. Does the individual require more assistance to participate in everyday tasks? Do the behaviors associated with an individual’s diagnosis of autism impact his ability to navigate his environment, interact with others, complete assignments, etc?
V. Symptoms are not just based on a developmental delay or result of another type of impairment. While co-morbidities do exist (individuals who have multiple impairments, one of which is autism), the symptoms described above must be a direct result of the individual’s autism and not a separate impairment. This is where we can differentiate between delayed development and atypical development. While individuals may have mild to severe developmental delays, they also develop in a manner that is atypical.
In having both of my children evaluated (one for her atypical speech, the other for his gross motor delays), there is no harm in having your child evaluated. It’s a lot to accept, but at least you can receive feedback and possibly services. And if you disagree with the diagnosis and/or suggested services, you can go to a different professional to seek out more information and decline services.
Wow, that was a lot to write! Do not hesitate to ask any questions and I will try to direct you to the appropriate sources. I hope someone out there finds this helpful — if you do, please share it.