Autism is a complex developmental disability that typically appears during the first three years of life. “It is the result of a neurological disorder that affects the functioning of the brain and impacts the normal development of the brain in the areas of social interaction and communication skills” (Bee & Boyd 226). Children and adults with autism typically have difficulties in verbal and non-verbal communication, social interactions, and leisure or play activities. The overall incidence of autism is consistent around the globe, but is four times more prevalent in boys than girls.
Autism knows no racial, ethnic, or social boundaries, and family income, lifestyle, and educational levels do not affect the chance of autism’s occurrence” (Frith 85) Autism is one of five disorders coming under the umbrella of Pervasive Developmental Disorders (PDD), a category of neurological disorders characterized by “severe and pervasive impairment in several areas of development,” including social interaction and communications skills (Zager 26). “Autism is the most common of the Pervasive Developmental Disorders, affecting an estimated 2 to 6 per 1,000 individuals” (Wetherby 143).
This means that as many as 1. 5 million Americans today are believed to have some form of autism. While understanding of autism has grown tremendously since Dr. Leo Kanner first described it in 1943, most of the public, including many professionals in the medical, educational, and vocational fields, are still unaware of how autism affects people and how they can effectively work with individuals with autism. Contrary to popular understanding, many children and adults with autism may make eye contact, show affection, smile and laugh, and demonstrate a variety of other emotions, although in varying degrees.
Like other children, they respond to their environment in both positive and negative ways. Every person with autism is an individual, and like all individuals, has a unique personality and combination of characteristics. Some individuals mildly affected may exhibit only slight delays in language and greater challenges with social interactions. The person may have difficulty initiating or maintaining a conversation. Communication is often described as talking at others (for example, talking in the form of monologue, allowing no interjecting comments from the other party).
For children with autism, sensory integration problems are common. Their senses may be over-or under-active. The fuzz on a peach may actually be experienced as painful or the smell may make the child gag. Some children with autism are particularly sensitive to sound, finding even the most ordinary daily noises painful. “Many professionals feel that some of the typical autism behaviors are actually a result of sensory integration difficulties” (Mesibov 59) There is no known single cause for autism, but it is generally accepted that it is caused by abnormalities in brain structure or function.
Brain scans show differences in the shape and structure of the brain in autistic versus non-autistic children. Researchers are investigating a number of theories, including the link between heredity, genetics and medical problems. In many families, there appears to be a pattern of autism or related disabilities, further supporting a genetic basis to the disorder. While no one gene has been identified as causing autism, researchers are searching for irregular segments of genetic code that autistic children may have inherited.
It also appears that some children are born with a susceptibility to autism, but researchers have not yet identified a single “trigger” that causes autism to develop. Other researchers are investigating the possibility that under certain conditions, a cluster of unstable genes may interfere with brain development resulting in autism. Still other researchers are investigating problems during pregnancy or delivery as well as environmental factors such as viral infections, metabolic imbalances, and exposure to environmental chemicals.
Whatever the cause, it is clear that children with autism and PDD are born with the disorder or born with the potential to develop it. Bad parenting does not cause it. Autism is not a mental illness. Children with autism are not unruly kids who choose not to behave. Furthermore, no known psychological factors in the development of the child have been shown to cause autism. There are no medical tests for diagnosing autism. “An accurate diagnosis must be based on observation of the individual’s communication, behavior, and developmental levels” (Cohen 103).
However, because many of the behaviors associated with autism are shared by other disorders, various medical tests may be ordered to rule out or identify other possible causes of the symptoms being exhibited. A brief observation in a single setting cannot present a true picture of an individual’s abilities and behaviors. Parental (and other caregivers’) input and developmental history are very important components of making an accurate diagnosis. At first glance, some persons with autism may appear to have mental retardation, a behavior disorder, and problems with hearing, or even odd and eccentric behavior.
To complicate matters further, these conditions can co-occur with autism. However, it is important to distinguish autism from other conditions, since an accurate diagnosis and early identification can provide the basis for building an appropriate and effective educational and treatment program. While there is no one behavioral or communications test that can detect autism, several screening instruments have been developed that are now used in diagnosing autism. CARS rating system (Childhood Autism Rating Scale), developed by Eric Schopler in the early 1970s, is based on observed behavior.
Using a 15-point scale, professionals evaluate a child’s relationship to people, body use, adaptation to change, listening response, and verbal communication. The Checklist for Autism in Toddlers (CHAT) is used to screen for autism at 18 months of age. It was developed by Simon Baron-Cohen in the early 1990s to see if autism could be detected in children as young as 18 months. The screening tool uses a short questionnaire with two sections, one prepared by the parents, the other by the child’s family doctor or pediatrician.
The Autism Screening Questionnaire is a 40 item screening scale that has been used with children four and older to help evaluate communication skills and social functioning. The Screening Test for Autism in Two-Year Olds, being developed by Wendy Stone at Vanderbilt, uses direct observations to study behavioral features in children under two. She has identified three skills areas – play, motor imitation, and joint attention – that seem to indicate autism. A 1996 survey conducted by the ICR Survey Research Group showed that at least one individual in 20 percent of U. S. useholds is a caregiver, either part-time or full-time.
Planning for the future of people with disabilities is something they and their families/caregivers must tackle, and the sooner the better. Whether the person with special needs is 4 or 40 years old, it is imperative that families create a plan (Volkmar 111). “Despite the growing number of persons with developmental disabilities in this country, less than 20 percent of families have done any planning” (Volkmar 111). Isolated in worlds of their own, people with autism appear indifferent and remote and are unable to form emotional bonds with others.
Although people with this baffling brain disorder can display a wide range of symptoms and disability, many are incapable of understanding other people’s thoughts, feelings, and needs. Often, language and intelligence fail to develop fully, making communication and social relationships difficult. Many people with autism engage in repetitive activities, like rocking or banging their heads, or rigidly following familiar patterns in their everyday routines. Some are painfully sensitive to sound, touch, sight, or smell. However, there is help and hope.
Gone are the days when people with autism were isolated, typically sent away to institutions. Today, many children with autism can be helped to attend school with other children. Methods are available to help improve their social, language, and academic skills. Even though more than 60 percent of adults with autism continue to need care throughout their lives, some programs are beginning to demonstrate that with appropriate support, many people with autism can be trained to do meaningful work and participate in the life of the community.