1. What is Autism Spectrum Disorder (ASD)?
Autism Spectrum Disorder, also referred to as autism, is a neurological disorder which causes developmental disability. Autism affects the way the brain functions, resulting in difficulties with communication and social interaction, and unusual patterns of behaviour, activities and interests.
There are, in fact, five Autism Spectrum Disorders described under the diagnostic category of Pervasive Developmental Disorders (PDD) that appear in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) of the American Psychiatric Association.
The term "spectrum" refers to a continuum of severity or developmental impairment. Children and adults with ASDs usually have particular communication, social and behavioural characteristics in common, but the conditions cover a wide spectrum, with individual differences in:
- Number and particular kinds of symptoms
- Severity: mild to severe
- Age of onset
- Levels of functioning
- Challenges with social interactions
When speaking of ASDs, most people are referring to three of the PDDs that are most common:
- Autistic Disorder (also called "autism" or "classic autism" or "AD")
- PDD-NOS (Pervasive Developmental Disorder - Not Otherwise Specified)
- Asperger's Disorder (also called "AS", "Asperger's Syndrome" and "Asperger Syndrome")
There is no standard "type" or "typical" person with an Autism Spectrum Disorder. More on ASDs...
The term "autism" is often used in two different ways. It is used to refer specifically to Autistic Disorder and it is also used more generally to refer to all Autism Spectrum Disorders.
Autistic Disorder usually appears during the first three years of life and is four times more common in boys than girls. Asperger Syndrome is often diagnosed later, once a child reaches school age. In general, ASDs occur in about 1 in 88 children. Autism is not related to race, ethnicity, family income, lifestyle or parenting.
People with ASDs develop differently from others in the areas of motor, language, and cognitive and social skills. Each person with an ASD is unique and will have different abilities. "Symptoms" or disabilities caused by ASDs might be very mild in one person and quite severe in another. Here are some examples of common types of characteristics and behaviours in a child or adult with an ASD:
Difficulty with Social Skills
- Some people with ASDs show no interest in other people
- Others might be interested in people, but not know how to talk, play with, or relate to them
- Initiating and maintaining a conversation is usually difficult for people with ASDs who are verbal
Problems with Communication
- Speech and language skills may begin to develop and then be lost, or they may develop very slowly, or they may never develop. Without appropriate intensive early intervention about 40% of children with ASDs do not talk at all
- People with ASDs might not be able to interpret non-verbal communication such as social distance cues, or the use of gestures and facial cues that most of us take for granted
Repeated Behaviours and Restricted Interests
- People with ASDs may have repeated ritualistic actions such as spinning, repeated rocking, staring, finger flapping, hitting self, etc.
- Small changes in the environment or in daily routines that most people can manage might trigger acute distress
- They may have restricted interests and seemingly odd habits. They may talk about or focus obsessively on only one thing, idea, or activity
Unusual Responses to Sensations
- People with ASDs may have both auditory and visual processing problems
- Sensory input may be scrambled and overwhelming
- Sensory problems vary in autism, from mild to severe with over and under-sensitivities
Some Co-occurring Conditions
- Neurological disorders including epilepsy
- Gastro-intestinal problems
- Fine and gross motor deficits
- Anxiety and depression
ASDs are diagnosed in a variety of ways, using a number of different measures and screening tools. A diagnosis of an ASD depends on the number and pattern of typical characteristics. It is based on observation of specific behaviours and disabilities by a multidisciplinary team of doctors and other professionals trained in autism diagnosis.
Parents, family members or other caregivers of children with ASDs are often the first to notice delays in the usual childhood developmental milestones or differences in the ability to speak, make eye contact, play with other children or interact socially.
Autism sometimes goes unnoticed or undiagnosed in both children and adults, especially when it is a mild case or when the person has other disabilities or health problems. In some high functioning individuals, ASDs may go unnoticed for years.
It may only be diagnosed during an educational impasse or a life crisis which puts a person in contact with professionals able to recognize the disorder.
Autism varies widely in its severity and symptoms. An accurate diagnosis and early identification greatly improve the chances of establishing appropriate educational supports and any necessary treatments and interventions.
The cause or causes of ASDs are still unknown. Classic Autism was first recognized in 1942 by Dr. Leo Kanner at John's Hopkins Hospital. At nearly the same time, an Austrian psychologist, Hans Asperger, described a similar group of patients. ASD has been recognized as a medical disorder only in modern times, but there are many historical accounts indicating that autism existed long before the 20th century.
It is generally accepted that ASD is a neurological disorder. Parenting styles do not cause children to have ASDs. Today research around the world focuses on possible causes such as genetics, differences in biological brain function, pre- and post-natal brain development, environmental factors, viral infections and immune responses and deficiencies. Many possible causes are being investigated.
The term "autism" is frequently used as a catch-all term for a wide variety of symptoms, disabilities and special abilities. There are people with Asperger Syndrome, "high functioning" autism and PDD-NOS who may enjoy a very high level of functioning and who may need little or no special treatment or educational programming.
In contrast there are many families who have children with seriously debilitating autism conditions who suffer deeply from a myriad of communication, behavioural, sensory and physical symptoms - children who will never reach their full potential without intensive support, special educational programming and effective evidence-based treatment.
Early scientifically validated effective treatment can lead to great improvement for many people with autism. Without appropriate individualized treatment, many people with autism will not develop effective communication and social skills and will continue to experience serious behaviour and learning difficulties.
In order to choose the right treatment, interventions and other supports for children and adults with ASDs, (from early childhood onward) people with ASDs, parents, families and service providers will need to become well informed about the resources that are available.
Careful on-going assessment of the needs and individual strengths and weaknesses of the person affected by ASD will be key. The availability and accessibility of effective evidence-based treatments and interventions will also be critical. We do not believe that any one single treatment, intervention or program will benefit all people with an ASD. We support professional ABA/EIBI-based treatments and educational approaches because these treatments are based on scientifically validated research and have been shown to be effective for many people.
In general, those ASD conditions that cause disabling medical, behavioural and communication problems can be alleviated with some combination of elements of the following kinds of interventions:
- Behaviour analysis and intervention
- Social and play related interventions
- Assistance with communication
- Sensory integration and motor skills therapy
- Biomedical approaches
- Life-skills building
- Counseling and other therapies
Like other persons with disabilities, people with autism conditions are becoming more organized and are speaking out about their lives and their rights as disabled individuals. There are an increasing number of support groups run by and for adults with autism, both on-line and in support group settings.
Helpful resources for people with ASD can also be found in our "Resources near you" section. Check listings for professionals and services that might help. And finally, our Blog is filled with helpful articles and information, use the "search" box to find exactly what you're looking for.