When people hear the label, “Autism,” they think of the infamous character portrayed by Dustin Hoffman in 1988. They imagine a math genius with a near inability to change his daily schedule, very little ability to communicate, and a seemingly unreasonable level of stress. As always, however, as great as the movie is, it’s not a good portrayal of individuals who have Autistic Spectrum Disorders as a whole. Because of the depth of this subject, I’m going to split this post into two. That way I can cover all that needs to be covered in decent text lengths. Today, we’re going to focus on the definition of Autistic Spectrum Disorders and their symptoms.
So what is the Autistic Spectrum? And why are there multiple disorders? You’ve probably heard of an individual having Autism, but it’s a well-kept secret that there are many, many categories that fall under just one label.
In May 2013, According to Autism Speaks, one of the most influential Autism orgnaizations in the world, the classification system of disorders on the Autistic Spectrum were reorganized to all fit under one umbrella term of ASD – Autistic Spectrum Disorders by the DSM-5 Diagnostic Manual. Basically, a number of disorders that were originally categorized as related but separate disorders are now falling under the same label: Autistic Spectrum Disorders.
Click on image to enlarge.
The National Institute of Neurological Disorders and Stroke define ASD as, “a range of complex neurodevelopment disorders, characterized by social impairments, communication difficulties, and restricted, repetitive, and stereotyped patterns of behavior.” Here are how these disorders are broken up:
Autism Disorder (Classic Autism) – This is the category of Autism that Raymond falls under in the movie, Rain Man. Even though it’s the most severe of the disorders, however, the individuals diagnosed with Classic Autism are on a spectrum of their own, meaning some have mild cases and some have more severe cases. As each of our brains are different, so are all cases of Autism.
Childhood Disintegrative Disorder – The U.S. Library of Medicine defines Childhood Disintegrative Disorder as, “a condition in which children develop normally through age 3 or 4. Then, over a few months, children lose language, motor, social, and other skills that they already learned.” This condition is reported to be similar to Classic Autism, but generally in the more severe form. Intervention is generally similar to that of Classic Autism as well.
Asperger Syndrome – This syndrome is more like Classic Autism than any of the others, however, it’s considered a less severe diagnosis. WebMD says, “…children with Asperger’s syndrome generally have normal intelligence and near-normal language development, although they may develop problems communicating as they get older.” Once again, this is a spectrum disorder, meaning some individuals will display more severe symptoms than others.
*Note Later Added- Aspergers is no longer considered its own diagnosis. The DSM-V recently categorized these children as diagnosable with basic Autism. Many education systems and parents are hesitant to agree to these changes, however.
Rett Syndrome – The Mayo Clinic says Rett Syndrome is, “a rare genetic disorder that affects the way the brain develops. It occurs almost exclusively in girls.” Apparently, most symptoms of Rett Syndrome start to appear around or after children reach six months of age. Some of these symptoms are slowed growth, decreases in coordination, communication, and thinking abilities, unusual hand and eye movements, abnormal breathing, irritability, seizures, and strange, unexpected behaviors. Although this is technically a genetic disorder, it displays traits that are largely Autistic in nature. (While there is no known cure, according to CBS News, they have found hopeful results in their work with restoring the mutated gene in lab mice.)
Pervasive Developmental Disorder-Not Otherwise Specified (PDD- NOS) – The Child Study Center of Yale defines PDD-NOS as, “a ‘subthreshold’ condition in which some – but not all – features of autism or another explicitly identified Pervasive Developmental Disorder are identified.” The article is very clear when it points out that PDD itself isn’t a diagnosis, while PDD-NOS is. (PDD alone is simply the classification of the type of disorder.) Basically, this is what an individual is labeled with when he displays certain symptoms of Autism, but not enough to be fully diagnosed with it. This is probably the mildest of the disorders that are categorized under ASD. Kids with this diagnosis often have the ability to succeed in the world on their own, especially with proper training and help. In fact, in my experience, a good number of people in the world who have this disorder have minor enough problems that they’re never even officially diagnosed. Instead of symptoms, their friends and family simply view their differences as personal quirks.
As I’ve said before, no neurological disorder (or genetic disorder) will show up the same exact way in any two individuals. Why? Everyone’s brain works differently and is constructed to uniquely fit that person. I’ve made this visual representation of a spectrum to give you an idea of what a spectrum is, to show you how individual each person’s diagnosis really is. Not only will that person have the diagnosis of one of the categorized disorders above, but each disorder will have a spectrum like this one, meaning that no matter what disorder an individual has, it can be mild or severe for that disorder. (If I wanted to be really technical, I would have made a spectrum for each disorder I listed above. In consideration of your time [and mine], however, I figured you could just apply this image to each disorder respectively.)
Symptoms and Traits of Individuals with Autistic Spectrum Disorders
- Social Developmental Delay – One of the most prominent features of ASD is the inability to socially interact appropriately with others. In the students and colleagues I’ve known that have ASDs, they often lack the ability to tailor discussions or reactions to social situations appropriately. Their struggles start early, as even babies with an ASD often keep to themselves rather than join groups like most children naturally do. Often, they prefer to be alone (or with adults instead of peers), either because it keeps them from becoming overstimluated, or they simply don’t know how to join a group of friends. This doesn’t mean, however, that they’re not lonely. Medical News Today says, “If the symptoms are not severe, the person with ASD may seem socially clumsy, sometimes offensive in his/her comments, or out of synch with everyone else. If the symptoms are more severe, the person may seem not to be interested in other people at all.” With training, however, (something we’ll discuss in Part II of this post) children with these disorders can generally be worked with to successfully improve their social skills.
- Problems Communicating – Children with ASDs often have break-downs in communication cycles, both in sending and receiving. Many of the children with ASDs don’t have natural inflection when they speak. The monotone voices that many of them speak with can make it difficult to understand what these children are trying to express for the lack of inflection. On the severe end of the spectrums, this lack of communication skills can mean the child might be completely nonverbal or know only a few words; on the milder end, he or she might struggleonly with the more complicated language skills. An example of this is how these children often take everything literally. The social nuances of idioms and expressions are difficult for them to understand, as is humor. It’s not impossible, but it often takes training and practice to teach them how to respond to specific situations and phrases.
- Sensory Problems – According to Science Daily, Albert Einstein College of Medicine at Yeshiva produced the most conclusive study of sensory integration problems linked with Autism. Using brain imaging scans, scientists fed children with and without ASDs different sensory stimuli at different times. They found that in children with ASDs, the brains don’t absorb the stimuli the same way the average children do. In simple terms, this helps explain why children with ASD are often so sensitive to sensory stimuli. Children with ASDs are often bothered by too much light, too much sound (or certain types of sounds like clocks ticking or bees buzzing), certain smells, tastes, or textures. Things that wouldn’t bother the average person can bring someone with an ASD annoyance, tears, or to a tantarum because the stimulation is just more than he can bear. To him, a sound most people might find slightly annoying sounds like a megaphone being blasted in his ear.
- Rigidity – In her article, “Teaching People with Autism/Asperger’s to be More Flexible” by a successful animal science, Temple Grandin, PhD., Grandin says, “Rigidity in both behavior and thinking is a major characteristic of people with autism/AS. They have difficulty understanding the concept that sometimes it is OK to break a rule.” Grandin should know, as she has Autism herself. I know a bit about rigidity myself, as I struggle with it in small doses in my personal anxiety (Click here for my post on Rigidity.), but often, children with Autism or Autistic tendencies take it to a whole new level. I once was working with an elementary aged student who couldn’t find his literacy textbook. Hoping he wouldn’t notice, I gave him the textbook of an absent student. Most students would say, “Thanks,” and begin reading. This student, however, has Aspergers, and instead of taking the book, he nearly had an anxiety attack. He began to flap his arms up and down and pace, saying over and over again, “But this book’s not mine! It has his name in it! I need my book!” Blessedly, one of his classmates located his book. If we hadn’t found the book, it would have been a much bigger problem.
- Unusual, Repetetive Motor Movements – The Center for Disease Control and Prevention says a red flag for children with ASDs is when they perform strange physical behaviors, such as arm flapping, rocking their bodies back and forth, or spinning in circles. Something also common to children with ASDs is toe walking, where the child walks on the balls of his feet instead of placing the whole foot on the ground like average children do. The Autism Reasearch Institute’s article, “Toe Walking,” by Stephen M. Edelson, Ph.D., says, “A dysfunctional vestibular system, a common problem in autism, may be responsible for toe walking. The vestibular system provides the brain with feedback regarding body motion and position.”
- Obsessions – The Mayo Clinic lists Obsessions as one of the top symptoms of children with Aspergers. The obsessions apply to Classic Autism as well. The Mayo Clinic describes these as, “Showing an intense obsession with one or two specific, narrow subjects, such as baseball statistics, train schedules, weather or snakes.” My mother, who’s taught grades three through eight over the last fifteen years, has had students with ASDs who’ve had obsessions with everything from Star Wars to plumbing. These obsessions go far beyond what you might consider simply “nerd-like.” Children with these obsessions will think about their particular topics of choice nearly non-stop, and will talk about them as much as possible without noticing that their obsessions are driving away peers or annoying adults.
- Low Muscle Tone – According to Autism Society, “About 30 percent of children with autism have moderate to severe loss of muscle tone, which can limit their gross and fine motor skills.” I’ve seen this in children I’ve interacted with. While the low muscle tone doesn’t mean these children can’t succeed in physical sports and activities, it means that physical activities will often be more difficult for them than for other children. This doesn’t mean, however, that these children should avoid physical activity. On the contrary, physical activity is incredibly good for these kids, as it can help them rebuild and maintain muscle tone. Physical therapy can be helpful if coordination and strength are lacking enough.
- High Comorbidity with other Disorders – Autism-help.org reports that most children diagnosed with an ASD will experience comorbidity with other disorders. Comorbidity is where more than one disorder occurs in an individual simultaneously. My Tourette’s is comorbid with my OCD tendencies. Children with an ASD are often diagnosed with other disorders, such as ADHD, Tourette’s or a Tic Disorder, OCD, Seizures, General Anxiety Disorder, Depression, Learning Disabilities, or Gastrogenteritis. Remember, however, that these aren’t guarenteed. They’re simply disorders that tend to occur with many cases of ASDs. Just because someone has an ASD doesn’t necessarily mean he will have another disorder that goes along with it.
Scientists are nowhere near nailing down Autistic Spectrum Disorders, but we’ve learned about these disorders by leaps and bounds in these last few decades. With the large amounts of information we share through scientific journals, books, online chat rooms, and personal blogs, we’re able to share knowledge more than we ever have before. Please join me later this week for the second part of my post on Autistic Specturm Disorders. In Part II, we’re going to be discussing the causes of Autism, as well as treatments and outlooks for life.
What about you? What experiences have you had with Autistic Spectrum Disorders, or what questions do you have about them? Please comment in the Comment Box below. And don’t forget you can receive extra resources that I don’t include in my posts, and information on neurological disorders, education, and inspiration (as well as a thank you gift for subscribing!) if you sign up for my weekly newsletter