Overview of Autism

Autism is a severely handicapping biological disorder characterized by extreme self-preoccupation and withdrawal from reality. It begins at birth or within the first 3 years of life. Autistic characteristics will vary dependent on the individual and the severity of the autism. It is the result of a neurological disorder and it affects functioning of the brain.  The rate of autism has increased enormously in the past 10 years where previously it was occurring in 10 children per 10,000 live births, some studies are showing the prevalence as high as 60 per 10,000. It is four times more prevalent in boys than girls and knows no racial, ethnic or social boundaries. Family income, lifestyle or educational levels do not affect the chance of occurrence. The reasons for the increase are being debated, but the most likely cause appears to be the over vaccinations of infants.

Autism interferes with the normal development of the brain in areas which control verbal and nonverbal communication, social interaction, and sensory development. Children or adults with autism may exhibit repeated body movements such as hand flapping and rocking, show unusual responses to people or attachments to objects, and resist changes in routine. In some cases, aggressive and/or self-injurious behavior may be present.
Autism is often referred to as a spectrum disorder, meaning the symptoms and characteristics of autism can present themselves in a wide variety of combinations, from mild to severe. Although autism is defined by a certain set of behaviors, children and adults can exhibit any combination of the behaviors in any degree of severity. Two children, both with a diagnosis of autism, can act very differently from one another.

Two common characteristics they may exhibit include arching their back away from their caregiver to avoid physical contact and failing to anticipate being picked up (i.e., becoming limp). As infants, they are often described as either passive or overly agitated babies. They may be quiet most of the time making little demands on their parents or they may be overly agitated where they cry continuously during their waking hours. 

In the first few years of life, some autistic toddlers reach developmental milestones, such as talking, crawling, and walking, much earlier than the average child; whereas others are considerably delayed. Approximately two-thirds of autistic children develop normally until somewhere between 1 1/2 to 3 years of age; then autistic symptoms begin to emerge. These individuals are often referred to as having 'regressive' autism. Some people in the field believe that vaccinations, exposure to a virus, or the onset of seizures may be responsible for this regression. 

During childhood, autistic children may fall behind their same-aged peers in the areas of communication, social skills, and cognition. In addition, dysfunctional behaviors may start to appear, such as self-stimulatory behaviors (i.e., repetitive, non-goal directed behavior, such as rocking, hand-flapping), self-injury (e.g., hand-biting, head banging), sleeping and eating problems, poor eye contact, insensitivity to pain, hyper-/hypo-activity, and attention deficits.

Autistic individuals sometimes have difficulty with the transition to puberty. Approximately 20% have seizures for the first time during puberty which may be due to hormonal changes. In addition, many behavior problems can become more frequent and more severe during this period. However, others experience puberty with relative ease.

In contrast to 20 years ago when many autistic individuals were institutionalized, there are now many flexible living arrangements. Usually, only the most severe individuals live in institutions. In adulthood, some people with autism live at home with their parents; some live in residential facilities; some live semi-independently (such as in a group home); and others live independently. There are autistic adults who graduate from college and receive graduate degrees; and some develop adult relationships and may marry. In the work environment, many autistic adults can be reliable and conscientious workers. Unfortunately, these individuals may have difficulty getting a job. Since many of them are socially awkward and may appear to be 'eccentric' or 'different,' they often have difficulty with the job interview.

Treatment Options

Click here to be taken to the Autism Society of America, treatment options overview.

Applied Behavior Analysis and Other Skills-Based Therapies

Applied Behavior Analysis (ABA) is one of the more popular skills-based therapy.  It consists of teaching skills by breaking them down into small steps and teaching one step at a time, rewarding correct responses. Most people have heard of the Lovaas method, an intensive ABA program developed by Dr. O.I. Lovaas at the University of California, Los Angeles.

Methods of ABA include; verbal behavior therapy and task analysis.

Other skill-based therapies include:

• Discrete Trial Teaching (DTT), which uses an instruction-prompt-response-reward pattern to help people with autism learn complex tasks.
  
• In the early 1970s, Eric Schopler, a professor of psychology at the University of North Carolina, created a program for the Treatment and Education of Autistic and Communication Handicapped Children.  Known more commonly by its acronym, TEACCH, the program emphasizes teaching functional skills and modifying the teaching environment to support the needs of the individual. Vocational preparation is an important part of the program. Note: the visual strategies used are effective with the visual learners, but may not be as useful for auditory learners.
  
• The Picture Exchange Communication System (PECS), a method devised to help nonverbal autistic people to communicate. At the first level of PECS, a person may use picture icons to request a desired item. The pictures can also be used to help individuals learn attributes such as colors and numbers, or how to form sentences.  The system is also used to help regulate behavior and schedule activities.