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What is Autism?
Are there varying degrees of Autism? Yes, people may have mild, moderate or severe autism. These designations refer to the degree, (duration, frequency, or intensity) of behaviors when the individual demonstrates autistic characteristics.
What causes Autism? Given the limits of our neurological understanding of autism, it is impossible to point to a single cause of autism. It appears that there are many causes, and research continues. Recent research in neuroanatomy has indicated abnormalities in the brains of individuals with autism. It is still unknown why these areas of the brain develop differently in individuals with autism.
Because of a lack of specific information about what causes this syndrome, some people may be distracted from seeking effective interventions.
What is the difference between Pervasive Developmental Disorder (PDD) and autism? Autism and PDD are behavioral diagnoses. At the present time, there are no medical tests for autism. Autism is diagnosed based on the child's behavior. Both children diagnosed with autism and PDD will benefit from education programs designed for autistics.
It is essential that children diagnosed as PDD receive the same education as children diagnosed with autism. Both autistic and PDD children should be placed into a good early education program immediately after diagnosis. Children diagnosed with PDD tend to fall into two groups: (1) very mild autistic symptoms, or (2) some autistic symptoms in a child who has other severe neurological problems.
Therefore, some children diagnosed as PDD may be almost normal; and others have severe neurological problems, such as epilepsy, microencephaly or cerebral palsy. The problem with the autism and PDD diagnoses is that they are NOT precise. They are based only on behavior. In the future, brain scans will be used for precise diagnosis. Today, there is not any type of brain scan that can be used for diagnosing PDD, or autism.
How is the diagnosis of autism made? The diagnosis is made by a professional experienced in the evaluation of children with developmental disorders. A qualified professional may be a pediatrician, pediatric neurologist, child psychiatrist, or psychologist. The diagnosis is based on a history of the child's development provided by those who know the child well, as well as clinical interview/observation of the child.
At what age can Autism be diagnosed? Although some children show autistic patterns of social interaction almost from birth, it is difficult to give a definitive diagnosis of autism before age three. This is because rates of development in infants and young children are widely variable. Also, autism is frequently accompanied by mental retardation (about 70% of the time). Some behaviors associated with autism are also frequently found in children who are mentally retarded.
This may make it difficult to discriminate between the two conditions, or determine that both conditions are present, in very young children. By the time a child is three or four, cognitive development can be more accurately assessed. At the same time, social development can be more clearly assessed for delay or deviance.
A child's social development can be assessed by observation of the child's pattern of non-verbal interaction with both familiar and unfamiliar people. Parents can help in this assessment by observing and reporting how the child relates (non-verbally) through gestures, facial expression, and eye contact with peers and adults.
What is the difference between Autism and PDD or PDD-NOS? Pervasive Developmental Disorder (PDD) is a category designated by the American Psychiatric Association to indicate children with delay or deviance in their social /language/motor and /or cognitive development. A child may have delays in social development and delays in one or more of the other categories. The profiles of children with a PDD can vary tremendously. PDD is not one disorder but a category that encompasses a wide range of delays of different magnitude in different domains. Autism is the most severe of the pervasive developmental disorders. Autism indicates a primary disturbance in the individual's ability to relate to others. Language delay and cognitive delays are also common.
PDD-NOS represents Pervasive Developmental Disorder-Not Otherwise Specified. This is a diagnosis given to a child who exhibits impairment in the development of reciprocal social interaction, verbal and non-verbal communication, or when stereotyped behavior or activities are present. However, the child does not meet the criteria for any specific pervasive developmental disorder.
What is the best intervention for my child with Autism/PDD? Can Autism be cured? There is no cure for autism at present. There are many kinds of interventions suggested by people and professionals with different degrees of experience with autistic people. Be wary of any intervention that promises a cure or that suggests that the particular method advocated is the only effective approach.
There is data to indicate that the best intervention for autism/PDD is early intensive intervention that utilizes behavioral methods and speech and language therapy to remediate specific deficits.
(*NOTE: Using EEG Biofeedback, Sensory Integration Training, Auditory Integration Training, and Sound Therapy treatment plans that are customized for each patient's individual needs, The Attention & Achievement Center has produced significant improvements in the lives of patients with autism and autistic spectrum disorders.)
What about medication for my child with Autism? There aren't any medications that can cure autism, nor any particular medication that is recommended for individuals with autism. Medications can be recommended to help with very specific target symptoms that are associated with autism. Some of these symptoms might include extreme difficulty attending to the pertinent aspects of the environment or aggression towards self or others.
If I have one child with autism, what are the chances of having another? Current data suggest that the likelihood of having a child with autism, if the biological parents already have one child with autism, is at least 1/20. This rate may be an underestimate, given that many families with one autistic child will stop having children due to stress or the fear of having another child with the disorder.
What is the prognosis for my child with Autism/PDD? Clearly, it is impossible to make a generalization about how any individual child will grow and progress. All children continue to develop, despite delays or the presence of deviant behaviors. Information that we have currently about the progress of adults with autism is based on the treatments these individuals received twenty or thirty years ago.
Our knowledge base about what educational strategies are most effective with these children has increased tremendously over the last ten to twenty years. A child diagnosed with autism will receive much different intervention beginning at an earlier age than was possible many years ago. This means each child's chances for remedying behavior are greater today than years ago.
FREQUENTLY ASKED QUESTIONS ABOUT PERVASIVE DEVELOPMENTAL DISORDERS (PDD)
What are the characteristics that define a diagnosis of a PDD or Asperger's? The characteristics required for a diagnosis of any Pervasive Developmental Disorder are listed in The Diagnostic and Statistical Manual of the American Psychological Association, which was last revised in 1994.
The three major characteristics are: problems in communication or use of verbal language, poor social skills, and a restricted range of interests and repetitive behaviors.
Who is allowed to diagnose a person with Asperger's or PDD? Medical doctors (GP's, psychiatrists, pediatricians) and psychologists are permitted to give a formal diagnosis of any type of PDD. Social workers, therapists, nurses, occupational therapists, and speech-language pathologists may provide a professional opinion as to the likelihood that a child or an individual has the disorder.
Will my doctor have heard about PDD or Asperger's? Most doctors will be familiar with the terms "PDD" and "Autism", however some may not have heard of the labels (such as "Asperger's Disorder") more recently included under the umbrella of PDD in 1994. Physicians who more commonly work with children or adults with developmental delays may be more familiar with Asperger's Disorder. Because the symptoms of Asperger's Disorder are much more subtle than other forms of PDD (such as autism), a diagnosis may be difficult to determine, even if the doctor is familiar with Asperger's Disorder.
Is it possible that more than one person in my family has PDD? Yes it is. Studies are increasingly pointing to a genetic basis for autism and other Pervasive Developmental Disorders. Multiple occurrences of the disorder may occur in the same generation or across generations.
Should I do anything to prepare for my child being assessed? The doctor may want to see any previous assessments that your child has had; if you have them, bring them along to the appointment. Also, as a part of the assessment, developmental milestones will be discussed. It is helpful to think of these beforehand and gather any records you may have (for instance, a baby book that you have recorded milestones). Make a list of the characteristics, problems, or behaviors that are concerning you before the appointment. As well, write out any questions that you may have for the doctor.
What is the process involved in getting a diagnosis from a professional? It depends on the individual completing the assessment and the individual being assessed. Some doctors may not make a diagnosis immediately and will prefer instead to wait and see how a young child progresses over time. Those who are very familiar with PDD conditions may feel confident about making a diagnosis immediately.
During the interview(s) the assessor will want to know the characteristics that are concerning and the child's or adult’s developmental milestones. Standardized tests (such as tests of intelligence and language abilities) may be a part of an assessment, especially if the diagnostician is a psychologist.
My child already has another diagnosis. Will that diagnosis remain if they are diagnosed with PDD? This is a complex question and there may be considerable variation as to how professionals respond to this issue. Sometimes, a diagnosis that is given before a diagnosis of PDD or Asperger's, addresses some of the problems that may be evident (for example, a learning disability or attention deficit problem). However, this label may not account for the whole range of characteristics that a diagnosis of PDD addresses. It is therefore most helpful to think of your child as having the diagnosis which is most inclusive of all the symptoms which s/he exhibits.
If an individual has symptoms which are not explained by a diagnosis of PDD (such as depression or severe anxiety), these labels may be given in addition to a diagnosis of PDD. In this case, they may need special attention in the individual's treatment plan. Most doctors are open to their patients getting a second opinion, and it is your right to do so.
Where can I go to get a diagnosis? Start with your family doctor. They may be able to refer you to a specialist in the field. As well, some local hospitals have specialized clinics for children experiencing developmental, behavior, or mental health problems.
Does it matter if my child is diagnosed with a specific PDD as opposed to PDD NOS? If your child is young (i.e., under three years of age), it may be difficult to determine the specific Pervasive Developmental Disorder that is most appropriate. What is most important, initially, is knowing that your child has some form of PDD; in later years, questions about the specific diagnosis under the umbrella of PDD can be revisited, and the label can be "fine-tuned" if needed.
Will a diagnosis of PDD or Asperger's work against my child in the future? Probably not. Unfortunately, inappropriate use of diagnoses has happened in the past with other childhood disorders and many parents are understandably leery of having their child "labeled". A diagnosis of PDD will hopefully help you to get the most appropriate services and treatment for your child. As well, it is critical that your child's treatment and educational plans are made with this diagnosis in mind.
Who should I tell my child's diagnosis to? Any professional involved with your child (teachers, doctors, social workers, therapists) should know that your child has been diagnosed with PDD. In some cases, if your child is very mildly affected by PDD or Asperger's it may not be necessary to tell others involved with your child (such as camp counselors, swimming coaches, etc.). However, in most cases, telling these people helps them understand your child better and interact more effectively with them.
Now that my child has been diagnosed, what's next? When your child is diagnosed, the most important next step is for you and professionals involved with your child to learn about the many methods of intervention used with individuals with PDD.
FREQUENTLY ASKED QUESTIONS ABOUT AUTISTIC BEHAVIORS Is it autism or is my child being _____? When trying to address specific behaviors, a good place to start is to take into consideration how these behaviors may be the result of the neurological impairments that are associated with autism. From this perspective, parents and teachers can then begin to examine their student’s sensory environment for things that may be causing problematic behaviors.
Things such as fire alarms and school bells may be causing physical pain for someone with autism who has a high degree of sensitivity to high-pitched sounds. Other possible causes of problematic behaviors could be uncomfortable or ill fitting clothes that a student may be asked to wear.
How do I handle my child with autism when he _____? Because of problems with processing and integrating information, many children with autism often exhibit difficult behaviors. To be sure, this can be very challenging for parents and educators.
Various methods and techniques have proven successful towards the reduction of these problematic behaviors. Some of the most effective methods have relied upon the reduction of confusion in the life of the autistic child. This can be achieved through the implementation of consistent structures that children may rely upon to get them through each day.
Techniques using schedule boards that are reviewed and updated each morning have been very beneficial. Confusion also decreases with simple and consistent instructions for the completion of various tasks.
These proactive measures may help reduce the incidence of problematic behaviors. Very often children with autism will respond favorably to environments and tasks that have been designed to match their learning strengths.
Why do children with autism often display these behaviors: compulsiveness, perfectionism, odd movements and a need for organization? Perfectionism, odd movements and a need for organization may be viewed as compensating behaviors that help individuals with autism cope with their various neurological impairments. These compensating behaviors often provide individuals with some much needed stability in a world that may seem very confusing.
What is different about my child's sensory systems? Children with autism may be hyposensitive or hypersensitive in their responses to various sensory inputs. Being hyposensitive may include a high degree of tolerance to pain. This circumstance can be dangerous and should always be considered when children with autism are working around hot surfaces or objects.
Other children with autism may be hypersensitive to pain or refuse to wear anything but loose fitting, soft clothing. This circumstance is often referred to as tactile defensiveness and should be considered whenever touching a child with autism.
Is my child with autism being stubborn? Many children with autism seem to be very stubborn. While that may be true, it is also true that this is a far too simplistic rationale for the behaviors. Keep in mind the role that neurological impairments play in the behaviors of children with autism. What may seem like an example of stubbornness may result from not having understanding or empathy for others. This often results in self-centeredness.
Confusion is common in the lives of children with autism. When steps are taken to help them understand their environment and what is expected of them, it is possible to reduce or replace behaviors that previously seemed to be examples of stubbornness.
Why is Early Intervention important? Both scientific studies and practical experience have shown that the prognosis is greatly improved if a child is placed into an intense, highly structured educational program by age two or three. Autistic children perform stereotypical behaviors, such as rocking or twiddling a penny, because engaging in repetitive behaviors shuts off sounds and sights that cause confusion and/or pain. The problems are that if the child is allowed to shut out the world, his brain will not develop.
(*NOTE: Using EEG Biofeedback, Sensory Integration Training, Auditory Integration Training, and Sound Therapy treatment plans that are customized for each patient's individual needs, The Attention & Achievement Center has produced significant improvements in the lives of patients with autism and autistic spectrum disorders.)
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How can my child be assessed if he/she can not talk?