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Autism

History

The word "autism" was first used in the English language by Swiss psychiatrist Eugene Bleuler in a 1912 issue of the American Journal of Insanity. It comes from the Greek word for "self," αυτος (autos). Autism was actually confused with schizophrenia during the early stages of observation. Bleuler used the term to describe the schizophrenics' seeming difficulty in connecting with other people.

However, the classification of autism as a separate disorder or disease did not occur until 1943 when psychiatrist Dr. Leo Kanner of the Johns Hopkins Hospital in Baltimore reported on 11 child patients with striking behavioral similarities and introduced the label "early infantile autism." He suggested the term "autism" to describe the fact that the children seemed to lack interest in other people.

At the same time, an Austrian scientist named Dr. Hans Asperger made similar observations, although his name has since become attached to a different higher-functioning form of autism known as Asperger syndrome.

Autism and Asperger's Syndrome are today listed in the DSM-IV-TR as two of the five pervasive developmental disorders (PDD), which also include Childhood disintegrative disorder, Rett syndrome and Pervasive Developmental Disorder Not Otherwise Specified (or atypical autism). Health care providers also refer to autism spectrum disorders (ASD) which includes only three of those listed in PDD: Autistic disorder, Asperger syndrome, Pervasive Developmental Disorder Not Otherwise Specified. All of these conditions are characterized by varying degrees of deficiencies in communication skills and social interactions, along with restricted, repetitive, and stereotyped patterns of behavior.

Characteristics

On the surface, individuals who have autism are physically indistinguishable from those without. Sometimes autism co-occurs with other disorders, and in those cases outward differences may be apparent.

Individuals diagnosed with autism can vary greatly in skills and behaviors, and their response to sensory input shows marked differences in a number of ways from that of other people. Certain stimulations, such as sounds, lights, and touch, will often affect someone with autism differently than someone without, and the degree to which the sensory system is affected can vary greatly from one individual to another. Persons with autism may possess the following characteristics from the sheet linked Autism

Autistic children may display or fail to display certain behaviors. Some behaviors cited by the National Institute of Child Health and Human Development and listed below may simply mean a normal delay in one or more areas of development, while others are more typical of ASDs—Autistic Spectrum Disorders.

Behaviors

   * does not respond to his/her name.
   * cannot explain what he/she wants.
   * language skills are slow to develop or speech is delayed.
   * doesn't follow directions.
   * at times, the child seems to be deaf.
   * seems to hear sometimes, but not other times.
   * doesn't point or wave "bye-bye."
   * used to say a few words or babble, but now he/she doesn't.
   * throws intense or violent tantrums.
   * has odd movement patterns.
   * is overly active, uncooperative, or resistant.
   * doesn't know how to play with toys.
   * doesn't smile when smiled at.
   * has poor eye contact.
   * gets "stuck" doing the same things over and over and can't move on to other things.
   * seems to prefer to play alone.
   * gets things for him/herself only.
   * is very independent for his/her age.
   * does things "early" compared to other children.
   * seems to be in his/her "own world."
   * seems to tune people out.
   * is not interested in other children.
   * walks on his/her toes.
   * shows unusual attachments to toys, objects, or schedules (i.e., always holding a string   
     or having to put socks on before pants).
   * spends a lot of time lining things up or putting things in a certain order.
   * unconcerned about dangers around him/her (i.e.,standing in the middle of the street 
     without worrying about getting hit by a car).
   * dislikes playing pretend.

Additional information on Social Behavior of students with Autism can be found at http://www.autism.org/social.html

Social development

As infants develop they tend to gaze at people, turn toward voices, grasp at fingers and other objects and smile. However, most autistic children do not:

   Show special interest in faces 
   Seem to have tremendous difficulty learning to engage 
   Lacking the eye contact and interaction with others 
   Do not seek parental attention  
   Prefer being alone 
   Passively accept such things as hugs and cuddling without reciprocating
   Resist attention 
   Lack of social cues 
   Seldom seek comfort from others or respond to parents' displays of anger or affection 

Research has suggested that, despite popular belief, autistic children are attached to their parents. Although this may be difficult for others to pick up because their particular ways of expressing this attachment may differ from the patterns of expression used by their typical peers. Though social deficits are common, autistic children may vary significantly in their levels of social attachment and interaction.

Many children with autism experience social alienation during their school-age years. As a response to this, or perhaps because their social surroundings simply do not "fit" them, many report inventing imaginary friends, worlds, or scenarios. Making friends in real life and maintaining those friendships often proves to be difficult for those with autism.

Sensory system

    Oversensitivity or under reactivity to touch, movement, sights, or sounds
    Physical clumsiness or carelessness
    Poor body awareness 
    Easily distracted
    Impulsive physical or verbal behavior
    An activity level that is unusually high or low
    Not unwinding or calming oneself
    Difficulty learning new movements
    Difficulty in making transitions from one situation to another
    Social and/or emotional problems
    Delays in speech, language or motor skills
    Specific learning difficulties/delays in academic achievement

However, it is important to remember that while most people with autism have some degree of sensory integration difficulty, not every person who has sensory problems is autistic.

Communication

Some people with high-functioning autism demonstrate advanced cognitive ability, but lack the skills or are not inclined to interact with others socially.

Some infants who later show signs of autism coo and babble during the first few months of life, but stop soon afterwards. Others may be delayed, developing language as late as the teenage years.

Sometimes, the body language of people with autism can be difficult for other people to understand. Facial expressions, movements, and gestures may be easily misunderstood. Also, their tone of voice has a much more subtle inflection in reflecting their feelings, and the auditory system of a person without autism.

They struggle to let other's know what they need. They may scream in frustration or resort to grabbing what they want. Communication difficulties may contribute to autistic people becoming socially anxious or depressed or prone to self-injurious behaviors.

DSM Definition

Autism is defined in section 299.00 of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as:

  1. A total of six (or more) items from (1), (2) and (3), with at least two from (1), and one each from (2) and (3):
        1. qualitative impairment in social interaction, as manifested by at least two of the following:
              1. marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction
              2. failure to develop peer relationships appropriate to developmental level
              3. a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest)
              4. lack of social or emotional reciprocity
        2. qualitative impairments in communication as manifested by at least one of the following:
              1. delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)
              2. in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
              3. stereotyped and repetitive use of language or idiosyncratic language
              4. lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level
        3. restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following:
              1. encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
              2. apparently inflexible adherence to specific, nonfunctional routines or rituals
              3. stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements)
              4. persistent preoccupation with parts of objects
  2. Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years:
        1. social interaction
        2. language as used in social communication
        3. symbolic or imaginative play.
  3. The disturbance is not better accounted for by Rett's Disorder or Childhood Disintegrative Disorder.

These are rules of thumb and may not necessarily apply to all diagnosed autistics.

Alternative Definition

Autism is a complex developmental disorder. It affects the brain's normal development of social and communication skills, which is probably due to too few or many brain chemicals called neurotransmitters.

Types of Autism (Alternative Names)

     Autistic disorder/autism spectrum
     Infantile autism
     Autistic-like/autistic tendencies
     High-functioning autism
     Low-functioning autism
     Pervasive developmental delay

Treatment

     No cure
     Constructive activities
     Visual aids
     Learning to communicate by pointing, using pictures or sign language
     Take medications

Applied Behavior Analysis (ABA)[49] is an approach in which tasks are systematically reduced to component parts and then reconstructed through repetition and positive reinforcement. The approach also attempts to identify and analyze behaviors that are harmful or that interfere with learning to ensure they are not reinforced. Ultimately the goal is to help children to succeed and become independent socially and academically.

Causes

Knowing what causes autism is hard to pin point. There is currently no consensus, and researchers are studying a wide range of possible genetic and environmental causes. Since autistic individuals are all somewhat different from one another, there are likely multiple "causes" that interact with each other in subtle and complex ways, and thus give slightly differing outcomes in each individual. Other information on causes can be found at Causes of Autism

Physiology and Neurology

A possible explanation for the characteristics of the syndrome is a variation in the way the brain itself reacts to sensory input and how parts of the brain then handle the information. The study indicated that there were abnormal patterns in the way the brain cells were connected in the temporal lobe of the brain. (The temporal lobe deals with language.) These abnormal patterns would seem to indicate inefficient and inconsistent communication inside the brain of autistic people.

Autism appears to involve a greater amount of the brain. You cannot compartmentalize autism. It's much more complex.