Wednesday 12 September 2012

What is Autism?

Autism is defined behaviorally by symptoms that appear prior to age 3. According to the Diagnostic Statistical Manual ( IV) the criteria for diagnosing Autism are abnormal or delayed development in 3 areas:

1) Impairment and delays in Social Interaction (Social Skills)
2) Qualitative impairment and delays in communication ( Language)
3) Restrictive, repetitive and stereotyped patterns in behavior ( Behavior Repertoire)

Under these three categories there are sub categories as described below. In order to meet the criteria for autism, there has to be a total of of six (or more) items from (1), (2), and
(3), with at least two from (1), and one each from (2) and (3):

A total of 6 or more items is required to meet the criteria for Autism in

 1) Impairment and delays in Social Interaction (Social Skills) ( at least 2 from this category)

(a) 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 (e.g., not reponding to name everytime her/his name is called, does not make eye contact)

(b) failure to develop peer relationships appropriate to developmental level. (e.g., your child tends to play by himself/herself in a situation where there are other children present or engage in tantrum behavior when peers initiate play)

(c) a lack of spontaneous seeking to share enjoyment, interests, or achievements with other
people (e.g., by a lack of showing, bringing,lack in joint attention, or pointing out objects of interest)

(d) lack of social or emotional reciprocity (e.g., does not like hug, tickles, or show empathy when another child is crying)


 2) Qualitative impairment and delays in communication ( Language) (at least 1 from this category)

(a) 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)

(b) in individuals with adequate speech, marked impairment in the ability to initiate or sustain a
conversation with others

(c) stereotyped and repetitive use of language or idiosyncratic language (e.g., saying the same word, scripting from movies, making unusual sounds)

(d) lack of varied, spontaneous make-believe play or social imitative play appropriate to
developmental level


3) Restrictive, repetitive and stereotyped patterns in behavior ( Behavior Repertoire) (at least 1 from this category)

(a) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that
is abnormal either in intensity or focus (e.g., lining up objects, spinning object in the same way, not playing with toys appropriately)

(b) apparently inflexible adherence to specific, nonfunctional routines or rituals (e.g., engages in tantrum behavior when going from one place to the next)

(c) stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting or complex
whole-body movements)

(d) persistent preoccupation with parts of objects (e.g., constantly playing with the same toy in the same way)

If you read this and think your child has autism, please contact your local pediatrician immediately. Your pediatrician can refer you to someone who can conduct a formal assessment and refer you to a provider that can provide effective treatment. The earlier intervention is sought, the more likely your child will improve. There is no cure for autism but with effective treatment and intervention, your child's autism can improve and in some cases the diagnosis can be taken away.

In choosing a treatment, feel empowered as a parent to take your time and do some research to see what is out there. Like I always say, the best treatments are the ones that report all their outcomes and evidence. Some treatments do report outcomes and evidence but they may not be socially valid, reliable or make any behavior improvements over time.

Please make yourself aware and be aware of fad treatments. Fad treatments claim to "Cure" autism and make your child better. Till date, there is no known cause for autism. There is no cure for autism. Choosing an effective program that is based on improving behavior is they way to go. I hope you feel empowered as a parent to make valid and reliable decisions on a treatment.

Here are two great links to help you think about some treatments out there and also links to help you with your questions on vaccinations, gluten free diets, etc

A Parent's Guide to Autism Spectrum Disorders

Suggested Links to Research Studies 

Vaccinations and Autism

Gluten and Casein Free Diets & Autism

Malaysian Parent Support Group

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