Autism is a brain development disorder that is characterized by impaired social interaction and communication, and restricted and repetitive behavior, all starting before a child is three years old. This set of signs distinguishes autism from milder autism spectrum disorders (ASD) such as pervasive developmental disorder not otherwise specified (PDD-NOS).
Autism falls under the category of Pervasive Developmental Disorders, which includes disorders like Rett Syndrome and Childhood Disintegrative Disorder, and then autism is then divided up in many different subtypes including Asperger's Syndrome.
A blurred shot of a child playing the piano - Photo Credit: Clark Young on Unsplash
For reasons as yet unidentified, autism has become an epidemic in America over the last couple of decades. While considerable controversy surrounds the issue of why this condition is escalating so rapidly, the number of children diagnosed with autism has risen from one in 2,000 to one in 59 today. Other proposed causes, such as childhood vaccines, are controversial, and the vaccine hypotheses lack any convincing scientific evidence.
Autism and ADHD could present with each other or with a variety of other conditions - but they do not "typically" present together.
Some autism symptoms could appear like inattention. You should not easily confuse someone with ADHD with someone with autism as their functioning and behavior are different.
Autistic individuals display many forms of repetitive or restricted behavior, which the Repetitive Behavior Scale-Revised (RBS-R) categorizes as follows:
- Stereotypy is apparently purposeless movement, such as hand flapping, making sounds, head rolling, or body rocking.
- Compulsive behavior is intended and appears to follow rules, such as arranging objects in a certain way.
- Sameness is resistance to change; for example, insisting that the furniture not be moved or refusing to be interrupted.
- Ritualistic behavior involves the performance of daily activities the same way each time, such as an unvarying menu or dressing ritual. This is closely associated with sameness and an independent validation has suggested combining the two factors.
- Restricted behavior is limited in focus, interest, or activity, such as preoccupation with a single television program or toy.
- Self-injury includes movements that injure or can injure the person, such as biting oneself. A 2007 study reported that self-injury at some point affected about 30% of children with ASD.
No single repetitive behavior seems to be specific to autism, but only autism appears to have an elevated pattern of occurrence and severity of these behaviors. Early behavioral or cognitive intervention can help children gain self-care, social, and communication skills. There is no currently no known cure for autism.
Children and Adults with ASD May:
- Avoid eye contact and want to be alone
- Repeat actions over and over again
- Have trouble adapting when a routine changes
- Not look at objects when another person points at them
- Not play "pretend" games (for example, not pretend to feed a doll)
- Have trouble expressing their needs using typical words or motions
- Prefer not to be held or cuddled, or might cuddle only when they want to
- Have unusual reactions to the way things smell, taste, look, feel, or sound
- Lose skills they once had (for example, stop saying words they were using)
- Have trouble relating to others or not have an interest in other people at all
- Appear to be unaware when people talk to them, but respond to other sounds
- Be very interested in people, but not know how to talk, play, or relate to them
- Not point at objects to show interest (for example, not point at an airplane flying over)
- Have trouble understanding other people's feelings or talking about their own feelings
- Repeat or echo words or phrases said to them, or repeat words or phrases in place of normal language
The number of people diagnosed has been increasing dramatically since the 1980s, partly due to changes in diagnostic practice and government-subsidized financial incentives for named diagnoses; the question of whether actual rates have increased is unresolved.
- The rate of autism among adults aged 18 years and over in the United Kingdom is 1.1%.
- 2018 figures now place autism rates as 1 in 59 in the U.S.
- Boys are at higher risk for ASD than girls. The sex ratio averages 4.3:1 and is greatly modified by cognitive impairment: it may be close to 2:1 with intellectual disability and more than 5.5:1 without.