Autism is an interesting research field because pervasive disorders are very difficult to treat. In addition, autism is extremely problematic and contains a wide range of behaviors including deficits in language, perceptual, and motor development.
Personally, I have never observed or confronted an autistic child or adult. However, I have spoken with many friends, peers, or family members that have experienced autistic people. These family members or peers have told me their various stories of frustration, discouragement, and depression with the developmental disorder. In addition, advertisements such as commercials on TV with Doug Flutie are powerful and spark interest and curiosities about autism. Because autism is tough to treat and creates many problematic behaviors, I almost feel compelled to pay special respect and attention to this disorder. After all, TV commercials are overly expensive, hard to make, time consuming, and typically are only made by either big corporations or important foundations. These types of people have spent a lot of time and energy into making people aware of autism. As a result, finding ways to treat and better understand autism is costly and time consuming. This proves that autism is an important area to be emphasized and studied.
Autism is a pervasive developmental disorder, a group of disabling conditions that are among the most difficult to treat. In addition, autism is one of the most frequent and most puzzling and disabling of the pervasive developmental disorders.
Although the views on autism have varied in the past, there is general information that we know about the disorder. Information on autism can be identified, described, and better recognized through the DSM-IV description and criteria of autism, the history of autism, and through current trends in the diagnosis and treatment of autism.
The Diagnostic and Statistical Manual of Mental Disorders (DSM- IV) describes autism through diagnostic features:
The essential features of Autistic Disorder are the presence of markedly abnormal or impaired development in social interaction and communication and a markedly restricted repertoire of activity and interests. Manifestations of the disorder vary greatly depending on the development level and chronological age of the individual. Autistic Disorder is sometimes referred to as early infantile autism, childhood autism, or KannerвЂ™s autism. (American Psychiatric Association, 1994, 66)
The impairment in social interaction is gross and sustained. In addition, there may be вЂњmarked impairment in the use of multiple nonverbal behaviors (e.g., eye-to-eye gaze, facial expression, body postures, and gestures) to regulate social interaction and communicationвЂќ (American Psychiatric Association, 1994, 66). Also, there may be вЂњfailure to develop peer relationships appropriate to developmental level that may take different forms at different ages. For example, younger individuals could have little or no interest in friendship but lack understanding of the conventions of social interactionвЂќ (American Psychiatric Association, 66). Furthermore, there may be a вЂњlack of spontaneous seeking to share enjoyment, interests, or achievements with other peopleвЂќ (American Psychiatric Association, 66). An example of this would be not showing or pointing out things that they find interesting or exciting.
The impairment in communication is described and marked by sustained affects in both verbal and nonverbal skills (American Psychiatric Association, 1994, 66). For example, there may be a вЂњdelay in, or lack of, the development of spoken languageвЂќ (American Psychiatric Association, 1994, 66). Also, when the individual does speak, there may be вЂњmarked impairment in the ability to initiate or sustain a conversation with others, or a repetitive use of language or idiosyncratic languageвЂќ (American Psychiatric Association, 66). Often, when speech develops the pitch, intonation, rate, rhythm, or stress may be abnormal. An example of this would be if the speech is monotonous and contains a question-like rise in pitch at the end of each sentence. Repetition is also fairly prevalent when describing Autistic Disorder. The autistic child may repeat certain jingles or commercials from on television that he/she likes or finds interest in (American Psychiatric Association, 66).
Individuals with Autistic Disorder also tend to have вЂњrestricted, repetitive, and stereotyped patterns of behavior, interests, and activitiesвЂќ (American Psychiatric Association, 1994, 67). In addition, there may be an encompassing вЂњpreoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focusвЂќ (American Psychiatric Association, 67). Individuals with autistic disorder display a range of interests and are typically preoccupied with one narrow interest . In addition, they may insist on sameness and show resistance to or distress over trivial changes . Other abnormalities may include strange postures (walking on tiptoe, odd hand movements and abnormal body postures) (American Psychiatric Association, 67).
The Diagnostic and Statistical Manual of Mental Disorders criteria for 299.00 Autistic Disorder is as follows:
(I) A total of six (or more) items from (A), (B), and (C), with at least two from (A), and one each from (B) and (C)
(A) qualitative impairment in social interaction, as manifested by at least two of the following:
1. marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, 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 to other people)
4. lack of social or emotional reciprocity ( note: in the description, it gives the following as examples: not actively participating in simple social play or games, preferring solitary activities, or involving others in activities only as tools or “mechanical” aids )
(B) 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
(C) restricted repetitive and stereotyped patterns of behavior, interests and activities, as manifested by at least two 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
(II) Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years:
(A) social interaction
(B) language as used in social communication
(C) symbolic or imaginative play
(III) The disturbance is not better accounted for by Rett’s Disorder or Childhood Disintegrative Disorder
Other typical characteristics of autism are вЂњaffect isolation, unrelated ness to others, twiddling behavior, inconsistent developmental continuity, self-destructive behavior, temper tantrums-anxiety, apparent confusion, and orderlinessвЂќ (Webster, Konstantareas, Oxman &, Mack, 1980, 6-8). All of which are described in similar terms through the DSM-IV.
Historically, researchers and professionals overtime have changed their viewpoints and understandings of autism. As a result, the definitions, characteristics, and approaches to the treatment of autism have all been reviewed (Olley, 1992, 3). вЂњToday, the term autism is usually associated with the syndrome described by Kanner, but its use began much earlier in psychiatry. Bleur (1911/1950) used the term to describe a withdrawal into fantasy in schizophreniaвЂќ (Olley, 3). However, KannerвЂ™s (1943) use of the word autism reflected his emphasis on the social deficits of the disorder, but were still confused with a syndrome of schizophrenia by some(Olley, 3). Although the term autism was introduced in this century, it has been present for many generations. There are reports documented long before Kanner and Bleur that show the observation and study of the origin of children with very deviant social and language development. Early on, characteristics, such as avoiding the gaze of others and showing no recognition of parentвЂ™s absence were observed in autism (Olley, 3). Later on, researchers and observers began to label this deficit as withdrawal. For his time, Kanner was accurate with many of his observations on the symptoms of autism. Unlike Bleur, Schizophrenia is differentiated from autism in KannerвЂ™s studies. Kanner described autism as being вЂњвЂfrom the start anxiously and tensely impervious to peopleвЂ™вЂќ (Olley, 4). In addition, Kanner saw people with autism living in a world, which they have been вЂњtotal strangers from the beginning. вЂ¦[and] also pointed out the isolated play, unusual language traits, insistence on ritual behavior, and resistance to change. вЂќ (Olley, 4).
Historically, Kanner was wrong about some of the aspects of autism, but was overall quite accurate. Early optimism of children with autism вЂњconcluded that the children had вЂintelligent physiognomiesвЂ™ and that their faces showed вЂserious-mindednessвЂ™вЂќ (Olley, 1992, 4). This is where the myth of the autistic child as a вЂњlatent geniusвЂќ has endured and caused great distress for family members and teachers (Olley, 4). During this time, some people believed that autistic children were prodigies who could not associate with the more common world. However, more recent research has consistently found about 80% of people with autism to function in the mentally retarded range of intellectual development and the other 20% show social language, and other learning problems that seriously impair their adaptive behavior (Olley, 4). Consequently, the optimistic suggestion that autistic children are geniuses is unfounded and baseless through research.