AND AUTISM SPECTRUM DISORDER (ASD)
Glen Dunlap and Mary-Kay Bunton-Pierce
is a developmental disability that affects a person's ability to
communicate, understand language, play, and interact with others.
Autism is a behavioral syndrome, which means that its definition
is based on patterns of behaviors that a person exhibits. Autism
is not an illness or a disease. It is not contagious and, as far
as we know, it is not acquired through contact with the environment.
Autism is a neurological disability that is presumed to be present
from birth and is always apparent before the age of three. Although
autism affects the functioning of the brain, the specific cause
of autism is unknown. In fact, it is widely assumed that there are
most likely multiple causes, each of which may be manifested in
different forms, or subtypes, of autism. Future research will help
us understand the etiologies of autism.
Spectrum Disorder (ASD) is an increasingly popular term that refers
to a broad definition of autism including the classical form of
the disorder as well as closely related disabilities that share
many of the core characteristics. ASD includes the following diagnoses
and classifications: (1) Pervasive Developmental DisorderóNot Otherwise
Specified (PDD-NOS), which refers to a collection of features that
resemble autism but may not be as severe or extensive; (2) Rett's
syndrome, which affects girls and is a genetic disorder with hard
neurological signs, including seizures, that become more apparent
with age; (3) Asperger syndrome, which refers to individuals with
autistic characteristics but relatively intact language abilities,
and; (4) Childhood Disintegrative Disorder, which refers to children
whose development appears normal for the first few years, but then
regresses with the loss of speech and other skills until the characteristics
of autism are conspicuous. Although the classical form of autism
can be readily distinguished from other forms of ASD, the terms
autism and ASD are often used interchangeably.
with autism and ASD vary widely in ability and personality. Individuals
can exhibit severe mental retardation or be extremely gifted in
their intellectual and academic accomplishments. While many individuals
prefer isolation and tend to withdraw from social contact, others
show high levels of affection and enjoyment in social situations.
Some people with autism appear lethargic and slow to respond, but
others are very active and seem to interact constantly with preferred
aspects of their environment.
with autism are characterized primarily by develop- mental difficulties
in verbal and nonverbal communication, social relatedness, and leisure
and play activities. All individuals with autism experience substantial
problems with social interactions. In addition, people with autism
often exhibit unusual, repetitive, and perseverative movements (including
stereotyped and self-stimulatory behaviors), resistance to changes
in routines and in other features of their environments, apparent
oversensitivity or undersensitivity to specific kinds of stimulation,
and extreme tantrums, aggression or other forms of acting out behavior.
It is also observed that individuals with autism have uneven patterns
of skill development. Some people display superior abilities in
particular areas (such as music, mechanics, and arithmetic calculations),
while other areas show significant delay.
principal source for diagnosing autism is the Diagnostic and Statistical
Manual of the American Psychiatric Association, Fourth Edition (DSM-IV,1994).
Although children affected by autism are being identified at earlier
ages than was the case previously, the diagnosis usually does not
occur until sometime between two and three years of age. Diagnosticians
are often reluctant to issue a formal diagnosis before the age at
which complex language is expected to emerge. However, early intervention
services can still be provided on the basis of developmental delay,
even without a formal diagnosis of autism.
diagnosis of autism is often provided by developmental pediatricians,
psychologists, child psychiatrists, or neurologists. At the time
of (or prior to) diagnosis, a comprehensive evaluation is typically
arranged. Such an evaluation usually includes a neurological examination,
tests for biochemical abnormalities, and other assessments designed
to rule out physical and diagnostic conditions. A battery of developmental
and educational evaluations is also conducted to help develop an
appropriate early intervention plan. Family involvement is integral
to this entire process.
1997, the Centers for Disease Control and Prevention (1999) estimated
that a broad definition of autism may be present in as many as one
person out of every 500. This estimate suggests that there are roughly
500,000 people in the United States who could be described as having
autism or autism spectrum disorder.
is well established that autism occurs in four times as many boys
as girls (NICHCY, 1999) and that there are no known racial, social,
economic, or cultural distinctions. Although it is possible that
there are some genetic linkages with some forms of autism, there
are no associations with particular familial or cultural histories
or practices. Earlier theories that implicated parents' behavior
in the occurrence of autism have been thoroughly discredited.
have been occasional speculations about clusters of autism in some
areas of the country, and it has been suggested that such clusters
may be associated with environmental contaminants or regional medical
practices. To date, however, there have been no clear data that
support these speculations.
to Intervention and Educational Support
autism was first identified as a syndrome more than 50 years ago,
a variety of intervention strategies have been suggested. These
interventions and treatments have risen from a range of theoretical
positions, but most have not proven to be effective with large numbers
of children. This pattern continues today, with a large number of
diverse treatment approaches being touted as uniquely effective
in resolving patterns of autistic behavior. For the most part, such
claims have not been substantiated in controlled research. The message
for families, teachers, and other consumers is to be cautious when
considering new, grandiose testimonials, and to be very thoughtful
and selective when constructing plans for intervention and support.
though autism has attracted an array of spurious treatments, a good
deal of real progress has occurred, and some very credible approaches
have been demonstrated repeatedly to be effective in improving the
behaviors and adaptability of people with autism. Interventions
that are derived from an educational and behavioral orientation
have been shown to help children and adults affected by autism,
primarily by teaching new skills that enable the person to function
more successfully in the daily world of home, school, work, and
community interactions. Years of research and experience have produced
some relevant guidelines for providing instruction and intervention
for individuals with autism. For example, it is important that interventions
be developed on an individualized basis. The label of autism by
itself is not prescriptive. It does not indicate what intervention
should be provided or how intervention should be provided.
a set of general rules, it is widely agreed that people with autism
respond better in a context where there is structure and clear guidelines
regarding expectations for appropriate and inappropriate behavior.
It is also recommended that the environ- ment include systems or
materials, such as written or picture schedules, that can help the
person to comprehend and predict the flow and sequence of activities.
The focus of intervention and instructional efforts should be to
develop functional skills that will be of immediate and ongoing
value in the context of daily living. This typically includes strategies
for enhancing a person's ability to communicate, to understand language,
and to get along socially in complex home, school, work, and community
important guideline for intervention pertains to family involvement.
To the greatest extent possible, family members should be encouraged
to participate in all aspects of assessment, curriculum planning,
instruction, and monitoring. Parents and other family members very
often have the most useful information about an individual's history
and learning characteristics, so effective intervention and instruction
should take advantage of this vital resource. Furthermore, because
families are so essential in the lives of people with autism, family
support that helps strengthen the family system is regarded as a
vital element in providing effective intervention for people with
Psychiatric Association. (1994).(4th ed.). Diagnostic and statistical
manual of mental disorders. Washington, DC: Author.
for Disease Control. (1999).
Autism among children.
Fact sheet available online.
Information Center for Children and Youth with Disabilities.(1999).
Autism and pervasive developmental disorder. (Fact Sheet Number
1). Available from NICHCY, PO Box 1492, Washington, DC 20013.
Sheet available on line.
and Resources on Autism,
ERIC Minibibliography No. E13.
of Autism and Developmental Disorders
Plenum Publishing Corp.
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of Positive Behavior Interventions
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