Changes in diagnostic criteria of autism

(by Laura Galanti)

There have been changes in criteria for the diagnosis of autism from the fourth edition of the diagnostic and Statistical Manual of Mental Disorders (DSM-IV) to the DSM-V. The changes from the DSM-IV to the DSM-V include the combination of the subgroups Asperger’s syndrome and not other specified (PDD-NOS) into one autism spectrum disorder category (Hoogenhout & Malcolm-Smith, 2014). The changes were made because there was not enough evidence to support the differences, which led to problems with research but the study by Hoogenhout and Malcolm-Smith (2014) supports that the DSM-5 was more successful in determining the Theory of Mind development beyond intellectual functioning.

The new criteria to diagnosis ASD states that the following four criteria must be met (Justice & Redle, 2014):

1. Symptoms of ASD must develop during childhood
2. The symptoms of ASD must affect an individual’s everyday functioning
3. The symptoms must include problems with social communication and social interaction (for example, problems with participating in and initiating conversations)
4. The symptoms must include restricted and repetitive patterns of behavior (example, fixed interests and repetitive behaviors)

References

Hoogenhout, M., Malcolm-Smith, S. (2014). Theory of mind in autism spectrum         disorder: Does DSM classification predict development? Research in Autism Spectrum Disorders, 8(6), 597-607.

Justice, L. M., & Redle, E. E. (2014). Communication sciences and disorders: a clinical   evidence-based approach (Third ed.). Upper Saddle River, NJ: Pearson Education Inc.

 

Causes of autism spectrum disorders

(by Laura Galanti)

Autism is most likely caused by the combination of genetic risk factors and the specific interaction with the environment, for example a rare mutation in a gene can contribute to autism (Autism Speaks Inc., 2010). 10-15% of cases of autism have a specific genetic cause such as Angelman’s Syndrome, Fragile X Syndrome, and Tuberous Sclerosis (Autism Speaks Inc., 2010). Exposure to certain environmental agents such as chemical or infections agents can also lead to autism (Autism Speaks Inc., 2010).

Autism is four more times likely to affect boys than girls, although girls usually have more severe symptoms (Justice & Redle, 2014, p. 211). Also genetics is a determining factor in autism, there is a higher rate in individuals who are children of family members who are also affected by the disorder (Justice & Redle, 2014, p. 212). There is no strong evidence of the link between vaccination and risk of developing autism, although some people used to believe that the MMR vaccinations may lead to autism (Justice & Redle, 2014, p. 212).

References

Autism Speaks Inc. (2010). Autism: Diagnosis, causes, and symptoms. Retrieved from http://www.autismspeaks.org/sites/default/files/100_day_kit_section_1.pdf

Justice, L. M., & Redle, E. E. (2014). Communication sciences and disorders: a clinical   evidence-based approach (Third ed.). Upper Saddle River, NJ: Pearson   Education Inc.

Common treatments for autism spectrum disorders

(by K.)

There are no medications that can cure autism or treat the symptoms, but there are medications out there that can make functioning in everyday life easier for people with autism. These medications can help manage symptoms such as, inability to focus, depression, seizures, and control energy levels. Early interventions are common in using therapy to help the child talk and socialize with others. It is also beneficial to get treatment for specific symptoms, such as speech and language delays. Speech therapy is important for improving the person’s communication skills, whether it’s verbal, by gestures, or pictures. Besides medication, Applied Behavior Analysis (ABA) has become a widely used approach in many schools and clinics. ABA encourages positive behaviors and discourages negative behaviors in order to improve multiple different skills. Relationship-Based Approach is another common way for parents and caregivers to get involved in the child with autism’s life. This approach focuses mainly in creating emotional relationships with the caregivers.

Personal experience with children with autism spectrum disorders

(by E.)

Autistic persons have communication disorders, whether that is trouble keeping a conversation, how to use words or being completely nonverbal (not use speech). Different methods can be used to help improve a child’s communication skills. One method is Verbal Behavior Therapy. What Verbal Behavior Therapy does is it motivates a child to learn language by connecting words with their purposes. The Learner is taught that words can help obtain desired objects or other results. They also learn how to use language to make requests and communicate ideas. This therapy is a great tool in order to help increase their communication skills.

Working with Autistic children I see that some struggle more with communication while others just struggle socially. Each person is different and each must be approached differently. One learner I work with we use the method of Verbal behavior therapy, teaching mands or requests as the most basic type of language. Just by using this therapy methods we have seen leaps and bounds in his vocabulary and communication. Another learner I work with is not nonverbal, but severely struggles with the social aspect of language. He only communicates when he needs something, or if we ask him a question. He also struggles with repetitive behaviors. He will say things over and over again to himself and likes to wiggle his fingers in front of his face.  Lastly a different learner I work with communicates very well but he struggles with understanding others emotions and inferencing what is going on. He also gets very frustrated when things don’t happen the way he thinks they should. This learner also obsesses over certain things like sneezing and saying “God bless you.” He will purposely sneeze so someone will say “God bless you,” and also gets very upset if no one says it. He also obsesses over the show ‘Handy Mandy.’ All these learners have different difficulties and we have to approach each situation differently. People should know the cause of autism spectrum disorders is not known and symptoms vary, though they all include social aspects, communication and repetitive behaviors. Therapies like Verbal Behavior Therapy can greatly increase language and communication skills.

Hearing Loss & Autism

(by Kathleen Schaefer)

Studies have showed a strong correlation between learning disabilities in children and hearing loss. In fact, one study showed that 44-63% of children with autism spectrum disorders in their sample also had a hearing impairment (Skott et al., 1986). Other studies show lower prevalence but still demonstrate an increased risk of conductive hearing loss in children with autism spectrum disorders (Rosenhall et al., 1999). Some also believe that the lack of proper hearing can account for attention deficit disorders that also go along with autism. It is important to seek medical attention from a throat, nose and ear specialist to get further testing if you suspect you or someone you know to have some type of hearing disorder. It will help them a lot in the long run, especially children. If hearing loss is diagnosed at a young age, the child’s quality of life will be drastically improved.

References

Rosenhall, U., Nordin, V., Sandstrom; M., Ahlsen, G., & Gillberg, C. (1999). Autism and  hearing loss. Journal of Autism & Developmental Disorders, 29(5), 349-357.

Skoff, B., Fein, D., McNally, B., Lucci, D., Humes-Barrtlo, M., and Waterhouse, L. (1986). Brainstem auditory evoked potential in autism. Psychophysiology, 23, 462.

 

Social interactions in autism

(by Jessica Scheets)

A big issue that goes along with autism spectrum disorder is the social aspect of it. Many times kids with autism have a hard time communicating with their peers and can often times experience social anxiety. Impaired social skills can emerge as early as the first year of life and can continue to affect foundational social behaviors throughout life (Ventola, 2014).

Personally, I have worked very closely with a peer who has ASD. She was on my cross-country team all 4 years of high school. Throughout my experience, I learned a lot about her disorder and also how to help her with it. I noticed that her social interactions were off, and did not have very proper communication skills. Many times she was skittish around new people and very clingy to the ones that she did know. Her vocabulary was poor, often times asking what words meant. Being around her so much was very rewarding for myself because I got to see what exactly this disorder entailed while also creating a friendship with such a special girl.

 

Reference

Ventola, P., Saulnier, C., Steinberg, E., Chawarska, K., & Klin, A. (2014). Early-Emerging Social Adaptive Skills in Toddlers with Autism Spectrum Disorders: An Item Analysis. Journal Of Autism & Developmental Disorders, 44(2), 283-293. doi:10.1007/s10803-011-1278-x

Cousin diagnosed with Asperger’s syndrome

(by Elizabeth Turner)

I have a very close personal experience with a person who has Asperger Syndrome. My cousin was diagnosed with AS when she was about 3.5 years old. She is now 18 and has been in therapy since she was diagnosed. My cousin has a fixation on horses and has been since she was a young child. Every time she sees a picture or movie that has a horse in it, she will talk about horses on and on for the next few hours. She is very knowledgeable about them, but she can’t tell when she has talked about them for too long and it is time to move on to a new topic. If she is not talking about horses though, she does not talk at all. . My cousin also does not have hardly any friends at school. My aunt, her mother, has told me that teachers have come to her and told her that she is often made fun of at school because the other girls as seeing her as being unusual and not normal. She has a hard time talking to other people and knowing when she has gone too far when she talks about something she likes. She is definitely different, but it also makes me sad that other people look at her in a way that is negative and say things about her that is hurtful. I think most people don’t know exactly why she is the way she is so they just classify her as weird or not normal. Therapists are hoping to curb her excessive interest in horses while still using it as a tool to encourage more communicative behavior. 

Signs of Asperger’s syndrome

(by Madison Goehring and M.)

Though Asperger’s Syndrome doesn’t directly affect language, it does cause communication with others to be difficult for individuals with Asperger’s. Most symptoms become noticeable when the child enters school and teachers begin to notice the interactions between with the child and their classmates.

The symptoms of Asperger Syndrome vary in each case, but common symptoms include having a difficult time relating to others, unable to understand social and emotional issues, lacking instincts to express thoughts and feelings, being unable to understand non-literal phrases, tendency to discuss self, lack of eye contact, inappropriate staring, poor perception of personal space, being distressed by loud noises, lights, strong tastes or textures, lack of coordination and motor skills, repetitive speech, advanced vocabulary on a specific topic, having few interests and/or focusing intently on few things. Cases may have multiple mixes of these symptoms.

The difference between those who have Asperger’s rather than being diagnosed with Autism is the growth in cognitive function and language development. With Autism, the individual show severe delay in both areas (Attwood, 2007). While with Asperger’s, the individual may be first diagnosed with Autism due to some delay but as the individual grows, both areas develop normal for their appropriate age (Attwood, 2007).

Most children get diagnosed around the ages 6 to 8 having a high comorbidity with other developmental disorders such as Attention Deficit Hyperactive Disorder. With this disorder, the individual with Asperger’s show high levels of stress and anxiety due to attempts of communication with others (Attwood, 2007). This constant anxiety tends to leave the individual in high state of alertness causing social exhaustion. With high anxiety and alertness, it becomes an overload on their sensory system and can lead to clinical depression or anger management. Along with this type of depression, individuals with Asperger’s tend to escape into their vivid imagination having make-believe friends who replace the loneliness caused by reality (Attwood, 2007).

References

Attwood, T. (2007). The complete guide to asperger’s syndrome. London, England. Philadelphia, Pennsylvania: Jessica Kingsley Publishers.

Lopata, C., Thomeer, M. L., Volker, M.A., & Nida, R. E. (2006). Effectiveness of a cognitive-behavioral treatment on the social behaviors of children with asperger disorder. Focus On Autism And Other Development Disabilites, 21(4), 237-244. Doi:10.1177/10883576060210040501

 

 

Resources for individuals with Asperger’s syndrome

(by M.)

–          OASIS @ MAAP: This is the Online Asperger Syndrome Information and Support center whose main goal is to “create a single resource for families, individuals, and medical professionals who deal with challenges of Asperger Syndrome.”

Website: http://www.aspergersyndrome.org/

–          Autism Speaks: This is an organization that provides individuals and their families resources to understand and work through difficult areas of Asperger’s Syndrome as well as raise awareness of Autism Spectrum Disorders and funding research to study each form of the disorder.

Website: http://www.autismspeaks.org/family-services/resource-library/asperger-syndrome

–          ASPEN: Known also as Asperger Autism Spectrum Education Network focuses on educating about the issues involved with the disorder, showing support to those who have the disorder, and increasing advocacy in accurate educational programs, medical research funding, and public awareness.

Website: http://www.autismspeaks.org/family-services/resource-library/asperger-syndrome

 

Nephew diagnosed with Asperger’s

(by Eric Hurt)

Within the last eight years Autism Spectrum Disorder has directly affected my family with the birth of my nephew Stephen. At the age of 3 ½ Stephen was exhibiting more and more unusual behavior for a child his age. Luckily my mother-in-law (his aunt) is also his pediatrician, and for a year she was almost certain that Stephen was autistic based on his social interactions, what and how he ate, his desire to maintain certain rituals, the manner in which he played with certain objects, and how he spoke in a high pitched, almost sing song manner. I can remember at least two heated arguments between Stephen’s father and his pediatrician, who is also Stephen’s father’s biological mother over the issue of his potential autism. Stephen’s parents were in a state of denial over the fact that their sons inability to carry on conversations without becoming fixated on the topic of dinosaurs, or how Stephen never responded to his name, and would only eat very specific foods that could not touch each other on the plate or he would break into hysterics was not abnormal. Eventually Stephen’s parents came to terms with the difficulties their son was having and took him to a child counselor at school, and then an SLP when he was 5 years of age.

Stephen was diagnosed with a higher functioning form of autism called Asperger’s because he has maintained his linguistic skills and cognitive development. Meaning that he comprehends what is being said and can formulate a response, and that he does not have an intellectual disability. He still becomes fixated on certain things such as dinosaurs, the PC game Civilization, and history books. When he and I go out to new places to eat that are unfamiliar to him, it requires a long explanation as to why we are going there, and what they have on the menu. Nothing can be taken for granted with an autistic child particularly when it concerns expressing emotions. My nephew had to be explained why we tell each other “I love you” and why when one family member says, “I love you.” That you are supposed to reply “I love you too.” Stephen new that he loved his family, but was baffled as to why he needed to say it because in his mind we are family, and everyone knew family members loved each other. My nephew also takes what people say literally, again I can recall an instance when I told him one holiday that if I ate another bite I would explode. Stephen replied “Uncle Eric that is impossible because your body is designed to force you to vomit once you become too full.” Astounding, insight from a 5 year old, and since he takes what you say literally, he has a difficult time with humor in joke form. Having Asperger’s Stephen still goes to a public school where he excels academically, but remains socially aloof from other students, which used to be a topic of anguish for our family, but to my nephew it gives him more time to study, or read about dinosaurs without being bothered. Like so many things in life situations are all about perspective and one day my super smart, socially awkward, little nephew will become either a paleontologist, or an architect, and all those children that pick on him today, will call him “boss” in the working adult world later.