Autism Informations: January 2006

Wednesday, January 18, 2006

HOW IS AUTISM DIAGNOSED?

Since the characteristics of the disorder vary so much, ideally a child should be evaluated by a multidisciplinary team which may include a neurologist, psychologist, developmental pediatrician, speech/language therapist, learning consultant, or another professional knowledgeable about autism. Diagnosis is difficult for a practitioner with limited training or exposure to autism. Sometimes, autism has been misdiagnosed by well-meaning professionals. Difficulties in the recognition and acknowledgment of autism often lead to a lack of services to meet the complex needs of individuals with autism.

A brief observation in a single setting cannot present a true picture of an individual's abilities and behaviors. Parental (and other caregivers') input and developmental history are very important components of making an accurate diagnosis. At first glance, some persons with autism may appear to have mental retardation, a behavior disorder, problems with hearing, or even odd and eccentric behavior. To complicate matters further, these conditions can co-occur with autism. However, it is important to distinguish autism from other conditions, since an accurate diagnosis and early identification can provide the basis for building an appropriate and effective educational and treatment program. Sometimes professionals who are not knowledgeable about the needs and opportunities for early intervention in autism do not offer an autism diagnosis even if it is appropriate. This hesitation may be due to a misguided wish to spare the family. Unfortunately, this too can lead to failure to obtain appropriate services for the child.

You may hear different terms used to describe children within this spectrum, such as autistic-like, autistic tendencies, autism spectrum, high-functioning or low-functioning autism, more-abled or less-abled; but more important than the term used to describe autism is understanding that whatever the diagnosis, children with autism can learn and function normally and show improvement with appropriate treatment and education.

Every person with autism is an individual, and like all individuals, has a unique personality and combination of characteristics. Some individuals mildly affected may exhibit only slight delays in language and greater challenges with social interactions. They may have difficulty initiating and/or maintaining a conversation. Their communication is often described as talking at others instead of to them. (For example, monologue on a favorite subject that continues despite attempts by others to interject comments).

There are no medical tests for diagnosing autism. An accurate diagnosis must be based on observation of the individual's communication, behavior, and developmental levels. Two children, both with the same diagnosis, can act completely different from one another and have varying capabilities.

However, because many of the behaviors associated with autism are shared by other disorders, various medical tests may be ordered to rule out or identify other possible causes of the symptoms being exhibited.

People with autism also process and respond to information in unique ways. In some cases, aggressive and/or self-injurious behavior may be present. Persons with autism may also exhibit some of the following traits:

Insistence on sameness; resistance to change
Difficulty in expressing needs, using gestures or pointing instead of words
Repeating words or phrases in place of normal, responsive language
Laughing (and/or crying) for no apparent reason showing distress for reasons not apparent to others
Preference to being alone; aloof manner
Tantrums
Difficulty in mixing with others
Not wanting to cuddle or be cuddled
Little or no eye contact
Unresponsive to normal teaching methods
Sustained odd play
Spinning objects
Obsessive attachment to objects
Apparent over-sensitivity or under-sensitivity to pain
No real fears of danger
Noticeable physical over-activity or extreme under-activity
Uneven gross/fine motor skills
Non responsive to verbal cues; acts as if deaf, although hearing tests in normal range.

For most of us, the integration of our senses helps us to understand what we are experiencing. For example, our sense of touch, smell and taste work together in the experience of eating a ripe peach: the feel of the peach's skin, its sweet smell, and the juices running down your face. For children with autism, sensory integration problems are common, which may throw their senses off they may be over or under active. The fuzz on the peach may actually be experienced as painful and the smell may make the child gag. Some children with autism are particularly sensitive to sound, finding even the most ordinary daily noises painful. Many professionals feel that some of the typical autism behaviors, like the ones listed above, are actually a result of sensory integration difficulties.

There are also many myths and misconceptions about autism. Contrary to popular belief, many autistic children do make eye contact; it just may be less often or different from a non-autistic child. Many children with autism can develop good functional language and others can develop some type of communication skills, such as sign language or use of pictures. Children do not "outgrow" autism but symptoms may lessen as the child develops and receives treatment.

One of the most devastating myths about autistic children is that they cannot show affection. While sensory stimulation is processed differently in some children, they can and do give affection. However, it may require patience on the parents' part to accept and give love in the child's terms.

Wednesday, January 04, 2006

LEARNING STYLES AND AUTISM

Written by Stephen M. Edelson, Ph.D.
Center for the Study of Autism, Salem, Oregon

'Learning styles' is a concept which attempts to describe the methods by which people gain information about their environment. People can learn through seeing (visually), hearing (auditorily), and/or through touching or manipulating an object (kinesthetically or 'hands-on' learning). For example, looking at a picture book or reading a textbook involves learning through vision; listening to a lecture live or on tape involves learning through hearing; and pressing buttons to determine how to operate a VCR involves learning kinesthetically.

Generally, most people learn using two to three learning styles. Interestingly, people can assess their own interests and lifestyle to determine the ways in which they obtain much of their information about their environment. In my case, when I read a book, I can easily understand the text. In contrast, it is difficult for me to listen to an audiotape recording of that book -- I just cannot follow the story line. Thus, I am a strong visual learner, and a moderate, possibly poor, auditory learner. As far as kinesthetic learning, I am very good at taking apart objects to learn how an object works, such as a vacuum cleaner or a computer.

One's learning style may affect how well a person performs in an educational setting, especially from junior high on through college. Schools usually require both auditory learning (i.e., listening to a teacher) and visual learning (i.e., reading a textbook). If one is poor at one of these two ways of learning sources, he/she will likely depend mostly on his/her strength (e.g., a visual learner may study the textbook rather than rely on the lecture content). Using this logic, if one is poor at both visual and auditory learning, he/she may have difficulty in school. Furthermore, one's learning style may be associated with one's occupation. For example, those individuals who are kinesthetic learners may tend to have occupations involving their hands, such as shelf stockers, mechanics, surgeons, or sculptors. Visual learners may tend to have occupations which involve processing visual information, such as data processors, artists, architects, or manufacturing part sorters. Moreover, auditory learners may tend to have jobs which involve processing auditory information, such as sales people, judges, musicians, 9-1-1 operators, and waiters/waitresses.

Based on my experience as well as those of my colleagues, it appears that autistic individuals are more likely to rely on only one style of learning. By observing the person, one may be able to determine his/her primary style of learning. For example, if an autistic child enjoys looking at books (e.g., picture books), watching television (with or without sound), and tends to look carefully at people and objects, then he/she may be a visual learner. If an autistic child talks excessively, enjoys people talking to him/her, and prefers listening to the radio or music, then he/she may be an auditory learner. And if an autistic child is constantly taking things apart, opening and closing drawers, and pushing buttons, this may indicate that the child is a kinesthetic or 'hands-on' learner.

Once a person's learning style is determined, then relying on this modality to teach can greatly increase the likelihood that the person will learn. If one is not sure which learning style a child has or is teaching to a group with different learning styles, then the best way to teach could be to use all three styles together. For example, when teaching the concept 'jello,' one can display a package and bowl of jello (visual); describe its features such as its color, texture, and use (auditory); and then let the person touch and taste it (kinesthetic).

One common problem evidenced by autistic children is running around the classroom and not listening to the teacher. This child may not be an auditory learner; and thus, he/she is not attending to the teacher's words. If the child is a kinesthetic learner, the teacher may choose to place his/her hands on the child's shoulders and then guide the student back to his/her chair, or go to the chair and move it towards the student. If the child learns visually, the teacher may need to show the child his/her chair or hand them a picture of the chair and gesture for the child to sit down.

Teaching to the learning style of the student may make an impact on whether or not the child can attend to and process the information which is presented. This, in turn, can affect the child's performance in school as well as his/her behavior. Therefore, it is important that educators assess for learning style as soon as an autistic child enters the school system and that they adapt their teaching styles in rapport with the strengths of the student. This will ensure that the autistic child has the greatest chance for success in school.

More …. http://www.autism.org/contents.html

God bless you!!!

Sunday, January 01, 2006

THE FACTS OF AUTISM

WHAT IS AUTISM?

Researchers in all around the world are trying to understand autism: what is it, what causes it, how to diagnose it, how to treat it. Autism is very complex. No two people with autism are exactly the same. No two people with autism respond to treatment in the same way. So research in autism is also very complex. Some people have compared solving the puzzle of autism to peeling an onion: new insights reveal themselves one layer at a time. Knowledge of autism is always changing, as research peels away more and more layers of this perplexing disease.

Autism is a complex biological disorder that generally lasts throughout a person’s life. It is called a developmental disability because it starts before age three, in the developmental period, and causes delays or problems with many different ways in which a person develops or grows.

Autism impacts the normal development of the brain in the areas of social interaction and communication skills. Children and adults with autism typically have difficulties in verbal and non-verbal communication, social interactions, and leisure or play activities. The disorder makes it hard for them to communicate with others and relate to the outside world. In some cases, aggressive and/or self-injurious behavior may be present. Persons with autism may exhibit repeated body movements (hand flapping, rocking), unusual responses to people or attachments to objects and resistance to changes in routines. Individuals may also experience sensitivities in the five senses of sight, hearing, touch, smell, and taste.

Communication, both verbal (spoken) and nonverbal (unspoken)
Social interactions with other people, both physical (such as hugging or holding) and verbal (such as having a conversation)
Routines or repetitive behaviors, like repeating words or actions over and over, obsessively following routines or schedules for their actions, or having very specific ways of arranging their belongings.

The symptoms of the disorder cut off people with autism from the world around them.Children with autism may not want their mothers to hold them. Adults with autism may not look others in the eye. Some people with autism never learn how to talk. These behaviors not only make life difficult for people who have autism, but also make life hard for their families, their health care providers, their teachers, and anyone who comes in contact with them.

Autism is a lifelong disability, meaning that if left untreated it will affect people their entire lives. Left untreated, many people with autism will not learn to talk, behave normally, or develop social skills, so that they are unable to live on their own. There is no one cure for autism, but the good news is that there are a wide variety of treatment options which work to varying degrees of success for some people, and those will be discussed below.

The uniqueness of each individual with autism makes the experience of raising a child with autism different for each family. But there are some consistent themes or issues that most families will want to be aware to be able to provide the best support to the individual and to family members.

Autism is a complex disorder that affects people differently. Because people with autism have a lot of similarities and differences, doctors now think of autism as a “spectrum” disorder; so rather than being just one condition, autism is a group of conditions with a range of similar features. Doctors use the term “autism spectrum disorder (ASD)” to describe people with mild symptoms, severe symptoms, or symptoms that fall anywhere in between.

In most cases, the symptoms of autism are measurable by certain screening tools at 18 months of age. However, parents and experts in autism treatment can usually detect symptoms before this time. In general, a formal diagnosis of autism can be made when a child is two, but is usually made when a child is between two and three, when he or she has a noticeable delay in developing language skills. Recent studies show that at least 20 percent of children with autism experienced a “regression,” as reported by their parents. This means that the children had a mostly normal development, but then had a loss of social or communication skills. To date, however, there is little information about this type of regression, such as the age it seems to start, how severe it is, and what, if anything, triggers it. Researchers are looking into a variety of possible causes for both early onset and regressive autism.

THE GENERAL TYPES OF AUTISM

We have outlined some major points that help distinguish the differences between the specific diagnoses used:

Autistic Disorder:
Impairments in social interaction, communication, and imaginative play prior to age 3 years. Stereotyped behaviors, interests and activities.

Asperger's Disorder:
Characterized by impairments in social interactions and the presence of restricted interests and activities, with no clinically significant general delay in language, and testing in the range of average to above average intelligence.

Pervasive Developmental Disorder- Not Otherwise Specified
(Commonly referred to as atypical autism) a diagnosis of PDD-NOS may be made when a child does not meet the criteria for a specific diagnosis, but there is a severe and pervasive impairment in specified behaviors.

Rett's Disorder :
A progressive disorder which, to date, has occurred only in girls. Period of normal development and then loss of previously acquired skills, loss of purposeful use of the hands replaced with repetitive hand movements beginning at the age of 1-4 years.

Childhood Disintegrative Disorder:
Characterized by normal development for at least the first 2 years, significant loss of previously acquired skills. (American Psychiatric Association 1994)

Depending on his or her specific symptoms, a person with autism can be in any one of these categories.

Autism is a spectrum disorder. In other words, the symptoms and characteristics of autism can present themselves in a wide variety of combinations, from mild to severe. Although autism is defined by a certain set of behaviors, children and adults can exhibit any combination of the behaviors in any degree of severity. Two children, both with the same diagnosis, can act very differently from one another and have varying skills.

Therefore, there is no standard "type" or "typical" person with autism. Parents may hear different terms used to describe children within this spectrum, such as: autistic-like, autistic tendencies, autism spectrum, high-functioning or low-functioning autism, more-abled or less-abled. More important to understand is, whatever the diagnosis, children can learn and function productively and show gains from appropriate education and treatment. The Autism Society of America provides information to serve the needs of all individuals within the spectrum. Diagnostic categories have changed over the years as research progresses.

What Causes Autism?

Researchers from all over the world are devoting considerable time and energy into finding the answer to this critical question. Medical researchers are exploring different explanations for the various forms of autism. Although a single specific cause of autism is not known, current research links autism to biological or neurological differences in the brain. In many families there appears to be a pattern of autism or related disabilities— which suggests there is a genetic basis to the disorder—although at this time no gene has been directly linked to autism. The genetic basis is believed by researchers to be highly complex, probably involving several genes in combination.

Several outdated theories about the cause of autism have been proven to be false. Autism is not a mental illness. Children with autism are not unruly kids who choose not to behave. Autism is not caused by bad parenting. Furthermore, no known psychological factors in the development of the child have been shown to cause autism.

Autism is not a disease that you “get,” the same way you can get the flu. Instead, scientists think autism has its beginnings before a person is even born. No one knows the exact cause or causes of autism, but scientists have some theories. Some of the researchers in are focusing their efforts on possible genetic causes of autism. These results lead researchers to believe that some people could have an error in their genes that makes them more likely to develop autism. The researchers are also looking into other factors that could be involved in autism, in addition to genetics, including neurological, infectious, metabolic, immunologic, and environmental.

Who usually gets autism?

Current figures show that autism occurs in all racial, ethnic, and social groups. These statistics also show that boys are three-to-four times more likely to be affected by autism than girls are. In addition, if a family has one child with autism, there is a 5-to-10 percent chance that the family will have another child with autism. In contrast, if a family does not have a child with autism, there is only a 0.1-to-0.2 percent chance that the family will have a child with autism.

God bless you!!!